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Chang JY, Chun MH, Lee A, Lee A, Lee CM. Effects of training with a rehabilitation device (Rebless®) on upper limb function in patients with chronic stroke: A randomized controlled trial. Medicine (Baltimore) 2024; 103:e38753. [PMID: 38941364 DOI: 10.1097/md.0000000000038753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Upper limb dysfunction is one of the most common sequelae of stroke and robotic therapy is considered one of the promising methods for upper limb rehabilitation. OBJECTIVE This study aimed to explore the clinical effectiveness of upper limb training using a rehabilitation robotic device (Rebless®) for patients with stroke. METHODS In this prospective, unblinded, randomized controlled trial, patients were randomly assigned to receive robotic training (experimental group, n = 15) or conventional therapy (control group, n = 15). Both groups received upper limb training lasting for 30 minutes per session with a total of 10 training sessions within 4 weeks. Motor function, functional evaluation, and spasticity were clinically assessed before and after the training. Cortical activation was measured using functional near-infrared spectroscopy at the 1st and 10th training sessions. RESULTS The experimental group demonstrated a significant improvement in the Fugl-Meyer assessment-upper extremity score and the modified Ashworth scale grade in elbow flexors. The cortical activity of the unaffected hemisphere significantly decreased after 10 training sessions in the experimental group compared with the control group. CONCLUSIONS The experimental group showed significant improvement in the Fugl-Meyer assessment-upper extremity score and spasticity of elbow flexors and had significantly decreased cortical activity of the unaffected hemisphere. Training with Rebless® may help patients with chronic stroke in restoring upper limb function and recovering the contralateral predominance of activation in motor function.
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Affiliation(s)
- Jong Yoon Chang
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Ho Chun
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Anna Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ahro Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chang Min Lee
- Research Institute of Future City and Society, Yonsei University, Seoul, Republic of Korea
- PlayIdeaLab Incorporation, Seoul, Republic of Korea
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das Neves MF, Pinto AP, Maegima LT, Lima FPS, Lopes-Martins RÁB, Lo Schiavo Arisawa EA, Lima MO. Effects of photobiomodulation on pain, lactate and muscle performance (ROM, torque, and EMG parameters) of paretic upper limb in patients with post-stroke spastic hemiparesis-a randomized controlled clinical trial. Lasers Med Sci 2024; 39:88. [PMID: 38453765 DOI: 10.1007/s10103-024-04035-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
The objective of the study was to investigate the impact of photobiomodulation (PBM) on the paretic upper limb in post-stroke patients with spastic hemiparesis and to understand the potential of PBM as a long-term non-invasive therapy for reducing the side effects caused by spasticity in the hemiparetic upper limb after a stroke. This is a double-blind randomized clinical trial constituted of 27 participants, being Control group (CG = 12 healthy individuals) and PBM group (PBMG = 15 post-stroke individuals). In the CG, the baseline blood lactate (BL) was evaluated, followed by the evaluation of the IC torque of the biceps and triceps muscles, with the isokinetic dynamometer associated with surface electromyography (EMG) and, subsequently, a new measurement of BL. The PBMG received 10 sessions of treatment with PBM (780 nm, Power: 100 mV, Power Density: 3.18 W/cm2, Energy: 4 J, Fluency: 127.4 J/cm2, Time: 40 s per point and 1.280 s total, Spot: 0.0314 cm2, 32 Points: 16 points (brachial biceps) and 16 points (brachial triceps) applied with contact at 90°, Total Energy: 64 J), which in the pre-treatment evaluation measured BL, the visual analogue scale (VAS) of pain; torque and EMG of the same muscles in the IC, subsequently, a new measurement of VAS and BL, and measurement of range of motion (ROM) during the reaching movement. At the conclusion of the ten sessions, all participants underwent a reassessment, wherein all tests originally administered during the initial evaluation were repeated. Subsequently, the data were analyzed using the Shapiro-Wilk normality test. For related data, the paired t-test was used for normal distributions and the Wilcoxon test for non-normal data. For unrelated data, the t test was used for normal distributions and the Mann-Whitney test for non-normal data. Muscle torque was higher for the CG, with a significant difference (CGxPBMG = p < 0.0001). There was no significant difference between the EMG values of the CG in relation to the Pre-PBM phase and with the Post-PBM phase of the PBMG (p > 0.05). On the other hand, there was a 38% reduction in pain reported by hemiparetic patients (p = 0.0127) and a decrease in BL in the PBMG. Post-PBM ROM increased by 46.1% in the elbow extension of the paretic limb. In conclusion, Photobiomodulation (PBM) demonstrated significant improvements in muscle performance, reducing fatigue and pain levels, and enhancing range of motion in post-stroke patients with spastic hemiparesis. These findings support the potential integration of PBM into rehabilitation protocols, but further research and clinical trials are needed to validate and expand upon these promising outcomes.
