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Gavrilović M, Popović DB. A principal component analysis (PCA) based assessment of the gait performance. BIOMED ENG-BIOMED TE 2021; 66:449-457. [PMID: 34243223 DOI: 10.1515/bmt-2020-0307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 06/23/2021] [Indexed: 11/15/2022]
Abstract
The gait assessment is instrumental for evaluating the efficiency of rehabilitation of persons with a motor impairment of the lower extremities. The protocol for quantifying the gait performance needs to be simple and easy to implement; therefore, a wearable system and user-friendly computer program are preferable. We used the Gait Master (instrumented insoles) with the industrial quality ground reaction forces (GRF) sensors and 6D inertial measurement units (IMU). WiFi transmitted 10 signals from the GRF sensors and 12 signals from the accelerometers and gyroscopes to the host computer. The clinician was following in real-time the acquired data to be assured that the WiFi operated correctly. We developed a method that uses principal component analysis (PCA) to provide a clinician with easy to interpret cyclograms showing the difference between the recorded and healthy-like gait performance. The cyclograms formed by the first two principal components in the PCA space show the step-to-step reproducibility. We suggest that a cyclogram and its orientation to the coordinate system PC1 vs. PC2 allow a simple assessment of the gait. We show results for six healthy persons and five patients with hemiplegia.
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Affiliation(s)
- Marija Gavrilović
- Faculty of Electrical Engineering, University of Belgrade, Bulevar Kralja Aleksandra 73, 11000 Belgrade, Serbia
| | - Dejan B Popović
- Serbian Academy of Sciences and Arts (SASA), Belgrade, Serbia.,Aalborg University, Aalborg, Denmark
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2
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Wavelet coherence analysis of muscle coupling during reaching movement in stroke. Comput Biol Med 2021; 131:104263. [PMID: 33636422 DOI: 10.1016/j.compbiomed.2021.104263] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/06/2021] [Accepted: 02/06/2021] [Indexed: 11/22/2022]
Abstract
Agonist-antagonist coordination is essential to ensure the accuracy and stability of voluntary movement, which can be presented by time-varying coupling between agonist-antagonist electromyographic (EMG) signals. To discover the stroke-induced neurological change in paretic muscles, the wavelet coherence is firstly compared with coherence by simulated data and is utilized to represent the time-varying coupling of experimental data during elbow-tracking tasks. The simulation in this study demonstrates that the wavelet coherence is superior to coherence in the detection of short-time coupling between simulated signals. In addition, the experiment in this study is designed to explore the coupling between agonist-antagonist activations during the dynamic process. In the experiment, 10 post-stroke patients and 10 age-matched adults serving as controls were recruited and asked to perform elbow sinusoidal trajectory tracking tasks. Both the elbow angle and EMG signals of biceps and triceps were recorded simultaneously. Experimental results showed that wavelet coherence could represent the time-varying coupling between two EMG signals in the time-frequency domain, and its dynamic character was appropriate in the dynamic process to discover the functional coupling. According to the time and frequency analysis, the lower functional coupling in the post-stroke group and the obvious wavelet coherence difference between the two groups in the lower frequency range suggested a possible hypothesis mechanism that the weakening of coupling between agonist-antagonist muscles in the affected sides might in fact be stroke-induced damage in the direct corticospinal pathways.
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Liu G, Chia CH, Cao Y, Tang XW, Tian S, Shen XY, Chen Y, Lu RR, Wu JF, Wu Y. Differential Changed Excitability of Spinal Motor Neurons Innervating Tibialis Anterior and Peroneus Muscles Cause Foot Inversion After Stroke. Front Neurol 2020; 11:544912. [PMID: 33329299 PMCID: PMC7732441 DOI: 10.3389/fneur.2020.544912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 10/30/2020] [Indexed: 11/29/2022] Open
Abstract
Objective: To study differential post-stroke changes of excitability of spinal motor neurons innervating a group of antagonist muscles of ankle and their effects on foot inversion. Methods: F waves in tibialis anterior (TA) and peroneus muscles (PN) were recorded. The condition of spasticity and foot inversion in stroke patients were also evaluated. The differences of F wave parameters between patients and healthy controls (HC), as well as TA and PN, were investigated. Results: There were natural differences in the persistence of the F waves (Fp) and F/M amplitude ratio (F/M) between TA and PN in HC. Stroke patients showed significantly higher F/M in TA and PN, while there was no difference in Fp comparing to HC. The natural differences in F wave parameters between TA and PN were differentially retained after stroke. The natural difference of the two muscles in Fp remained unchanged and the F/M difference disappeared in those without spasticity or foot inversion, while the Fp difference disappeared and the F/M difference remained in those with spasticity or foot inversion. Conclusion: Based on the natural difference of the number and size of spinal motor neurons innervating TA and PN, their excitability may change differently according to the severity of the stroke, which may be the reason of foot inversion.
