TY - JOUR
T1 - A Neuromuscular Electrical Stimulation (NMES) and robot hybrid system for multi-joint coordinated upper limb rehabilitation after stroke
AU - Rong, Wei
AU - Li, Waiming
AU - Pang, Mankit
AU - Hu, Junyan
AU - Wei, Xijun
AU - Yang, Bibo
AU - Wai, Honwah
AU - Zheng, Xiaoxiang
AU - Hu, Xiaoling
PY - 2017/4/26
Y1 - 2017/4/26
N2 - Background: It is a challenge to reduce the muscular discoordination in the paretic upper limb after stroke in the traditional rehabilitation programs. Method: In this study, a neuromuscular electrical stimulation (NMES) and robot hybrid system was developed for multi-joint coordinated upper limb physical training. The system could assist the elbow, wrist and fingers to conduct arm reaching out, hand opening/grasping and arm withdrawing by tracking an indicative moving cursor on the screen of a computer, with the support from the joint motors and electrical stimulations on target muscles, under the voluntary intention control by electromyography (EMG). Subjects with chronic stroke (n = 11) were recruited for the investigation on the assistive capability of the NMES-robot and the evaluation of the rehabilitation effectiveness through a 20-session device assisted upper limb training. Results: In the evaluation, the movement accuracy measured by the root mean squared error (RMSE) during the tracking was significantly improved with the support from both the robot and NMES, in comparison with those without the assistance from the system (P < 0.05). The intra-joint and inter-joint muscular co-contractions measured by EMG were significantly released when the NMES was applied to the agonist muscles in the different phases of the limb motion (P < 0.05). After the physical training, significant improvements (P < 0.05) were captured by the clinical scores, i.e., Modified Ashworth Score (MAS, the elbow and the wrist), Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), and Wolf Motor Function Test (WMFT). Conclusions: The EMG-driven NMES-robotic system could improve the muscular coordination at the elbow, wrist and fingers. Trial registration: ClinicalTrials.gov. NCT02117089; date of registration: April 10, 2014
AB - Background: It is a challenge to reduce the muscular discoordination in the paretic upper limb after stroke in the traditional rehabilitation programs. Method: In this study, a neuromuscular electrical stimulation (NMES) and robot hybrid system was developed for multi-joint coordinated upper limb physical training. The system could assist the elbow, wrist and fingers to conduct arm reaching out, hand opening/grasping and arm withdrawing by tracking an indicative moving cursor on the screen of a computer, with the support from the joint motors and electrical stimulations on target muscles, under the voluntary intention control by electromyography (EMG). Subjects with chronic stroke (n = 11) were recruited for the investigation on the assistive capability of the NMES-robot and the evaluation of the rehabilitation effectiveness through a 20-session device assisted upper limb training. Results: In the evaluation, the movement accuracy measured by the root mean squared error (RMSE) during the tracking was significantly improved with the support from both the robot and NMES, in comparison with those without the assistance from the system (P < 0.05). The intra-joint and inter-joint muscular co-contractions measured by EMG were significantly released when the NMES was applied to the agonist muscles in the different phases of the limb motion (P < 0.05). After the physical training, significant improvements (P < 0.05) were captured by the clinical scores, i.e., Modified Ashworth Score (MAS, the elbow and the wrist), Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), and Wolf Motor Function Test (WMFT). Conclusions: The EMG-driven NMES-robotic system could improve the muscular coordination at the elbow, wrist and fingers. Trial registration: ClinicalTrials.gov. NCT02117089; date of registration: April 10, 2014
KW - Neuromuscular electrical stimulation
KW - Robot
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85018189523&partnerID=8YFLogxK
U2 - 10.1186/s12984-017-0245-y
DO - 10.1186/s12984-017-0245-y
M3 - Journal article
C2 - 28446181
SN - 1743-0003
VL - 14
JO - Journal of NeuroEngineering and Rehabilitation
JF - Journal of NeuroEngineering and Rehabilitation
IS - 1
M1 - 34
ER -