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Affiliation(s)
- Marcele Florêncio das Neves
- Laboratório de Engenharia de Reabilitação Sensório Motora, Instituto de Pesquisa E Desenvolvimento, IP&D, Universidade Do Vale Do Paraíba, UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
| | - Ana Paula Pinto
- Laboratório de Engenharia de Reabilitação Sensório Motora, Instituto de Pesquisa E Desenvolvimento, IP&D, Universidade Do Vale Do Paraíba, UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
| | - Letícia Tiemi Maegima
- Laboratório de Engenharia de Reabilitação Sensório Motora, Instituto de Pesquisa E Desenvolvimento, IP&D, Universidade Do Vale Do Paraíba, UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
| | - Fernanda Pupio Silva Lima
- Laboratório de Engenharia de Reabilitação Sensório Motora, Instituto de Pesquisa E Desenvolvimento, IP&D, Universidade Do Vale Do Paraíba, UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil.
- Programa de Pós Graduação Em Engenharia Biomédica, Avenida Shishima Hifumi, Urbanova, SP, 2911, Brazil.
| | - Rodrigo Álvaro Brandão Lopes-Martins
- Post-Graduate Program in Human Movement and Rehabilitation, Research Group in Biophotonics and Experimental Therapeutics in Health and Esthetics, Universidade Evangélica de Goiás - UniEVANGÉLICA, Anápolis, Goiás, Brazil
| | - Emilia Angela Lo Schiavo Arisawa
- Laboratório de Engenharia de Reabilitação Sensório Motora, Instituto de Pesquisa E Desenvolvimento, IP&D, Universidade Do Vale Do Paraíba, UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
| | - Mário Oliveira Lima
- Laboratório de Engenharia de Reabilitação Sensório Motora, Instituto de Pesquisa E Desenvolvimento, IP&D, Universidade Do Vale Do Paraíba, UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
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Lee JE, Akimoto T, Chang J, Lee HS. Effects of joint mobilization combined with acupuncture on pain, physical function, and depression in stroke patients with chronic neuropathic pain: A randomized controlled trial. PLoS One 2023; 18:e0281968. [PMID: 37616239 PMCID: PMC10449141 DOI: 10.1371/journal.pone.0281968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/04/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVE To investigate the effectiveness of joint mobilization (JM) combined with acupuncture (AC) for the treatment of pain, physical function and depression in poststroke patients. METHODS A total of 69 poststroke patients were randomly assigned to the JM+AC group (n = 23), the JM group (n = 23), and the control group (n = 23). Patients in the JM+AC group and the JM group received JM for 30 minutes, twice a week for 12 weeks, and the JM+AC group received AC for 30 minutes separately once a week. The control group did not receive JM or AC. Pain (visual analog scale, shoulder pain and disability index, Western Ontario and McMaster universities osteoarthritis index), physical function (range of motion, 10-m walking speed test, functional gait assessment, manual function test, activities of daily living scale, instrumental activities of daily living scale), and depression (center for epidemiologic studies depression scale, Beck depression inventory) were assessed for each patient before and after the 12 weeks of intervention. RESULTS Pain and physical function were improved significantly in the JM+AC group compared with the JM and control groups. Physical function and depression were improved significantly in the JM+AC and JM groups compared with the control group. CONCLUSION The treatment of JM combined with AC improved pain, depression, and physical function of poststroke patients with chronic neuropathic pain in this study. This valuable finding provides empirical evidence for the designing therapeutic interventions and identifying potential therapeutic targets.
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Affiliation(s)
- Ji-Eun Lee
- Department of Exercise and Medical Science, Dankook University, Cheonan, Republic of Korea
| | - Takayuki Akimoto
- Laboratory of Muscle Biology, Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Jisuk Chang
- Department of Sports Management, Dankook University, Cheonan, Republic of Korea
| | - Ho-Seong Lee
- Department of Exercise and Medical Science, Dankook University, Cheonan, Republic of Korea
- Institute of Medical-Sports, Dankook University, Cheonan, Republic of Korea
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He J, Luo A, Yu J, Qian C, Liu D, Hou M, Ma Y. Quantitative assessment of spasticity: a narrative review of novel approaches and technologies. Front Neurol 2023; 14:1121323. [PMID: 37475737 PMCID: PMC10354649 DOI: 10.3389/fneur.2023.1121323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/19/2023] [Indexed: 07/22/2023] Open
Abstract
Spasticity is a complex neurological disorder, causing significant physical disabilities and affecting patients' independence and quality of daily lives. Current spasticity assessment methods are questioned for their non-standardized measurement protocols, limited reliabilities, and capabilities in distinguishing neuron or non-neuron factors in upper motor neuron lesion. A series of new approaches are developed for improving the effectiveness of current clinical used spasticity assessment methods with the developing technology in biosensors, robotics, medical imaging, biomechanics, telemedicine, and artificial intelligence. We investigated the reliabilities and effectiveness of current spasticity measures employed in clinical environments and the newly developed approaches, published from 2016 to date, which have the potential to be used in clinical environments. The new spasticity scales, taking advantage of quantified information such as torque, or echo intensity, the velocity-dependent feature and patients' self-reported information, grade spasticity semi-quantitatively, have competitive or better reliability than previous spasticity scales. Medical imaging technologies, including near-infrared spectroscopy, magnetic resonance imaging, ultrasound and thermography, can measure muscle hemodynamics and metabolism, muscle tissue properties, or temperature of tissue. Medical imaging-based methods are feasible to provide quantitative information in assessing and monitoring muscle spasticity. Portable devices, robotic based equipment or myotonometry, using information from angular, inertial, torque or surface EMG sensors, can quantify spasticity with the help of machine learning algorithms. However, spasticity measures using those devices are normally not physiological sound. Repetitive peripheral magnetic stimulation can assess patients with severe spasticity, which lost voluntary contractions. Neuromusculoskeletal modeling evaluates the neural and non-neural properties and may gain insights into the underlying pathology of spasticity muscles. Telemedicine technology enables outpatient spasticity assessment. The newly developed spasticity methods aim to standardize experimental protocols and outcome measures and enable quantified, accurate, and intelligent assessment. However, more work is needed to investigate and improve the effectiveness and accuracy of spasticity assessment.