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Cheng X, Zhu M, Liu Q, Feng Z, Meng Y. <p>Effectiveness of Metoprolol in Improving Cardiac and Motor Functions in Patients with Chronic Heart Failure: A Prospective Study</p>. Drug Des Devel Ther 2020; 14:3485-3494. [PMID: 32921985 PMCID: PMC7457782 DOI: 10.2147/dddt.s263026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/06/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- XiaoLiang Cheng
- Department of Endocrinology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Min Zhu
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Qing Liu
- School of Public Health, Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Zhenxia Feng
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Yong Meng
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People’s Republic of China
- Correspondence: Yong Meng Email
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Shu Q, Wu L, Zhang R, Zhang Q, Huang J, Meng Y. Age-dependent changes in cardiac performance, motor function, QoL, and mental status in metoprolol-treated chronic heart failure patients. Sci Rep 2019; 9:453. [PMID: 30679746 PMCID: PMC6345765 DOI: 10.1038/s41598-018-37520-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/06/2018] [Indexed: 01/11/2023] Open
Abstract
No previous study reports the effect of age on cardiac performance, motor function and quality of life (QoL) in Chinese chronic heart failure (CHF) patients. This single-center, prospective study enrolled CHF patients with resting heart rate (RHR) > 80 bpm, who were treated with metoprolol and were followed up at 1, 3, 6, and 12 months. Changes in cardiac, motor, and QoL parameters between patients aged ≥60 years and those aged <60 years were compared at all time points. P < 0.05 was considered significant. A total of 154 patients were enrolled (median age: 66.39 years; 116 aged ≥60 years, 38 aged <60 years; 95% New York Heart Association class III-IV). RHR decreased significantly in both patient groups (P < 0.0001 for both groups). Patients aged ≥60 years had a significant improvement in both ejection fraction (EF) at 6 and 12 months and in cardiac index (CI) at 3, 6, and 12 months. However, no major difference was observed in motor function in both groups. Significantly higher SF-8 scores showed greater improvement in QoL in the <60 age group at 12 months (P = 0.0008). Metoprolol demonstrated improvement in cardiac performance, motor function, QoL, and anxiety with increase in depression and burnout in both genders; however, the findings were independent of age.
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Affiliation(s)
- Qiuhong Shu
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Liyong Wu
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Ran Zhang
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Qian Zhang
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Jingjing Huang
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Yong Meng
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China.
