Self-Support Biofeedback Training for Recovery From Motor Impairment After Stroke
Self-Support Biofeedback Training for Recovery From Motor Impairment After Stroke
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DOI：
10.1109/access.2020.2987095
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发表时间：
2020-01-01
期刊：
影响因子：
3.9
通讯作者：
Shimoda, Shingo
中科院分区：
文献类型：
--
作者：
Alnahar, Fady;Ozaki, Ken-Ichi;Shimoda, Shingo
单侧手臂麻痹是中风的常见症状。在中风患者中，我们观察到非瘫痪手臂的自我引导生物力学支持意外地触发了瘫痪手臂正常肌肉协同作用的肌电活动。瘫痪手臂的肌肉活动变得与非瘫痪手臂的肌肉活动相似，并通过相似性指数（SI）进行量化。患者（n &x003D;54）的肌电图（EMG）信号和功能近红外光谱（fNIRS）显示，根据SI量化，自我支持运动可以立即改善肌肉活动40 &x2013;80 &x0025;，并且肌肉活动变得更接近年龄匹配的健康受试者的肌肉活动。使用这种自我支持的练习，我们调查了患者的对侧神经系统的招募是否可以重新激活他们的同侧神经回路并刺激功能恢复。我们提出了生物反馈训练与自我支持的运动，肌肉活动是可视化的，以鼓励适当的神经通路激活肌肉的麻痹arm. We开发的生物反馈系统和测试的恢复速度与患者（n & x 003 D;27）2个月。临床试验表明，以自我支持为基础的生物反馈训练使SI提高了约40 & x 0025;，脑卒中损伤评估集（SIAS）提高了约35 & x 0025;，功能独立性测量（FINS）提高了约20 & x 0025;。
Unilateral arm paralysis is a common symptom of stroke. In stroke patients, we observed that self-guided biomechanical support by the nonparetic arm unexpectedly triggered electromyographic activity with normal muscle synergies in the paretic arm. The muscle activities on the paretic arm became similar to the muscle activities on the nonparetic arm with self-supported exercises that were quantified by the similarity index (SI). Electromyogram (EMG) signals and functional near-infrared spectroscopy (fNIRS) of the patients (n & x003D;54) showed that self-supported exercise can have an immediate effect of improving the muscle activities by 40 & x2013;80 & x0025; according to SI quantification, and the muscle activities became much more similar to the muscle activities of the age-matched healthy subjects. Using this self-supported exercise, we investigated whether the recruitment of a patient & x2019;s contralesional nervous system could reactivate their ipsilesional neural circuits and stimulate functional recovery. We proposed biofeedback training with self-supported exercise where the muscle activities were visualized to encourage the appropriate neural pathways for activating the muscles of the paretic arm. We developed the biofeedback system and tested the recovery speed with the patients (n & x003D;27) for 2 months. The clinical tests showed that self-support-based biofeedback training improved SI approximately by 40 & x0025;, Stroke Impairment Assessment Set (SIAS) by 35 & x0025;, and Functional Independence Measure (FIM) by 20 & x0025;.