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Affiliation(s)
- Jian He
- Research Academy of Grand Health, Faculty of Sports Sciences, Ningbo University, Ningbo, China
| | - Anhua Luo
- Research Academy of Grand Health, Faculty of Sports Sciences, Ningbo University, Ningbo, China
| | - Jiajia Yu
- Research Academy of Grand Health, Faculty of Sports Sciences, Ningbo University, Ningbo, China
| | - Chengxi Qian
- Research Academy of Grand Health, Faculty of Sports Sciences, Ningbo University, Ningbo, China
| | - Dongwei Liu
- School of Information Management and Artificial Intelligence, Zhejiang University of Finance and Economics, Hangzhou, China
| | - Meijin Hou
- National Joint Engineering Research Centre of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopaedics and Traumatology of Traditional Chinese Medicine and Rehabilitation (Fujian University of TCM), Ministry of Education, Fuzhou, China
| | - Ye Ma
- Research Academy of Grand Health, Faculty of Sports Sciences, Ningbo University, Ningbo, China
- National Joint Engineering Research Centre of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopaedics and Traumatology of Traditional Chinese Medicine and Rehabilitation (Fujian University of TCM), Ministry of Education, Fuzhou, China
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Huo C, Xu G, Xie H, Zhao H, Zhang X, Li W, Zhang S, Huo J, Li H, Sun A, Li Z. Effect of High-Frequency rTMS Combined with Bilateral Arm Training on Brain Functional Network in Patients with Chronic Stroke: An fNIRS study. Brain Res 2023; 1809:148357. [PMID: 37011721 DOI: 10.1016/j.brainres.2023.148357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 03/06/2023] [Accepted: 03/31/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE Neurological evidence for the combinational intervention coupling rTMS with motor training for stroke rehabilitation remains limited. This study aimed to investigate the effects of rTMS combined with bilateral arm training (BAT) on the brain functional reorganization in patients with chronic stroke via functional near-infrared spectroscopy (fNIRS). METHODS Fifteen stroke patients and fifteen age-matched healthy participants were enrolled and underwent single BAT session (s-BAT) and BAT immediately after 5-Hz rTMS over the ipsilesional M1 (rTMS-BAT), measured cerebral haemodynamics by fNIRS. Functional connectivity (FC), the clustering coefficient (Ccoef), and local efficiency (Eloc) were applied to evaluate the functional response to the training paradigms. RESULTS The differences in FC responses to the two training paradigms were more pronounced in stroke patients than in healthy controls. In the resting state, stroke patients exhibited significantly lower FC than controls in both hemispheres. rTMS-BAT induced no significant difference in FC between groups. Compared to the resting state, rTMS-BAT induced significant decreases in Ccoef and Eloc of the contralesional M1 and significant increases in Eloc of the ipsilesional M1 in stroke patients. Additionally, these above two network metrics of the ipsilesional motor area were significantly positively correlated with the motor function of stroke patients. CONCLUSIONS These results suggest that the rTMS-BAT paradigm had additional effects on task-dependent brain functional reorganization. The engagement of the ipsilesional motor area in the functional network was associated with the motor impairment severity of stroke patients. fNIRS-based assessments may provide information about the neural mechanisms underlying combination interventions for stroke rehabilitation.
