Clarification of muscle synergy structure during standing-up motion of healthy young, elderly and post-stroke patients

Yang, Ningjia; An, Qi; Yamakawa, Hiroshi; Tamura, Yusuke; Yamashita, Atsushi; Takahashi, Kouji; Kinomoto, Makoto; Yamasaki, Hiroshi; Itkonen, Matti; Alnajjar, Fady; Shimoda, Shingo; Asama, Hajime; Hattori, Noriaki; Miyai, Ichiro

doi:10.1109/icorr.2017.8009215

Cited by 13 publications

(22 citation statements)

References 11 publications

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“…Eriksrud et al found that knee extension is a strong predictor of independence during STS transfer [37], and Lomaglio et al also showed that both knee extension and ankle dorsiflexion are related to STS performance [38]. In our previous study, it was found that poststroke patients delayed the peak time of synergy 2 and required larger hip and lumbar flexion to move forward compared with healthy controls [39].…”

Section: B Temporal Features Of Muscle Synergymentioning

confidence: 66%

Temporal Features of Muscle Synergies in Sit-to-Stand Motion Reflect the Motor Impairment of Post-Stroke Patients

Yang

Kogami

et al. 2019

IEEE Trans. Neural Syst. Rehabil. Eng.

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Sit-to-stand (STS) motion is an important daily activity, and many post-stroke patients have difficulty performing STS motion. Previous studies found that there are four muscle synergies (synchronized muscle activations) in the STS motion of healthy adults. However, for post-stroke patients, it is unclear whether muscle synergies change and which features primarily reflect motor impairment. Here, we use a machine learning method to demonstrate that temporal features in two muscle synergies that contribute to hip rising and balance maintenance motion reflect the motor impairment of post-stroke patients. Analyzing the muscle synergies of age-matched healthy elderly people (n = 12) and post-stroke patients (n = 33), we found that the same four muscle synergies could account for the muscle activity of post-stroke patients. Also, we were able to distinguish post-stroke patients from healthy people on the basis of the temporal features of these muscle synergies. Furthermore, these temporal features were found to correlate with motor impairment of post-stroke patients. We conclude that poststroke patients can still utilize the same number of muscle synergies as healthy people, but the temporal structure of muscle synergies changes as a result of motor impairment. This could lead to a new rehabilitation strategy for poststroke patients that focuses on activation timing of muscle synergies.

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Section: B Temporal Features Of Muscle Synergymentioning

confidence: 66%

Temporal Features of Muscle Synergies in Sit-to-Stand Motion Reflect the Motor Impairment of Post-Stroke Patients

Yang

Kogami

et al. 2019

IEEE Trans. Neural Syst. Rehabil. Eng.

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“…Similarly, the peak time also seemed to advance toward an earlier time in the motion progress. This reduced lag in peak times, together with the increased peak amplitude in normalized Synergy 2 (for hip raise), may explain the patient's motor recovery since former studies have found that the peak time of Synergy 2 delayed significantly after stroke onset when compared to that of healthy controls (Yang et al, 2017(Yang et al, , 2019. These former studies thereby insisted on teaching the patients the right time to raise their hips.…”

Section: Rehabilitation Of Muscle Synergymentioning

confidence: 95%

Clarify Sit-to-Stand Muscle Synergy and Tension Changes in Subacute Stroke Rehabilitation by Musculoskeletal Modeling

Wang

Yang

et al. 2022

Front. Syst. Neurosci.

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Post-stroke patients exhibit distinct muscle activation electromyography (EMG) features in sit-to-stand (STS) due to motor deficiency. Muscle activation amplitude, related to muscle tension and muscle synergy activation levels, is one of the defining EMG features that reflects post-stroke motor functioning and motor impairment. Although some qualitative findings are available, it is not clear if and how muscle activation amplitude-related biomechanical attributes may quantitatively reflect during subacute stroke rehabilitation. To better enable a longitudinal investigation into a patient's muscle activation changes during rehabilitation or an inter-subject comparison, EMG normalization is usually applied. However, current normalization methods using maximum voluntary contraction (MVC) or within-task peak/mean EMG may not be feasible when MVC cannot be obtained from stroke survivors due to motor paralysis and the subject of comparison is EMG amplitude. Here, focusing on the paretic side, we first propose a novel, joint torque-based normalization method that incorporates musculoskeletal modeling, forward dynamics simulation, and mathematical optimization. Next, upon method validation, we apply it to quantify changes in muscle tension and muscle synergy activation levels in STS motor control units for patients in subacute stroke rehabilitation. The novel method was validated against MVC-normalized EMG data from eight healthy participants, and it retained muscle activation amplitude differences for inter- and intra-subject comparisons. The proposed joint torque-based method was also compared with the common static optimization based on squared muscle activation and showed higher simulation accuracy overall. Serial STS measurements were conducted with four post-stroke patients during their subacute rehabilitation stay (137 ± 22 days) in the hospital. Quantitative results of patients suggest that maximum muscle tension and activation level of muscle synergy temporal patterns may reflect the effectiveness of subacute stroke rehabilitation. A quality comparison between muscle synergies computed with the conventional within-task peak/mean EMG normalization and our proposed method showed that the conventional was prone to activation amplitude overestimation and underestimation. The contributed method and findings help recapitulate and understand the post-stroke motor recovery process, which may facilitate developing more effective rehabilitation strategies for future stroke survivors.

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“…A minimum of six-week repetitive training can induce changes in the white matter to build new or augment existing synergies [ 53 , 106 , 121 ]. In the lower limb, while standing, stroke-affected patients and healthy individuals exhibited common synergies, since the stroke patients shifted the center of mass to maintain balance and their MS were similar to those of a healthy person [ 48 , 122 , 123 ]. In most studies, NNMF (multiplicative method) is used to study the synergies among stroke patients [ 51 , 52 , 107 , 109 ].…”

Section: Ms As a Physiological Marker For Neurorehabilitationmentioning

confidence: 99%

A Systematic Review on Muscle Synergies: From Building Blocks of Motor Behavior to a Neurorehabilitation Tool

Singh

Iqbal

White

et al. 2018

Applied Bionics and Biomechanics

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The central nervous system (CNS) is believed to utilize specific predefined modules, called muscle synergies (MS), to accomplish a motor task. Yet questions persist about how the CNS combines these primitives in different ways to suit the task conditions. The MS hypothesis has been a subject of debate as to whether they originate from neural origins or nonneural constraints. In this review article, we present three aspects related to the MS hypothesis: (1) the experimental and computational evidence in support of the existence of MS, (2) algorithmic approaches for extracting them from surface electromyography (EMG) signals, and (3) the possible role of MS as a neurorehabilitation tool. We note that recent advances in computational neuroscience have utilized the MS hypothesis in motor control and learning. Prospective advances in clinical, medical, and engineering sciences and in fields such as robotics and rehabilitation stand to benefit from a more thorough understanding of MS.

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Clarification of muscle synergy structure during standing-up motion of healthy young, elderly and post-stroke patients

Cited by 13 publications

References 11 publications

Temporal Features of Muscle Synergies in Sit-to-Stand Motion Reflect the Motor Impairment of Post-Stroke Patients

Temporal Features of Muscle Synergies in Sit-to-Stand Motion Reflect the Motor Impairment of Post-Stroke Patients

Clarify Sit-to-Stand Muscle Synergy and Tension Changes in Subacute Stroke Rehabilitation by Musculoskeletal Modeling

A Systematic Review on Muscle Synergies: From Building Blocks of Motor Behavior to a Neurorehabilitation Tool

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