Prediction of Myoelectric Biomarkers in Post-Stroke Gait

Electromyography (EMG) is sensitive to neuromuscular changes resulting from ischemic stroke and is considered a potential predictive tool of post-stroke gait and rehabilitation management. This study aimed to evaluate the potential myoelectric biomarkers for the classification of stroke-impaired muscular activity of the stroke patient group and the muscular activity of the control healthy adult group. We also proposed an EMG-based gait monitoring system consisting of a portable EMG device, cloud-based data processing, data analytics, and a health advisor service. This system was investigated with 48 stroke patients (mean age 70.6 years, 65% male) admitted into the emergency unit of a hospital and 75 healthy elderly volunteers (mean age 76.3 years, 32% male). EMG was recorded during walking using the portable device at two muscle positions: the bicep femoris muscle and the lateral gastrocnemius muscle of both lower limbs. The statistical result showed that the mean power frequency (MNF), median power frequency (MDF), peak power frequency (PKF), and mean power (MNP) of the stroke group differed significantly from those of the healthy control group. In the machine learning analysis, the neural network model showed the highest classification performance (precision: 88%, specificity: 89%, accuracy: 80%) using the training dataset and highest classification performance (precision: 72%, specificity: 74%, accuracy: 65%) using the testing dataset. This study will be helpful to understand stroke-impaired gait changes and decide post-stroke rehabilitation.

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Assessment of an Assistive Control Approach Applied in an Active Knee Orthosis Plus Walker for Post-Stroke Gait Rehabilitation

Sensors ◽

10.3390/s20092452 ◽

2020 ◽

Vol 20 (9) ◽

pp. 2452

Author(s):

Ana Cecilia Villa-Parra ◽

Jessica Lima ◽

Denis Delisle-Rodriguez ◽

Laura Vargas-Valencia ◽

Anselmo Frizera-Neto ◽

...

Keyword(s):

Healthy Subjects ◽

Muscle Activation ◽

Inertial Sensors ◽

Lower Limbs ◽

Trunk Muscles ◽

Control Group ◽

Gait Rehabilitation ◽

Control Approach ◽

Post Stroke ◽

Knee Orthosis

The goal of this study is the assessment of an assistive control approach applied to an active knee orthosis plus a walker for gait rehabilitation. The study evaluates post-stroke patients and healthy subjects (control group) in terms of kinematics, kinetics, and muscle activity. Muscle and gait information of interest were acquired from their lower limbs and trunk, and a comparison was conducted between patients and control group. Signals from plantar pressure, gait phase, and knee angle and torque were acquired during gait, which allowed us to verify that the stance control strategy proposed here was efficient at improving the patients’ gaits (comparing their results to the control group), without the necessity of imposing a fixed knee trajectory. An innovative evaluation of trunk muscles related to the maintenance of dynamic postural equilibrium during gait assisted by our active knee orthosis plus walker was also conducted through inertial sensors. An increase in gait cycle (stance phase) was also observed when comparing the results of this study to our previous work. Regarding the kinematics, the maximum knee torque was lower for patients when compared to the control group, which implies that our orthosis did not demand from the patients a knee torque greater than that for healthy subjects. Through surface electromyography (sEMG) analysis, a significant reduction in trunk muscle activation and fatigability, before and during the use of our orthosis by patients, was also observed. This suggest that our orthosis, together with the assistive control approach proposed here, is promising and could be considered to complement post-stroke patient gait rehabilitation.

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Use of hippotherapy in gait training for hemiparetic post-stroke

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2010000600015 ◽

2010 ◽

Vol 68 (6) ◽

pp. 908-913 ◽

Cited By ~ 38

Author(s):

Fernanda Beinotti ◽

Nilzete Correia ◽

Gustavo Christofoletti ◽

Guilherme Borges

Keyword(s):

Conventional Treatment ◽

Motor Impairment ◽

Gait Training ◽

Berg Balance Scale ◽

Positive Influence ◽

Lower Limbs ◽

Control Group ◽

Post Stroke ◽

Group B ◽

In The Beginning

OBJECTIVE: To evaluate the hippotherapy influence on gait training in post-stroke hemiparetic individuals. METHOD: The study was constituted of 20 individuals divided into two groups. Group A performed the conventional treatment while group B the conventional treatment along with hippotherapy during 16 weeks. The patients were evaluated by using the Functional Ambulation Category Scale, Fugl-Meyer Scale, only the lower limbs and balance sub items, Berg Balance Scale, and functional assessment of gait (cadence) in the beginning and end of the treatment. RESULTS: Significant improvements were observed in the experimental group including motor impairment in lower limbs (p=0.004), balance, over time (p=0.007) but a significant trend between groups (p=0.056). The gait independence, cadence and speed were not significantly in both groups (p=0.93, 0.69 and 0.44). CONCLUSION: Hippotherapy associated with conventional physical therapy demonstrates a positive influence in gait training, besides bringing the patients' gait standard closer to normality than the control group.