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Perez-Cruzado D, Gonzalez-Sanchez M, Cuesta-Vargas AI. Differences in Kinematic Variables in Single-Leg Stance between Patients with Stroke and Healthy Elderly People Measured with Inertial Sensors: A Cross-Sectional Study. J Stroke Cerebrovasc Dis 2018; 27:229-239. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.08.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/16/2017] [Indexed: 11/25/2022] Open
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Tamburella F, Moreno JC, Iosa M, Pisotta I, Cincotti F, Mattia D, Pons JL, Molinari M. Boosting the traditional physiotherapist approach for stroke spasticity using a sensorized ankle foot orthosis: a pilot study. Top Stroke Rehabil 2017; 24:447-456. [PMID: 28460597 DOI: 10.1080/10749357.2017.1318340] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Spasticity is a motor disorder that is commonly treated manually by a physical therapist (PhT) stretching the muscles. Recent data on learning have demonstrated the importance of human-to-human interaction in improving rehabilitation: cooperative motor behavior engages specific areas of the motor system compared with execution of a task alone. OBJECTIVES We hypothesize that PhT-guided therapy that involves active collaboration with the patient (Pt) through shared biomechanical visual biofeedback (vBFB) positively impacts learning and performance by the Pt during ankle spasticity treatment. A sensorized ankle foot orthosis (AFO) was developed to provide online quantitative data of joint range of motion (ROM), angular velocity, and electromyographic activity to the PhT and Pt during the treatment of ankle spasticity. METHODS Randomized controlled clinical trial. Ten subacute stroke inpatients, randomized into experimental (EXP) and control (CTRL) groups, underwent six weeks of daily treatment. The EXP group was treated with an active AFO, and the CTRL group was given an inactive AFO. Spasticity, ankle ROM, ankle active and passive joint speed, and coactivation index (CI) were assessed at enrollment and after 15-30 sessions. RESULTS Spasticity and CI (p < 0.005) decreased significantly after training only in the EXP group, in association with a significant rise in active joint speed and active ROM (p < 0.05). Improvements in spasticity (p < 0.05), active joint speed (p < 0.001), and CI (p < 0.001) after treatment differed between the EXP and CTRL groups. CONCLUSIONS PhT-Pt sharing of exercise information, provided by joint sensorization and vBFB, improved the efficacy of the conventional approach for treating ankle spasticity in subacute stroke Pts.
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Affiliation(s)
- Federica Tamburella
- a SPInal REhabilitation Lab and Laboratory (SPIRE Lab.), Neurorehabilitation1 - Spinal Center , IRCCS S. Lucia Foundation , Rome , Italy.,b Laboratory of Robotics Applied to Neurological Rehabilitation, (NeuroRobot Lab.), Neurorehabilitation1 - Spinal Center , IRCCS S. Lucia Foundation , Rome , Italy
| | - Juan C Moreno
- c Spanish National Research Council, Cajal Institute, Neural Rehabilitation Group , Madrid , Spain
| | - Marco Iosa
- d Clinical Laboratory of Experimental Neurorehabilitation , IRCCS S. Lucia Foundation , Rome , Italy
| | - Iolanda Pisotta
- b Laboratory of Robotics Applied to Neurological Rehabilitation, (NeuroRobot Lab.), Neurorehabilitation1 - Spinal Center , IRCCS S. Lucia Foundation , Rome , Italy
| | - Febo Cincotti
- e Department of Computer, Control and Management Engineering , Sapienza University of Rome , Rome , Italy.,f Neuroelectrical Imaging and BCI Lab , IRCCS S. Lucia Foundation , Rome , Italy
| | - Donatella Mattia
- f Neuroelectrical Imaging and BCI Lab , IRCCS S. Lucia Foundation , Rome , Italy
| | - José L Pons
- c Spanish National Research Council, Cajal Institute, Neural Rehabilitation Group , Madrid , Spain
| | - Marco Molinari
- b Laboratory of Robotics Applied to Neurological Rehabilitation, (NeuroRobot Lab.), Neurorehabilitation1 - Spinal Center , IRCCS S. Lucia Foundation , Rome , Italy
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de Almeida Oliveira R, Cintia dos Santos Vieira P, Fernanda Rodrigues Martinho Fernand L, Jorge Patrizzi L, Ferreira de Oliveira S, Aparecida Pascucci Sande de Souza L. Mental Practice and Mirror Therapy Associated with Conventional Physical Therapy Training on the Hemiparetic Upper Limb in Poststroke Rehabilitation: A Preliminary Study. Top Stroke Rehabil 2015; 21:484-94. [DOI: 10.1310/tsr2106-484] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Barbosa D, Santos CP, Martins M. The application of cycling and cycling combined with feedback in the rehabilitation of stroke patients: a review. J Stroke Cerebrovasc Dis 2014; 24:253-73. [PMID: 25444025 DOI: 10.1016/j.jstrokecerebrovasdis.2014.09.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 08/29/2014] [Accepted: 09/06/2014] [Indexed: 01/27/2023] Open
Abstract
Stroke is a leading cause of long-term disabilities, such as hemiparesis, inability to walk without assistance, and dependence of others in the activities of daily living. Motor function rehabilitation after stroke demands for methods oriented to the recovery of the walking capacity. Because of the similarities with walking, cycling leg exercise may present a solution to this problem. The aim of this article is to review the state of the art applications of cycling leg exercise as a (1) motor function rehabilitation method and an (2) aerobic training method for stroke patients as well as the commonly used (3) assessment tools. The cycling characteristics and applications, the applied test protocols as well as the tools used to assess the state and the recovery of patients and types of cycling devices are presented. In addition, the potential benefits of the use of other therapies, like feedback, together with cycling are explored. The application of cycling leg exercise alone and combined with feedback in stroke rehabilitation approaches has shown promising results. Positive effects on motor abilities were found in subacute and chronic patients. However, larger and normalized studies and assessments are needed because there is a high heterogeneity in the patients' characteristics, protocols and metrics. This wil allow the comparison between different studies related with cycling.
