Effect of Physical Therapy on Muscle Synergy Structure During Standing-Up Motion of Hemiplegic Patients

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

doi:10.1109/lra.2018.2811050

Cited by 27 publications

(15 citation statements)

References 19 publications

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“…Another study about the longitudinal changes in upper limb muscle synergies of stroke survivors showed the changes in the number of muscle synergies and the recruitment of muscles during the therapy (Hesam-Shariati et al, 2017 ). And proper intervention such as physical therapy on the standing-up motion of stroke survivors have been proved to improve the disordered and inadequate muscle synergy structure (Kogami et al, 2018 ). Furthermore, Cheung et al ( 2012 ) observed that distinct muscle organization patterns such as merging, preservation, and fractionation of muscle synergies occurred after cortical damage.…”

Section: Introductionmentioning

confidence: 99%

Alterations of Muscle Synergies During Voluntary Arm Reaching Movement in Subacute Stroke Survivors at Different Levels of Impairment

Pan

Sun

Xie

et al. 2018

Front. Comput. Neurosci.

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Motor system uses muscle synergies as a modular organization to simplify the control of movements. Motor cortical impairments, such as stroke and spinal cord injuries, disrupt the orchestration of the muscle synergies and result in abnormal movements. In this paper, the alterations of muscle synergies in subacute stroke survivors were examined during the voluntary reaching movement. We collected electromyographic (EMG) data from 35 stroke survivors, ranging from Brunnstrom Stage III to VI, and 25 age-matched control subjects. Muscle synergies were extracted from the activity of 7 upper-limb muscles via nonnegative matrix factorization under the criterion of 95% variance accounted for. By comparing the structure of muscle synergies and the similarity of activation coefficients across groups, we can validate the increasing activation of pectoralis major muscle and the decreasing activation of elbow extensor of triceps in stroke groups. Furthermore, the similarity of muscle synergies was significantly correlated with the Brunnstrom Stage (R = 0.52, p < 0.01). The synergies of stroke survivors at Brunnstrom Stage IV–III gradually diverged from those of control group, but the activation coefficients remained the same after stroke, irrespective of the recovery level.

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Section: Introductionmentioning

confidence: 99%

Alterations of Muscle Synergies During Voluntary Arm Reaching Movement in Subacute Stroke Survivors at Different Levels of Impairment

Pan

Sun

Xie

et al. 2018

Front. Comput. Neurosci.

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“…For example, in gait rehabilitation of impaired lower limbs, the restoration of local neural circuits in the impaired leg with self-supported supervision from the healthy leg may be an effective approach to restore primitive walking patterns. Traditional treatments by well-trained therapists [63], [64] that stimulate sensory receptors such as muscle spindles could share the same recovery mechanism as self-support training, because such therapies tend to increase the activation levels of local neural pathways. A detailed analysis of mirror movements after stroke [65] suggests that the activation of subcortical circuits must be compatible with the mid-level reflex loop during self-supported exercise, as an important common factor for recovery after stroke.…”

Section: Discussionmentioning

confidence: 99%

Self-Support Biofeedback Training for Recovery From Motor Impairment After Stroke

Alnajjar¹,

Itkonen²,

Yamasaki³

et al. 2020

IEEE Access

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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=54) showed that self-supported exercise can have an immediate effect of improving the muscle activities by 40-80% 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'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=27) for 2 months. The clinical tests showed that self-support-based biofeedback training improved SI approximately by 40%, Stroke Impairment Assessment Set (SIAS) by 35%, and Functional Independence Measure (FIM) by 20%. INDEX TERMS Stroke rehabilitation, muscle synergy, brain imagining, biofeedback training.

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“…In our protocol, we tried to avoid/reduce muscle fatigue; although this might not be fully possible, especially in the case of more demanding scenarios (e.g., during repetitive training tasks for poststroke treatment), it should be noted that muscle fatigue reduces strength and increases perceived effort, as observed in joint kinematics and movement complexity analyses in healthy individuals [54]. However, these changes due to muscle fatigue do not reflect alterations in the overall principal component shape [55, 56]. In contrast, our results are in agreement with prior results by Simkins et al [57], demonstrating that differences between joint movements in pathological conditions are comparable to the differences observed for able-bodied movement synergies, further supporting the hypothesis that altered synergies upon neurological injury are an expression of similar spinal mechanisms, as those regulating intact synergies in multijoint movements.…”

Section: Discussionmentioning

confidence: 99%

Motor Control System for Adaptation of Healthy Individuals and Recovery of Poststroke Patients: A Case Study on Muscle Synergies

et al. 2019

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Understanding the complex neuromuscular strategies underlying behavioral adaptation in healthy individuals and motor recovery after brain damage is essential for gaining fundamental knowledge on the motor control system. Relying on the concept of muscle synergy, which indicates the number of coordinated muscles needed to accomplish specific movements, we investigated behavioral adaptation in nine healthy participants who were introduced to a familiar environment and unfamiliar environment. We then compared the resulting computed muscle synergies with those observed in 10 moderate-stroke survivors throughout an 11-week motor recovery period. Our results revealed that computed muscle synergy characteristics changed after healthy participants were introduced to the unfamiliar environment, compared with those initially observed in the familiar environment, and exhibited an increased neural response to unpredictable inputs. The altered neural activities dramatically adjusted through behavior training to suit the unfamiliar environment requirements. Interestingly, we observed similar neuromuscular behaviors in patients with moderate stroke during the follow-up period of their motor recovery. This similarity suggests that the underlying neuromuscular strategies for adapting to an unfamiliar environment are comparable to those used for the recovery of motor function after stroke. Both mechanisms can be considered as a recall of neural pathways derived from preexisting muscle synergies, already encoded by the brain’s internal model. Our results provide further insight on the fundamental principles of motor control and thus can guide the future development of poststroke therapies.

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Effect of Physical Therapy on Muscle Synergy Structure During Standing-Up Motion of Hemiplegic Patients

Cited by 27 publications

References 19 publications

Alterations of Muscle Synergies During Voluntary Arm Reaching Movement in Subacute Stroke Survivors at Different Levels of Impairment

Alterations of Muscle Synergies During Voluntary Arm Reaching Movement in Subacute Stroke Survivors at Different Levels of Impairment

Self-Support Biofeedback Training for Recovery From Motor Impairment After Stroke

Motor Control System for Adaptation of Healthy Individuals and Recovery of Poststroke Patients: A Case Study on Muscle Synergies

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