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Lin HP, Xu Y, Zhang X, Woolley D, Zhao L, Liang W, Huang M, Cheng HJ, Zhang L, Wenderoth N. A usability study on mobile EMG-guided wrist extension training in subacute stroke patients-MyoGuide. J Neuroeng Rehabil 2024; 21:39. [PMID: 38515192 PMCID: PMC10956308 DOI: 10.1186/s12984-024-01334-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/07/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Effective stroke rehabilitation requires high-dose, repetitive-task training, especially during the early recovery phase. However, the usability of upper-limb rehabilitation technology in acute and subacute stroke survivors remains relatively unexplored. In this study, we introduce subacute stroke survivors to MyoGuide, a mobile training platform that employs surface electromyography (sEMG)-guided neurofeedback training that specifically targets wrist extension. Notably, the study emphasizes evaluating the platform's usability within clinical contexts. METHODS Seven subacute post-stroke patients (1 female, mean age 53.7 years, mean time post-stroke 58.9 days, mean duration per training session 48.9 min) and three therapists (one for eligibility screening, two for conducting training) participated in the study. Participants underwent ten days of supervised one-on-one wrist extension training with MyoGuide, which encompassed calibration, stability assessment, and dynamic tasks. All training records including the Level of Difficulty (LoD) and Stability Assessment Scores were recorded within the application. Usability was assessed through the System Usability Scale (SUS) and participants' willingness to continue home-based training was gauged through a self-developed survey post-training. Therapists also documented the daily performance of participants and the extent of support required. RESULTS The usability analysis yielded positive results, with a median SUS score of 82.5. Compared to the first session, participants significantly improved their performance at the final session as indicated by both the Stability Assessment Scores (p = 0.010, mean = 229.43, CI = [25.74-433.11]) and the LoD (p < 0.001; mean: 45.43, CI: [25.56-65.29]). The rate of progression differed based on the initial impairment levels of the patient. After training, participants expressed a keen interest in continuing home-based training. However, they also acknowledged challenges related to independently using the Myo armband and software. CONCLUSIONS This study introduces the MyoGuide training platform and demonstrates its usability in a clinical setting for stroke rehabilitation, with the assistance of a therapist. The findings support the potential of MyoGuide for wrist extension training in patients across a wide range of impairment levels. However, certain usability challenges, such as donning/doffing the armband and navigating the application, need to be addressed to enable independent MyoGuide training requiring only minimal supervision by a therapist.
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Affiliation(s)
- Hao-Ping Lin
- Singapore-ETH Centre, Future Health Technologies Programme, CREATE campus, 1 Create Way, CREATE Tower, #06-01, Singapore, 138602, Singapore
| | - Yang Xu
- Department of Rehabilitation, Shengjing Hospital of China Medical University, 16 Puhe Road, Shenyang, Liaoning, 110134, China
| | - Xue Zhang
- Department of Health Sciences and Technology, Neural Control of Movement Lab, ETH Zurich, Gloriastrasse 37/39 GLC G17.2, Zurich, 8092, Switzerland
| | - Daniel Woolley
- Department of Health Sciences and Technology, Neural Control of Movement Lab, ETH Zurich, Gloriastrasse 37/39 GLC G17.2, Zurich, 8092, Switzerland
| | - Lina Zhao
- Department of Rehabilitation, Shengjing Hospital of China Medical University, 16 Puhe Road, Shenyang, Liaoning, 110134, China
| | - Weidi Liang
- Department of Rehabilitation, Shengjing Hospital of China Medical University, 16 Puhe Road, Shenyang, Liaoning, 110134, China
| | - Mengdi Huang
- Department of Rehabilitation, Shengjing Hospital of China Medical University, 16 Puhe Road, Shenyang, Liaoning, 110134, China
| | - Hsiao-Ju Cheng
- Singapore-ETH Centre, Future Health Technologies Programme, CREATE campus, 1 Create Way, CREATE Tower, #06-01, Singapore, 138602, Singapore
| | - Lixin Zhang
- Department of Rehabilitation, Shengjing Hospital of China Medical University, 16 Puhe Road, Shenyang, Liaoning, 110134, China
| | - Nicole Wenderoth
- Singapore-ETH Centre, Future Health Technologies Programme, CREATE campus, 1 Create Way, CREATE Tower, #06-01, Singapore, 138602, Singapore.
