Differences in Muscle Synergy Symmetry Between Subacute Post-stroke Patients With Bioelectrically-Controlled Exoskeleton Gait Training and Conventional Gait Training

Tan, Chun Kwang; Kadone, Hideki; Watanabe, Hiroki; Marushima, Aiki; Hada, Yasushi; Yamazaki, Masashi; Sankai, Yoshiyuki; Matsumura, Akira; Suzuki, Kenji

doi:10.3389/fbioe.2020.00770

Cited by 26 publications

(29 citation statements)

References 44 publications

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“…It is thought that such repeated gait movements improve the motor and walking functions of paralyzed lower limbs. Previous studies have also reported improved coordination of paralyzed lower limbs and improved muscle activity patterns after HAL treatment [30][31][32] . Thus, HAL treatment is a method that restores the function of paralyzed lower limbs and aims for more physiologically efficient walking, which is different from compensatory walking (compensation for the non-paralyzed lower limbs).…”

Section: Discussionmentioning

confidence: 73%

“…However, few comparisons with the control group and many unclear points about the effectiveness of HAL have remained unresolved 29) . Indeed, many of them use clinical evaluation indexes, such as independence walking, MWS or CWS, and activities of daily living; however, in recent years, clinical trials have evaluated HAL treatment from various aspects, such as muscle activity, motion analysis, and brain activity 17,[30][31][32][33] .…”

Section: Discussionmentioning

confidence: 99%

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Effect of hybrid assistive limb treatment on maximal walking speed and six-minute walking distance during stroke rehabilitation: a pilot study

2021

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In stroke rehabilitation, gait assessment measures the maximal walking speed and six-minute walking distance, both of which have not been thoroughly investigated as determinants of walking ability. Here, we assessed the methods for evaluating these gait parameters using clinical data on hybrid assistive limb treatment compared with conventional training. [Participants and Methods] In total, 20 stroke patients (hybrid assistive limb group, n=9; conventional group, n=11) participated in this randomized controlled trial. For 12 sessions (three times per week in 4 weeks), the hybrid assistive limb and conventional groups performed gait treatment with hybrid assistive limb and conventional gait training, respectively. Short physical performance battery and walking ability (maximal walking speed and six-minute walking distance) were evaluated pre-and post-intervention. Subsequently, the patients were divided further into two groups: low-and high-balance score groups. [Results] Maximum walking speed and six-minute walking distance were significantly associated, with a positive relationship observed postintervention. The high-balance score group showed a significant improvement in the six-minute walking distance compared to the low-balance score group. However, no significant improvement in maximum walking speed was observed between both groups. [Conclusion] Due to its sensitivity in detecting differences in balance, six-minute walking distance may be a useful assessment parameter for stroke rehabilitation, particularly in the recovery of physiological walking ability.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Effect of hybrid assistive limb treatment on maximal walking speed and six-minute walking distance during stroke rehabilitation: a pilot study

2021

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“…Muscle synergy analysis has recently been applied to detect changes in the nervous system underlying the functional improvement achieved during rehabilitation after a stroke. [21][22][23][24] Muscle synergy is a hypothesis for the management of the redundancy issue in multi-joint movement, 25) and the physiological validity and robustness of muscle synergy analysis based on this hypothesis have been verified in previous studies. 26,27) Compared with previous EMG studies, which compare individual muscle activity patterns, muscle synergy analysis is able to provide a comprehensive assessment of movement coordination.…”

Section: Outcome Measurementmentioning

confidence: 80%

Gait Training after Stroke with a Wearable Robotic Device: A Case Report of Further Improvements in Walking Ability after a Recovery Plateau

Ishibashi

Yoshikawa

Koseki

et al. 2021

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Background: Conventional rehabilitation is known to improve walking ability after stoke, but its effectiveness is often limited. Recent studies have shown that gait training combining conventional rehabilitation and robotic devices in stroke patients provides better results than conventional rehabilitation alone, suggesting that gait training with a robotic device may lead to further improvements in the walking ability recovered by conventional rehabilitation. Therefore, the aim of this report was to highlight the changes in kinematic and electromyographic data recorded during walking before and after gait training with the Honda Walking Assist Device ® (HWAT) in a male patient whose walking speed had reached a recovery plateau under conventional rehabilitation. Case: The patient was a 42-year-old man with severe hemiplegia caused by right putaminal hemorrhage. He underwent conventional rehabilitation for 20 weeks following the onset of stroke, after which his walking speed reached a recovery plateau. Subsequently, we added robotic rehabilitation using HWAT to his regular rehabilitation regimen, which resulted in improved step length symmetry and gait endurance. We also noted changes in muscle activity patterns during walking. Discussion: HWAT further improved the walking ability of a patient who had recovered with conventional rehabilitation; this improvement was accompanied by changes in muscle activity patterns during walking. The improvement in gait endurance exceeded the smallest meaningful change in stroke patients, suggesting that this improvement represented a noticeable enhancement in the quality of life in relation to mobility in the community. Further clinical trials are needed to confirm the results of the present case study.

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“…We know that the CNS recruits these muscle synergies, which represent motor modules, to perform biomechanical tasks necessary for movement. For example, stroke patients exhibit differences in the number of muscle synergies, which may reflect disturbances in neural pathways and are related to deficits in motor function [29,33].…”

Section: Changes In the Number Of Muscle Synergies (Modular Organization)mentioning

confidence: 99%

A Perspective on Muscle Synergies and Different Theories Related to Their Adaptation

et al. 2021

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The human motor system is a complex neuro-musculo sensory system that needs further investigations of neuro-muscular commands and sensory-motor coupling to decode movement execution. Some researchers suggest that the central nervous system (CNS) activates a small set of modules termed muscle synergies to simplify motor control. Further, these modules form functional building blocks of movement as they can explain the neurophysiological characteristics of movements. We can identify and extract these muscle synergies from electromyographic signals (EMG) recorded in the laboratory by using linear decomposition algorithms, such as principal component analysis (PCA) and non-Negative Matrix Factorization Algorithm (NNMF). For the past three decades, the hypothesis of muscle synergies has received considerable attention as we attempt to understand and apply the concept of muscle synergies in clinical settings and rehabilitation. In this article, we first explore the concept of muscle synergies. We then present different strategies of adaptation in these synergies that the CNS employs to accomplish a movement goal.

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Differences in Muscle Synergy Symmetry Between Subacute Post-stroke Patients With Bioelectrically-Controlled Exoskeleton Gait Training and Conventional Gait Training

Cited by 26 publications

References 44 publications

Effect of hybrid assistive limb treatment on maximal walking speed and six-minute walking distance during stroke rehabilitation: a pilot study

Effect of hybrid assistive limb treatment on maximal walking speed and six-minute walking distance during stroke rehabilitation: a pilot study

Gait Training after Stroke with a Wearable Robotic Device: A Case Report of Further Improvements in Walking Ability after a Recovery Plateau

A Perspective on Muscle Synergies and Different Theories Related to Their Adaptation

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