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Huo C, Xu G, Sun A, Xie H, Hu X, Li W, Li Z, Fan Y. Cortical response induced by task-oriented training of the upper limb in subacute stroke patients as assessed by functional near-infrared spectroscopy. JOURNAL OF BIOPHOTONICS 2023; 16:e202200228. [PMID: 36222197 DOI: 10.1002/jbio.202200228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/28/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
Despite the popularity of task-oriented training for stroke, the cortical reorganization associated with this type of therapy remains to be fully elucidated due to the lack of dynamic assessment tools. A good tolerance for motion artifacts makes functional near-infrared spectroscopy (fNIRS) suitable for investigating task-induced cortical responses in stroke patients. Here, patients were randomly assigned to receive task oriented (n = 25) or cyclic rotary training (n = 25) with simultaneous cortical activation and effective connectivity network analysis between prefrontal and motor cortices (PFC/MC). Compared with cyclic rotary training, task-oriented training induced significantly increased activation in both hemispheres and enhanced influence of PFC on MC. In addition, significantly decreased activation lateralization and increased betweenness centrality of the contralesional MC suggested widespread involvement of the contralesional hemisphere during task-oriented training. This study verifies the feasibility of fNIRS combined with motor paradigms for assessing neural responses associated with stroke rehabilitation in real time.
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Affiliation(s)
- Congcong Huo
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Gongcheng Xu
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Aiping Sun
- Department of Neurological Rehabilitation, National Rehabilitation Hospital of National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Hui Xie
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Xiaoling Hu
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Wenhao Li
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Zengyong Li
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
- Key Laboratory of Neuro-Functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, Beijing, China
| | - Yubo Fan
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
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Zhang Y, Chen S, Ruan Y, Lin J, Li C, Li C, Xu S, Yan Z, Liu X, Miao P, Jia J. The Facial Skin Blood Flow Change of Stroke Patients with Facial Paralysis after Peripheral Magnetic Stimulation: A Pilot Study. Brain Sci 2022; 12:brainsci12101271. [PMID: 36291205 PMCID: PMC9599644 DOI: 10.3390/brainsci12101271] [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: 08/16/2022] [Revised: 08/31/2022] [Accepted: 09/10/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Facial paralysis (FP) is a common symptom after stroke, which influences the quality of life and prognosis of patients. Recently, peripheral magnetic stimulation (PMS) shows potential effects on peripheral and central nervous system damage. However, the effect of PMS on FP after stroke is still unclear. Methods: In this study, we applied PMS on the facial nerve of nine stroke patients with FP. At the same time, laser speckle contrast imaging (LSCI) was used to explore the facial skin blood flow (SkBF) in 19 healthy subjects and nine stroke patients with FP before and after the PMS intervention. The whole face was divided into 14 regions to compare the SkBF in different sub-areas. Results: In baseline SkBF, we found that there were no significant differences in the SkBF between the left and right faces in the healthy subjects. However, there was a significant difference in the SkBF between the affected and unaffected faces in Region 7 (Chin area, p = 0.046). In the following five minutes after the PMS intervention (Pre_0–5 min), the SkBF increased in Region 5 (p = 0.014) and Region 7 (p = 0.046) and there was an increasing trend in Region 3 (p = 0.088) and Region 6 (p = 0.069). In the five to ten minutes after the intervention (Post_6–10 min), the SkBF increased in Region 5 (p = 0.009), Region 6 (p = 0.021) and Region 7 (p = 0.023) and there was an increasing trend in Region 3 (p = 0.080) and left and right whole face (p = 0.051). Conclusions: These pilot results indicate that PMS intervention could increase facial skin blood flow in stroke patients with FP. A further randomized controlled trial can be performed to explore its possible clinical efficacy.
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Affiliation(s)
- Yongli Zhang
- School of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Shugeng Chen
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yinglu Ruan
- Department of Rehabilitation Medicine, Shanghai Jing’an District Central Hospital, Shanghai 200040, China
| | - Jiaying Lin
- School of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Chengdong Li
- School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai 200030, China
| | - Chong Li
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Shuo Xu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zhijie Yan
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xiangyun Liu
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Peng Miao
- School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai 200030, China
| | - Jie Jia
- School of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
- Department of Rehabilitation Medicine, Shanghai Jing’an District Central Hospital, Shanghai 200040, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
- National Center for Neurological Disorders, Shanghai 200040, China
- National Regional Medical Center, Fuzhou 350200, China
- Correspondence:
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Chen H, Liang J, Huang W, Yang A, Pang R, Zhao C, Wu K, Wang C, Yan K, Zhang Y, Lin S, Xie Y, Wu Y, Sun J. Age-related difference in muscle metabolism patterns during upper limb's encircling exercise: a near-infrared spectroscopy study. BIOMEDICAL OPTICS EXPRESS 2022; 13:4737-4751. [PMID: 36187255 PMCID: PMC9484442 DOI: 10.1364/boe.462551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/24/2022] [Accepted: 07/10/2022] [Indexed: 06/16/2023]
Abstract
Aging is usually accompanied by decrease in limb motor function and change in muscle metabolism patterns. However, few studies have investigated the aging effect on muscle hemodynamics of the upper extremity. This study aims to explore the aging effect on muscle metabolism patterns during upper limb's exercise. Twelve middle-aged and elderly subjects and 12 young subjects were recruited, and muscle oxygenation signals from these subjects' biceps brachii muscles were collected during active and passive upper limb's encircling exercise with near-infrared spectroscopy (NIRS). The old group showed stronger muscle hemodynamic metabolism than the young group. The multiscale fuzzy approximate entropy and multiscale transfer entropy analyses indicated higher complexity and stronger interlimb coupling of the muscle oxygenation signals for the old group. Based on the selected muscle metabolism features, the constructed support vector machine model showed a high accuracy rate for classifying the two groups of subjects: 91.6% for the passive mode and 87.5% for the active mode. Our results proved the specific muscle metabolism patterns in the upper limb's exercise for old subjects, promoting the understanding of the aging effect on muscle hemodynamics.
