A Neuromuscular Electrical Stimulation (NMES) and robot hybrid system for multi-joint coordinated upper limb rehabilitation after stroke

Wei Rong, Waiming Li, Mankit Pang, Junyan Hu, Xijun Wei, Bibo Yang, Honwah Wai, Xiaoxiang Zheng, Xiaoling Hu

Research output: Journal article publicationJournal articleAcademic researchpeer-review

25 Citations (Scopus)

Abstract

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
Original languageEnglish
Article number34
JournalJournal of NeuroEngineering and Rehabilitation
Volume14
Issue number1
DOIs
Publication statusPublished - 26 Apr 2017

Keywords

  • Neuromuscular electrical stimulation
  • Robot
  • Stroke

ASJC Scopus subject areas

  • Rehabilitation
  • Health Informatics

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