- Department of Health Sciences and Technology, Neural Control of Movement Lab, ETH Zurich, Gloriastrasse 37/39 GLC G17.2, Zurich, 8092, Switzerland.
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D'Antonio E, Galofaro E, Zenzeri J, Patané F, Konczak J, Casadio M, Masia L. Robotic Assessment of Wrist Proprioception During Kinaesthetic Perturbations: A Neuroergonomic Approach. Front Neurorobot 2021; 15:640551. [PMID: 33732131 PMCID: PMC7958920 DOI: 10.3389/fnbot.2021.640551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/09/2021] [Indexed: 12/01/2022] Open
Abstract
Position sense refers to an aspect of proprioception crucial for motor control and learning. The onset of neurological diseases can damage such sensory afference, with consequent motor disorders dramatically reducing the associated recovery process. In regular clinical practice, assessment of proprioceptive deficits is run by means of clinical scales which do not provide quantitative measurements. However, existing robotic solutions usually do not involve multi-joint movements but are mostly applied to a single proximal or distal joint. The present work provides a testing paradigm for assessing proprioception during coordinated multi-joint distal movements and in presence of kinaesthetic perturbations: we evaluated healthy subjects' ability to match proprioceptive targets along two of the three wrist's degrees of freedom, flexion/extension and abduction/adduction. By introducing rotations along the pronation/supination axis not involved in the matching task, we tested two experimental conditions, which differed in terms of the temporal imposition of the external perturbation: in the first one, the disturbance was provided after the presentation of the proprioceptive target, while in the second one, the rotation of the pronation/ supination axis was imposed during the proprioceptive target presentation. We investigated if (i) the amplitude of the perturbation along the pronation/supination would lead to proprioceptive miscalibration; (ii) the encoding of proprioceptive target, would be influenced by the presentation sequence between the target itself and the rotational disturbance. Eighteen participants were tested by means of a haptic neuroergonomic wrist device: our findings provided evidence that the order of disturbance presentation does not alter proprioceptive acuity. Yet, a further effect has been noticed: proprioception is highly anisotropic and dependent on perturbation amplitude. Unexpectedly, the configuration of the forearm highly influences sensory feedbacks, and significantly alters subjects' performance in matching the proprioceptive targets, defining portions of the wrist workspace where kinaesthetic and proprioceptive acuity are more sensitive. This finding may suggest solutions and applications in multiple fields: from general haptics where, knowing how wrist configuration influences proprioception, might suggest new neuroergonomic solutions in device design, to clinical evaluation after neurological damage, where accurately assessing proprioceptive deficits can dramatically complement regular therapy for a better prediction of the recovery path.
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Affiliation(s)
- Erika D'Antonio
- Assistive Robotics and Interactive Exosuits (ARIES) Laboratory, Institute of Computer Engineering (ZITI), University of Heidelberg, Heidelberg, Germany
| | - Elisa Galofaro
- Assistive Robotics and Interactive Exosuits (ARIES) Laboratory, Institute of Computer Engineering (ZITI), University of Heidelberg, Heidelberg, Germany.,Department of Informatics, Bioengineering, Robotics, and System Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Jacopo Zenzeri
- Robotics, Brain, and Cognitive Sciences Unit, Italian Institute of Technology, Genoa, Italy
| | - Fabrizio Patané
- Mechanical Measurements and Microelectronics (M3Lab) Lab, Engineering Department, University Niccolò Cusano, Rome, Italy
| | - Jürgen Konczak
- Human Sensorimotor Control Laboratory, University of Minnesota, Minneapolis, MN, United States
| | - Maura Casadio
- Department of Informatics, Bioengineering, Robotics, and System Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Lorenzo Masia
- Assistive Robotics and Interactive Exosuits (ARIES) Laboratory, Institute of Computer Engineering (ZITI), University of Heidelberg, Heidelberg, Germany.,Faculty of Engineering, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark (SDU), Odense, Denmark
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