Muscle Activity After Stroke: Perspectives on Deploying Surface Electromyography in Acute Care

Steele, Katherine M.; Papazian, Christina; Feldner, Heather A.

doi:10.3389/fneur.2020.576757

Cited by 15 publications

(8 citation statements)

References 49 publications

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“…Other studies proved that feedback is crucial for therapists; rehabilitation experts think that having information about muscular activation and joint positions could be very useful in assessing a patient’s conditions [ 30 ]. In this sense, surface electromyography sensors can be integrated into the structure of the robot to record the amount of muscular participation of the patients [ 31 ]. Precise position sensors can provide real-time information on the 3D configuration of the arm of the patient.…”

Section: Discussionmentioning

confidence: 99%

Technology Acceptance Model for Exoskeletons for Rehabilitation of the Upper Limbs from Therapists’ Perspectives

Luciani

Braghin

Pedrocchi

et al. 2023

Sensors

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Over the last few years, exoskeletons have been demonstrated to be useful tools for supporting the execution of neuromotor rehabilitation sessions. However, they are still not very present in hospitals. Therapists tend to be wary of this type of technology, thus reducing its acceptability and, therefore, its everyday use in clinical practice. The work presented in this paper investigates a novel point of view that is different from that of patients, which is normally what is considered for similar analyses. Through the realization of a technology acceptance model, we investigate the factors that influence the acceptability level of exoskeletons for rehabilitation of the upper limbs from therapists’ perspectives. We analyzed the data collected from a pool of 55 physiotherapists and physiatrists through the distribution of a questionnaire. Pearson’s correlation and multiple linear regression were used for the analysis. The relations between the variables of interest were also investigated depending on participants’ age and experience with technology. The model built from these data demonstrated that the perceived usefulness of a robotic system, in terms of time and effort savings, was the first factor influencing therapists’ willingness to use it. Physiotherapists’ perception of the importance of interacting with an exoskeleton when carrying out an enhanced therapy session increased if survey participants already had experience with this type of rehabilitation technology, while their distrust and the consideration of others’ opinions decreased. The conclusions drawn from our analyses show that we need to invest in making this technology better known to the public—in terms of education and training—if we aim to make exoskeletons genuinely accepted and usable by therapists. In addition, integrating exoskeletons with multi-sensor feedback systems would help provide comprehensive information about the patients’ condition and progress. This can help overcome the gap that a robot creates between a therapist and the patient’s human body, reducing the fear that specialists have of this technology, and this can demonstrate exoskeletons’ utility, thus increasing their perceived level of usefulness.

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Section: Discussionmentioning

confidence: 99%

Technology Acceptance Model for Exoskeletons for Rehabilitation of the Upper Limbs from Therapists’ Perspectives

Luciani

Braghin

Pedrocchi

et al. 2023

Sensors

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“…Shoulder abduction and finger extension strength can also predict functional recovery within 72 hours after stroke onset (Nijland et al, 2010). Along the same lines, surface electromyography is a noninvasive tool that can help assess neuromuscular changes during stroke rehabilitation, guiding the design of individualised intervention protocols (Steele et al, 2020; Zhu et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Spanish consensus of occupational therapists on upper limb assessment tools in stroke

Madroñero-Miguel

García

2023

British Journal of Occupational Therapy

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Introduction: There is a lack of explicit tool recommendations for upper limb (UL) assessment in stroke, occupational therapists are frequently underrepresented in consensus studies, and the frequency of use of tools is highly variable between countries. The objective was to generate national occupational therapy consensus recommendations on UL assessment tools in stroke, and to classify the tools that achieve consensus according to the International Classification of Functioning, Disability and Health (ICF) components. Methods: Three-round e-Delphi study of national scope. Occupational therapists working in Spain with training and experience in neurorehabilitation were recruited. Rounds were based on the completion of questionnaires on UL stroke assessment tools. Consensus was reached when ⩾75% of experts gave a ⩾7 rating on a nine-point Likert scale. Results: A total of 29 occupational therapists comprised the expert panel. Twenty-three (17.8%) assessment tools achieved consensus and were classified according to the ICF components of body functions and structures (7), activities (11), participation (3) and other (2). Conclusion: The expert panel recommended 23 outcome measures for UL recovery in stroke, representing all ICF components. The consensus recommendations are intended to assist occupational therapists in their clinical decision-making process, and to reduce the heterogeneity of research tools.

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“…Adopting wearable sensors in acute care will ultimately require that these sensors provide unique and valuable insights that are not available with current methods. 41 , 42 Detecting muscle activity alone may be sufficient to address a patient's question of whether or not their muscles are firing or to give therapists a tool to plan and evaluate their training sessions. For example, using EMG during the MMT or other clinical examinations may help patients and clinicians see activity, encourage engagement, and give clinicians confidence in their assessment.…”

Section: Discussionmentioning

confidence: 99%

Electromyography Recordings Detect Muscle Activity Before Observable Contractions in Acute Stroke Care

Papazian

Baicoianu

Peters

et al. 2021

Archives of Rehabilitation Research and Clinical Translation

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Objective To evaluate muscle activity in the arms of adult stroke survivors with limited or no arm movement during acute care. Design Prospective observational study. Setting Acute care regional stroke center. Participants We recruited adults (N=21) who had a stroke within the previous 5 days who were admitted to a level 1 trauma hospital and had a National Institutes of Health Stroke Scale score >1 for arm function at the time of recruitment. A total of 21 adults (13 men, 8 women) with an average age of 60±15 years were recruited an average of 3±1 days after their stroke. Eleven (7 men, 4 women; age, 56±11y) had no observable or palpable arm muscle activity (Manual Muscle Test [MMT]=0) and 10 (6 men, 4 women; age, 64±1y) had detectable activity (MMT>0). Interventions Dual mode sensors (electromyography and accelerometry) were placed on the anterior deltoid, biceps, triceps, wrist extensors, and wrist flexors of the impaired arm. Main Outcome Measures The number of muscle contractions, as well as average duration, amplitude, and co-contraction patterns were evaluated for each participant. Results Muscle contractions were observed in all 5 muscles for all participants using electromyography (EMG) recordings. Contractions were easily identified from 30 minutes of monitoring for participants with an MMT >0, but up to 3 hours of monitoring was required for participants with an MMT=0 to detect contractions in all 5 muscles during standard care. Only the wrist extensors demonstrated significantly larger amplitude contractions for participants with an MMT>0 than those with an MMT=0. Co-contraction was rare, involving less than 10% of contractions. Co-contraction of 2 muscles most commonly aligned with the flexor synergy pattern commonly observed after stroke. For participants with an MMT=0, the number of contractions and maximum amplitude were moderately correlated with MMT scores at follow-up. Conclusions Muscle activity was detected with surface EMG recordings during standard acute care, even for individuals with no observable activity by clinical examination. Wearable sensors may be useful for monitoring early muscle activity and movement after stroke.

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Muscle Activity After Stroke: Perspectives on Deploying Surface Electromyography in Acute Care

Cited by 15 publications

References 49 publications

Technology Acceptance Model for Exoskeletons for Rehabilitation of the Upper Limbs from Therapists’ Perspectives

Technology Acceptance Model for Exoskeletons for Rehabilitation of the Upper Limbs from Therapists’ Perspectives

Spanish consensus of occupational therapists on upper limb assessment tools in stroke

Electromyography Recordings Detect Muscle Activity Before Observable Contractions in Acute Stroke Care

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