Myoelectric Computer Interface Training for Reducing Co-Activation and Enhancing Arm Movement in Chronic Stroke Survivors: A Randomized Trial
Myoelectric Computer Interface Training for Reducing Co-Activation and Enhancing Arm Movement in Chronic Stroke Survivors: A Randomized Trial
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DOI：
10.1177/1545968319834903
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发表时间：
2019-04-01
影响因子：
4.2
通讯作者：
Slutzky, Marc W.
中科院分区：
文献类型：
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作者：
Mugler, Emily M.;Tomic, Goran;Slutzky, Marc W.
背景。异常的肌肉共激活会导致中风后的损伤。我们开发了肌电计算机接口（MyoCI）训练范例来减少异常的共激活。 MyoCI 提供有关肌肉激活模式的直观反馈，从而实现这些肌肉的解耦。客观的。旨在研究 3 对肌肉的 MyoCI 训练对中风后手臂运动恢复的耐受性和影响，包括训练剂量和等长训练与基于运动的训练的影响。方法。我们将患有中度至重度手臂损伤的慢性中风幸存者随机分为 3 组。两组在 6 周内测试了不同剂量的等长 MyoCI（60 分钟与 90 分钟），一组在没有手臂约束的情况下测试了 MyoCI（90 分钟）。主要结果是手臂损伤（Fugl-Meyer 评估）。次要结果包括第 6 周和第 10 周时的功能、痉挛和肘部活动范围。 结果。在所有 32 名受试者中，第 6 周和第 10 周时，3 对肌肉的 MyoCI 训练使损伤（Fugl-Meyer 评估）分别显着减少了 3.3 +/- 0.6 和 3.1 +/- 0.7 (P < 10(-4))。每组均较基线有显着改善；组间没有观察到显着差异。参与者的实验室和家庭功能在第 6 周和第 10 周也有所改善 (P
Background. Abnormal muscle co-activation contributes to impairment after stroke. We developed a myoelectric computer interface (MyoCI) training paradigm to reduce abnormal co-activation. MyoCI provides intuitive feedback about muscle activation patterns, enabling decoupling of these muscles. Objective. To investigate tolerability and effects of MyoCI training of 3 muscle pairs on arm motor recovery after stroke, including effects of training dose and isometric versus movement-based training. Methods. We randomized chronic stroke survivors with moderate-to-severe arm impairment to 3 groups. Two groups tested different doses of isometric MyoCI (60 vs 90 minutes), and one group tested MyoCI without arm restraint (90 minutes), over 6 weeks. Primary outcome was arm impairment (Fugl-Meyer Assessment). Secondary outcomes included function, spasticity, and elbow range-of-motion at weeks 6 and 10. Results. Over all 32 subjects, MyoCI training of 3 muscle pairs significantly reduced impairment (Fugl-Meyer Assessment) by 3.3 +/- 0.6 and 3.1 +/- 0.7 (P < 10(-4)) at weeks 6 and 10, respectively. Each group improved significantly from baseline; no significant differences were seen between groups. Participants' lab-based and home-based function also improved at weeks 6 and 10 (P