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Affiliation(s)
- Hucheng Chen
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, China
- Equal contribution
| | - Jianbin Liang
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, China
- Equal contribution
| | - Wenzhu Huang
- Fifth Affiliated Hospital of Foshan University, Foshan, China
| | - Anping Yang
- School of Medicine, Foshan University, Foshan, China
| | - Richong Pang
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, China
| | - Chaochao Zhao
- School of Medicine, Foshan University, Foshan, China
| | - Kai Wu
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou, China
| | - Chong Wang
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, China
| | - Kecheng Yan
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, China
| | - YiZheng Zhang
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, China
| | - Shuoshu Lin
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, China
| | - Yuanrong Xie
- School of Mechatronic Engineering and Automation, Foshan University, Foshan, China
| | - Yuxiang Wu
- Department of Health and Physical Education, Jianghan University, Wuhan, China
| | - Jinyan Sun
- School of Medicine, Foshan University, Foshan, China
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Boccuni L, Marinelli L, Trompetto C, Pascual-Leone A, Tormos Muñoz JM. Time to reconcile research findings and clinical practice on upper limb neurorehabilitation. Front Neurol 2022; 13:939748. [PMID: 35928130 PMCID: PMC9343948 DOI: 10.3389/fneur.2022.939748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
The problemIn the field of upper limb neurorehabilitation, the translation from research findings to clinical practice remains troublesome. Patients are not receiving treatments based on the best available evidence. There are certainly multiple reasons to account for this issue, including the power of habit over innovation, subjective beliefs over objective results. We need to take a step forward, by looking at most important results from randomized controlled trials, and then identify key active ingredients that determined the success of interventions. On the other hand, we need to recognize those specific categories of patients having the greatest benefit from each intervention, and why. The aim is to reach the ability to design a neurorehabilitation program based on motor learning principles with established clinical efficacy and tailored for specific patient's needs.Proposed solutionsThe objective of the present manuscript is to facilitate the translation of research findings to clinical practice. Starting from a literature review of selected neurorehabilitation approaches, for each intervention the following elements were highlighted: definition of active ingredients; identification of underlying motor learning principles and neural mechanisms of recovery; inferences from research findings; and recommendations for clinical practice. Furthermore, we included a dedicated chapter on the importance of a comprehensive assessment (objective impairments and patient's perspective) to design personalized and effective neurorehabilitation interventions.ConclusionsIt's time to reconcile research findings with clinical practice. Evidence from literature is consistently showing that neurological patients improve upper limb function, when core strategies based on motor learning principles are applied. To this end, practical take-home messages in the concluding section are provided, focusing on the importance of graded task practice, high number of repetitions, interventions tailored to patient's goals and expectations, solutions to increase and distribute therapy beyond the formal patient-therapist session, and how to integrate different interventions to maximize upper limb motor outcomes. We hope that this manuscript will serve as starting point to fill the gap between theory and practice in upper limb neurorehabilitation, and as a practical tool to leverage the positive impact of clinicians on patients' recovery.
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Affiliation(s)
- Leonardo Boccuni
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
- *Correspondence: Leonardo Boccuni
| | - Lucio Marinelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Department of Neuroscience, Division of Clinical Neurophysiology, Genova, Italy
| | - Carlo Trompetto
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Department of Neuroscience, Division of Neurorehabilitation, Genova, Italy
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, United States
- Department of Neurology and Harvard Medical School, Boston, MA, United States
| | - José María Tormos Muñoz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
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10
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Thomas SM, Delanni E, Christophe B, Connolly ES. Systematic review of novel technology-based interventions for ischemic stroke. Neurol Sci 2021; 42:1705-1717. [PMID: 33604762 DOI: 10.1007/s10072-021-05126-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To identify novel technologies pertinent to the prevention, diagnosis, treatment, and rehabilitation of ischemic stroke, and recommend the technologies that show the most promise in advancing ischemic stroke care. METHOD A systematic literature search on PubMed and Medscape was performed. Articles were assessed based on pre-determined criteria. Included journal articles were evaluated for specific characteristics and reviewed according to a structured paradigm. A search on www.clinicaltrials.gov was performed to identify pre-clinical ischemic stroke technological interventions. All clinical trial results were included. An additional search on PubMed was conducted to identify studies on robotic neuroendovascular procedures. RESULTS Thirty journal articles and five clinical trials were analyzed. Articles were categorized as follows: six studies pertinent to pre-morbidity and prevention of ischemic stroke, three studies relevant to the diagnosis of ischemic stroke, 16 studies about post-ischemic stroke rehabilitation, and five studies on robotic neuroendovascular interventions. CONCLUSIONS Novel technologies across the spectrum of ischemic stroke care were identified, and the ones that appear to have the most clinical utility are recommended. Future investigation of the feasibility and long-term efficacy of the recommended technologies in clinical settings is warranted.
