Scano A, Chiavenna A, Malosio M, Molinari Tosatti L, Molteni F. Muscle Synergies-Based Characterization and Clustering of Poststroke Patients in Reaching Movements.
Front Bioeng Biotechnol 2017;
5:62. [PMID:
29082227 PMCID:
PMC5645509 DOI:
10.3389/fbioe.2017.00062]
[Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 09/26/2017] [Indexed: 11/13/2022] Open
Abstract
Background
A deep characterization of neurological patients is a crucial step for a detailed knowledge of the pathology and maximal exploitation and customization of the rehabilitation therapy. The muscle synergies analysis was designed to investigate how muscles coactivate and how their eliciting commands change in time during movement production. Few studies investigated the value of muscle synergies for the characterization of neurological patients before rehabilitation therapies. In this article, the synergy analysis was used to characterize a group of chronic poststroke hemiplegic patients.
Methods
Twenty-two poststroke patients performed a session composed of a sequence of 3D reaching movements. They were assessed through an instrumental assessment, by recording kinematics and electromyography to extract muscle synergies and their activation commands. Patients’ motor synergies were grouped by the means of cluster analysis. Consistency and characterization of each cluster was assessed and clinically profiled by comparison with standard motor assessments.
Results
Motor synergies were successfully extracted on all 22 patients. Five basic clusters were identified as a trade-off between clustering precision and synthesis power, representing: healthy-like activations, two shoulder compensatory strategies, two elbow predominance patterns. Each cluster was provided with a deep characterization and correlation with clinical scales, range of motion, and smoothness.
Conclusion
The clustering of muscle synergies enabled a pretherapy characterization of patients. Such technique may affect several aspects of the therapy: prediction of outcomes, evaluation of the treatments, customization of doses, and therapies.
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