Evidence for improved muscle activation patterns after retraining of reaching movements with the MIME robotic system in subjects with post-stroke hemiparesis
Evidence for improved muscle activation patterns after retraining of reaching movements with the MIME robotic system in subjects with post-stroke hemiparesis
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DOI：
10.1109/tnsre.2004.827225
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发表时间：
2004-06-01
影响因子：
4.9
通讯作者：
Shor, PC
中科院分区：
文献类型：
--
作者：
Lum, PS;Burgar, CG;Shor, PC
此前，我们报道过，慢性中风受试者在镜像运动启动器 (MIME) 机器人设备中进行训练后，在等距力量、自由伸展范围和临床功能评估方面都有显着改善。我们在这项分析中的主要目标是调查机器人训练促进改善肌肉激活模式的假设。为此，我们检查了在主动约束模式下训练八种不同运动模式时记录的相互作用力、运动学和肌电图。在这种模式下，机器人将到达运动限制为朝向目标，并且运动速度与沿轨迹产生的力成正比。 13 名慢性中风受试者在八周内接受了 24 次为期 1 小时的 MIME 培训。第五周时，所有八种运动模式的工作输出均显着增加。低级别受试者增加了他们的范围，而高级别受试者则增加了他们的速度。八种运动模式中的六种减少了力量产生的方向错误。肌电图数据。提供了从桌面水平开始到肩部水平结束的四种运动模式中改善肌肉激活模式的证据。相比之下，没有证据表明任何桌面运动中的肌肉激活模式有所改善，并且两种运动模式中拮抗肌的激活有所增加。这种二分法可能与保持在桌面水平的运动期间肩带的补偿有关。将引入一个简单的生物力学模型来证明这种可能性的可能性。
Previously, we reported that chronic stroke subjects had significant improvements in isometric strength, free reaching extent, and clinical evaluations of function after training in the mirror-image movement enabler (MIME) robotic device. Our primary goal in this analysis was to investigate the hypothesis that the robotic training promoted improved muscle activation patterns. To this end, we examined the interaction forces, kinematics, and electromyograms recorded during training of eight different movement patterns in active-constrained mode. In this mode, the robot constrained the reaching movements to be toward the target, and the movement velocity was proportional to the force produced along the trajectory. Thirteen chronic stroke subjects trained in MIME for 24 1-h sessions over an eight-week period. Work output was significantly increased by week five in all eight movement patterns. Low-level subjects increased their extent of reach, while high-level subjects increased their speed. Directional errors in force production were reduced in six of eight movement patterns. Electromyographic data. provided evidence for improved muscle activation patterns in the four movement patterns that started at tabletop level and ended at shoulder level. In contrast, there was no evidence of improved muscle activation patterns in any of the tabletop movements, with increased activation of antagonists in two movement patterns. This dichotomy may have been related to compensation at the shoulder girdle during movements that remained at tabletop level. A simple biomechanical model will be introduced to demonstrate the likelihood of this possibility.