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Affiliation(s)
- Steven Mulackal Thomas
- Department of Neurological Surgery, Columbia University Irving Medical Center, 710 West 168th Street, New York, NY, 10032, USA.
| | - Ellie Delanni
- Department of Neurological Surgery, Columbia University Irving Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - Brandon Christophe
- Department of Neurological Surgery, Columbia University Irving Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - Edward Sander Connolly
- Department of Neurological Surgery, Columbia University Irving Medical Center, 710 West 168th Street, New York, NY, 10032, USA
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11
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Karunakaran KD, Peng K, Berry D, Green S, Labadie R, Kussman B, Borsook D. NIRS measures in pain and analgesia: Fundamentals, features, and function. Neurosci Biobehav Rev 2020; 120:335-353. [PMID: 33159918 DOI: 10.1016/j.neubiorev.2020.10.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/28/2020] [Accepted: 10/19/2020] [Indexed: 02/06/2023]
Abstract
Current pain assessment techniques based only on clinical evaluation and self-reports are not objective and may lead to inadequate treatment. Having a functional biomarker will add to the clinical fidelity, diagnosis, and perhaps improve treatment efficacy in patients. While many approaches have been deployed in pain biomarker discovery, functional near-infrared spectroscopy (fNIRS) is a technology that allows for non-invasive measurement of cortical hemodynamics. The utility of fNIRS is especially attractive given its ability to detect specific changes in the somatosensory and high-order cortices as well as its ability to measure (1) brain function similar to functional magnetic resonance imaging, (2) graded responses to noxious and innocuous stimuli, (3) analgesia, and (4) nociception under anesthesia. In this review, we evaluate the utility of fNIRS in nociception/pain with particular focus on its sensitivity and specificity, methodological advantages and limitations, and the current and potential applications in various pain conditions. Everything considered, fNIRS technology could enhance our ability to evaluate evoked and persistent pain across different age groups and clinical populations.
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Affiliation(s)
- Keerthana Deepti Karunakaran
- Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, United States.
| | - Ke Peng
- Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, United States; Département en Neuroscience, Centre de Recherche du CHUM, l'Université de Montréal Montreal, QC, Canada
| | - Delany Berry
- Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, United States
| | - Stephen Green
- Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, United States
| | - Robert Labadie
- Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, United States
| | - Barry Kussman
- Division of Cardiac Anesthesia, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, United States
| | - David Borsook
- Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, United States.
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12
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Identifying Resting-State Functional Connectivity Changes in the Motor Cortex Using fNIRS During Recovery from Stroke. Brain Topogr 2020; 33:710-719. [PMID: 32685998 DOI: 10.1007/s10548-020-00785-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 07/11/2020] [Indexed: 12/23/2022]
Abstract
Resting-state functional imaging has been used to study the functional reorganization of the brain. The application of functional near-infrared spectroscopy (fNIRS) to assess resting-state functional connectivity (rsFC) has already been demonstrated in recent years. The present study aimed to identify the difference in rsFC patterns during the recovery from the upper-limb deficit due to stroke. Twenty patients with mild stroke having an onset of four to eight weeks were recruited from the stroke clinic of our institute and an equal number of healthy volunteers were included in the study after ethical committee approval. The fNIRS signals were recorded bilaterally over the premotor area and supplementary motor area and over the primary motor cortex. Pearson Correlation is the method used to compute rsFC for the healthy group and patient group. For the healthy group, both intra-hemispheric and inter-hemispheric connections were stronger. RSFC analysis demonstrated changes from the healthy pattern for the patient group with an upper-limb deficit. The left hemisphere affected group showed disrupted ipsilesional and an increased contra-lesional connectivity. The longitudinal data analysis of rsFC showed improvement in the connections in the ipsilesional hemisphere between the primary motor area, somatosensory area, and premotor areas. In the future, the rsFC changes during the recovery could be used to predict the extent of recovery from stroke motor deficits.