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Affiliation(s)
- David Barbosa
- Department of Industrial Electronics, University of Minho, Azurém, Guimarães, Portugal
| | - Cristina P Santos
- Department of Industrial Electronics, University of Minho, Azurém, Guimarães, Portugal.
| | - Maria Martins
- Department of Industrial Electronics, University of Minho, Azurém, Guimarães, Portugal
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Characterization of Stroke- and Aging-Related Changes in the Complexity of EMG Signals During Tracking Tasks. Ann Biomed Eng 2014; 43:990-1002. [DOI: 10.1007/s10439-014-1150-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 10/04/2014] [Indexed: 10/24/2022]
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Ao D, Sun R, Song R. Comparison of complexity of EMG signals between a normal subject and a patient after stroke--a case study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2013:4965-8. [PMID: 24110849 DOI: 10.1109/embc.2013.6610662] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
An innovative method to quantitatively assess the motor function of upper extremities for post-stroke patients is proposed. A post-stroke patient and a normal subject were recruited to conduct a special performance of voluntary elbow flexion and extension by following a sinusoidal trajectory from 30° to 90° at 6 different peak angular velocities in a horizontal plane. During the test, the elbow angle and subject's electromyographic (EMG) signal (biceps brachii and triceps brachii) were recorded simultaneously. Fuzzy approximate entropy (fApEn) was applied to analyze the EMG signals. The results showed observable differences in fApEn when the control and the patient (unaffected and affected arms) were compared, and an uptrend of fApEn was detected with the increase in the tracking velocities in both the normal individual and patient (unaffected and affected arm). The fApEn values, which are a measure of complexity of EMG, could be used for the quantitative evaluation of the deficiencies of motor control induced by stroke.
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Lin SI, Lo CC, Lin PY, Chen JJJ. Biomechanical assessments of the effect of visual feedback on cycling for patients with stroke. J Electromyogr Kinesiol 2012; 22:582-8. [PMID: 22538084 DOI: 10.1016/j.jelekin.2012.03.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Revised: 03/13/2012] [Accepted: 03/24/2012] [Indexed: 11/16/2022] Open
Abstract
Stroke patients exhibit abnormal pattern in leg cycling exercise. The aim of this study was to investigate the effects of visual feedback on the control of cycling motion in stroke patients from kinesiological, kinematic and kinetic aspects. The cycling performance derived from cycling electromyography (EMG), cycling cadence, and torque of forty stroke subjects was evaluated under conditions with and without visual feedback of cycling cadence. Kinesiological indices, shape symmetry index (SSI) and area symmetry index (ASI) were extracted from EMG linear envelopes to evaluate the symmetry of muscle firing patterns during cycling. Roughness index (RI) was calculated from cycling cadence to represent cycling smoothness from kinematic aspects. Averaged cycling power (Pav), the product of cadence and torque, was used to represent force output. The rectus femoris EMG showed significantly greater ASI with visual feedback, however, the difference in SSI between the two conditions was not significant. For the biceps femoris, there was a significant decrease in SSI with visual feedback, while the ASI was not affected significantly by the task conditions. The cycling smoothness was better and the average power generated was larger when visual feedback was provided. This study found that the addition of visual feedback improved both neuromuscular control and overall performance. Such improvement is likely to be the result of better control of the rectus femoris muscle activation and coordination of both legs.
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Affiliation(s)
- Sang-I Lin
- Department of Physical Therapy, National Cheng Kung University, No. 1 Ta-Hsueh Road, Tainan, Taiwan
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