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13
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Near-infrared spectroscopy as a quantitative spasticity assessment tool: A systematic review. J Neurol Sci 2020; 412:116729. [PMID: 32120130 DOI: 10.1016/j.jns.2020.116729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/05/2020] [Accepted: 02/09/2020] [Indexed: 11/24/2022]
Abstract
The purpose of this paper is to systematically review the literature on the use of near-infrared spectroscopy (NIRS) for assessing spasticity. MEDLINE, CINAHL, and EMBASE were searched for human and/or animal studies written in the English language published until November 2018. that used NIRS to examine the hemodynamics and/or metabolism of spastic musculature were included. Of the 35 articles identified, five met the inclusion criteria. Two reviewers independently extracted spasticity outcomes, NIRS instrumentation specifications, and NIRS hemodynamic and metabolic measures from each article. Risk of bias was assessed using the Downs & Black tool for non-randomized studies. Three different models of NIRS devices were used in the five studies. Four studies examined the effects of passive limb movements and one examined active hand movements on NIRS parameters in spastic and non-spastic muscle. Owing to the small number and diverse nature of the studies, statistical comparison was deemed inappropriate. Rather, descriptive comparisons were drawn and levels of evidence were assigned based on the modified Sackett Scale. There is level 4 evidence that NIRS can non-invasively detect and measure differences between spastic and non-spastic muscles in blood volume and oxidative capacity changes over time or in response to interventions, and may correlate with other, established measures of spasticity, such as the Modified Ashworth Scale (MAS) and electromyography (EMG). Future research studies should use a validated definition of spasticity for inclusion criteria, a control group, and standardized NIRS variables.
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14
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Baur K, Rohrbach N, Hermsdörfer J, Riener R, Klamroth-Marganska V. The "Beam-Me-In Strategy" - remote haptic therapist-patient interaction with two exoskeletons for stroke therapy. J Neuroeng Rehabil 2019; 16:85. [PMID: 31296226 PMCID: PMC6625018 DOI: 10.1186/s12984-019-0547-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 06/05/2019] [Indexed: 11/29/2022] Open
Abstract
Background We present a robot-assisted telerehabilitation system that allows for haptic interaction between therapist and patient over distance. It consists of two arm therapy robots. Attached to one robot the therapists can feel on their own arm the limitations of the patient’s arm which is attached to the other robot. Due to the exoskeleton structure of the robot, movements can be performed in the three-dimensional space. Methods Fifteen physical and occupational therapists tested this strategy, named “Beam-Me-In”, while using an exoskeleton robot connected to a second exoskeleton robot in the same room used by the study experimenter. Furthermore, the therapists assessed the level of impairment of recorded and simulated arm movements. They quantified four typical impairments of stroke patients: reduced range of motion (active and passive), resistance to passive movement, a lack of ability to fractionate a movement, and disturbed quality of movement. Results On a Likert Scale (0 to 5 points) therapists rated the “Beam-Me-In” strategy as a very useful medium (mode: 4 points) to evaluate a patient’s progress over time. The passive range of motion of the elbow joint was assessed with a mean absolute error of 4.9∘ (absolute precision error: 6.4∘). The active range of motion of the elbow was assessed with a mean absolute error of 4.9∘ (absolute precision error: 6.5∘). The resistance to passive movement (i.e. modified Tardieu Scale) and the lack of ability to fractionate a movement (i.e. quantification of pathological muscle synergies) was assessed with an inter-rater reliability of 0.930 and 0.948, respectively. Conclusions The “Beam-Me-In” strategy is a promising approach to complement robot-assisted movement training. It can serve as a platform to assess and identify abnormal movement patterns in patients. This is the first application of remote three-dimensional haptic assessmen t applied to telerehabilitation. Furthermore, the “Beam-Me-In” strategy has a potential to overcome barriers for therapists regarding robot-assisted telerehabilitation.
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Affiliation(s)
- Kilian Baur
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich), Tannenstrasse 1, Zurich, 8092, Switzerland. .,Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland, Forchstrasse 340, Zurich, 8008, Switzerland.
| | - Nina Rohrbach
- Chair of Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, (TU Munich), Munich, Germany, Georg-Brauchle-Ring 60-62/III, Munich, 80992, Germany
| | - Joachim Hermsdörfer
- Chair of Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, (TU Munich), Munich, Germany, Georg-Brauchle-Ring 60-62/III, Munich, 80992, Germany
| | - Robert Riener
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich), Tannenstrasse 1, Zurich, 8092, Switzerland.,Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland, Forchstrasse 340, Zurich, 8008, Switzerland
| | - Verena Klamroth-Marganska
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich), Tannenstrasse 1, Zurich, 8092, Switzerland.,Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland, Forchstrasse 340, Zurich, 8008, Switzerland.,School of Health Professions, Institute of Occupational Therapy, Zurich University of Applied Sciences (ZHAW), Winterthur, Switzerland, Technikumstrasse 81, Winterthur, 8400, Switzerland
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15
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Tsai YL, Huang JJ, Pu SW, Chen HP, Hsu SC, Chang JY, Pei YC. Usability Assessment of a Cable-Driven Exoskeletal Robot for Hand Rehabilitation. Front Neurorobot 2019; 13:3. [PMID: 30814945 PMCID: PMC6381032 DOI: 10.3389/fnbot.2019.00003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 01/23/2019] [Indexed: 11/21/2022] Open
Abstract
Study design: Case series. Background: Robot-assisted rehabilitation mediated by exoskeletal devices is a popular topic of research. The biggest difficulty in the development of rehabilitation robots is the consideration of the clinical needs. This study investigated the usability of a novel cable-driven exoskeletal robot specifically designed for hand rehabilitation. Methods: The study consists of three steps, including prototype development, spasticity observation, and usability evaluation. First, we developed the prototype robot DexoHand to manipulate the patient's fingers based on the clinical needs and the cable-driven concept established in our previous work. Second, we applied DexoHand to patients with different levels of spasticity. Finally, we obtained the system usability scale (SUS) and assessed its usability. Results: Two healthy subjects were recruited in the pre-test, and 18 patients with stroke and four healthy subjects were recruited in the formal test for usability. The total SUS score obtained from the patients and healthy subjects was 94.77 ± 2.98 (n = 22), indicating an excellent level of usability. The satisfaction score was 4.74 ± 0.29 (n = 22), revealing high satisfaction with DexoHand. The tension profile measured by the cables showed the instantaneous force used to manipulate fingers among different muscle tone groups. Conclusions:DexoHand meets the clinical needs with excellent usability, satisfaction, and reliable tension force monitoring, yielding a feasible platform for robot-assisted hand rehabilitation.
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Affiliation(s)
- Yu-Lin Tsai
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Jian-Jia Huang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shu-Wei Pu
- Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Hsiang-Peng Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Shao-Chih Hsu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Jen-Yuan Chang
- Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Yu-Cheng Pei
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
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16
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Yang M, Yang Z, Yuan T, Feng W, Wang P. A Systemic Review of Functional Near-Infrared Spectroscopy for Stroke: Current Application and Future Directions. Front Neurol 2019; 10:58. [PMID: 30804877 PMCID: PMC6371039 DOI: 10.3389/fneur.2019.00058] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/16/2019] [Indexed: 02/05/2023] Open
Abstract
Background: Survivors of stroke often experience significant disability and impaired quality of life. The recovery of motor or cognitive function requires long periods. Neuroimaging could measure changes in the brain and monitor recovery process in order to offer timely treatment and assess the effects of therapy. A non-invasive neuroimaging technique near-infrared spectroscopy (NIRS) with its ambulatory, portable, low-cost nature without fixation of subjects has attracted extensive attention. Methods: We conducted a comprehensive literature review in order to review the use of NIRS in stroke or post-stroke patients in July 2018. NCBI Pubmed database, EMBASE database, Cochrane Library and ScienceDirect database were searched. Results: Overall, we reviewed 66 papers. NIRS has a wide range of application, including in monitoring upper limb, lower limb recovery, motor learning, cortical function recovery, cerebral hemodynamic changes, cerebral oxygenation, as well as in therapeutic method, clinical researches, and evaluation of the risk for stroke. Conclusions: This study provides a preliminary evidence of the application of NIRS in stroke patients as a monitoring, therapeutic, and research tool. Further studies could give more emphasize on the combination of NIRS with other techniques and its utility in the prevention of stroke.
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Affiliation(s)
- Muyue Yang
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai, China.,School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhen Yang
- Core Facility of West China Hospital, Sichuan University, Chengdu, China
| | - Tifei Yuan
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wuwei Feng
- Department of Neurology, Medical University of South Carolina, Charleston, SC, United States
| | - Pu Wang
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai, China
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17
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Lee BJB, Williams A, Ben-Tzvi P. Intelligent Object Grasping With Sensor Fusion for Rehabilitation and Assistive Applications. IEEE Trans Neural Syst Rehabil Eng 2018; 26:1556-1565. [PMID: 29994121 DOI: 10.1109/tnsre.2018.2848549] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This paper presents the design and control of the intelligent sensing and force-feedback exoskeleton robotic glove to create a system capable of intelligent object grasping initiated by detection of the user's intentions through motion amplification. Using a combination of sensory feedback streams from the glove, the system has the ability to identify and prevent object slippage, as well as adapting grip geometry to the object properties. The slip detection algorithm provides updated inputs to the force controller to prevent an object from being dropped, while only requiring minimal input from a user who may have varying degrees of functionality in their injured hand. This paper proposes the use of a high dynamic range, low cost conductive elastomer sensor coupled with a negative force derivative trigger that can be leveraged in order to create a controller that can intelligently respond to slip conditions through state machine architecture, and improve the grasping robustness of the exoskeleton. The improvements to the previous design are described while the details of the controller design and the proposed assistive and rehabilitative applications are explained. Experimental results confirming the validity of the proposed system are presented. Finally, this paper concludes with topics for future exploration.
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