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A comparison of mechanical parameters between the counter movement jump and drop jump in Biathletes

Journal of Human Kinetics ◽

10.2478/v10078-012-0064-y ◽

2012 ◽

Vol 34 (1) ◽

pp. 59-68 ◽

Cited By ~ 4

Author(s):

Henryk Król ◽

Władysław Mynarski

Keyword(s):

Vertical Jump ◽

Muscular Activity ◽

Lower Limbs ◽

Drop Jump ◽

Mean Power ◽

Line System ◽

Counter Movement Jump ◽

Drop Jumps ◽

Reaction Forces ◽

Vertical Jumps

AbstractThe main objective of the study was to determine to what degree higher muscular activity, achieved by increasedload in the extension phase (eccentric muscle action) of the vertical jump, affects the efficiency of the vertical jump.Sixteen elite biathletes participated in this investigation. The biathletes performed tests that consisted of five, single“maximal” vertical jumps (counter movement jump - CMJ) and five, single vertical jumps, in which the task was totouch a bar placed over the jumping biathletes (specific task counter movement jump - SCMJ). Then, they performedfive, single drop jumps from an elevation of 0.4m (DJ). Ground reaction forces were registered using the KISTLER9182C force platform. MVJ software was used for signal processing (Król, 1999) and enabling calculations forkinematic and kinetic parameters of the subject’s jump movements (on-line system). The results indicate that onlyheight of the jump (h) and mean power (Pmean) during the takeoff are statistically significant. Both h and Pmean arehigher in the DJ. The results of this study may indicate that elite biathletes are well adapted to eccentric work of thelower limbs, thus reaching greater values of power during the drop jump. These neuromuscular adaptive changes mayallow for a more dynamic and efficient running technique.

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Postural sway following inversion sprain of the ankle

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-81-5-243 ◽

1991 ◽

Vol 81 (5) ◽

pp. 243-247 ◽

Cited By ~ 67

Author(s):

MW Cornwall ◽

P Murrell

Keyword(s):

Ankle Sprain ◽

Postural Sway ◽

Center Of Pressure ◽

Control Group ◽

Mean Power ◽

Mean Power Frequency ◽

Linear Distance ◽

History Of ◽

Power Frequency ◽

The Mean

The single-limb sway of 20 individuals with a history of unilateral inversion ankle sprain was compared to that of a control group of 30 individuals without a history of ankle sprain. Using a force platform to obtain center-of-pressure data, the linear distance traveled (mm) and the mean power frequency, (Hz) of postural sway were calculated for each subject. The results of this study showed that postural sway amplitude was significantly greater in the injured group than in the control group. Contrary to previous investigations, this study indicates that individuals with a history of inversion ankle sprain are less stable in single-limb stance compared to a noninjured control group. This decreased stability is evident as much as 2 years following the injury.

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A Chinese Herbal Medicine, Tokishakuyakusan, Reduces the Worsening of Impairments and Independence after Stroke: A 1-Year Randomized, Controlled Trial

Evidence-based Complementary and Alternative Medicine ◽

10.1093/ecam/nep026 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 14

Author(s):

Hirozo Goto ◽

Nobuhiko Satoh ◽

Yoshinori Hayashi ◽

Hiroaki Hikiami ◽

Yutaka Nagata ◽

...

Keyword(s):

Herbal Medicine ◽

Controlled Trial ◽

Strength Function ◽

Functional Independence ◽

Lower Limbs ◽

Favorable Effect ◽

Control Group ◽

Stroke Patients ◽

Post Stroke ◽

Significant Difference

In post-stroke patients, the recurrence of stroke and progression of impairments lead to a bedridden state and dementia. As for their treatments, only anti-hypertension and anti-coagulation therapies to prevent the recurrence of stroke are available. In Asia, post-stroke patients with impairments are often treated with herbal medicine. The present study evaluated the effectiveness of tokishakuyakusan (TS) in improving the impairment and independence in post-stroke patients. Thirty-one post-stroke patients (mean age = 81.4 years) were recruited and enrolled. Participants were randomly assigned to the TS group (n= 16) or non-treatment (control) group (n= 15) and treated for 12 months. Impairments were assessed using the Stroke Impairment Assessment Set (SIAS). Independence was evaluated using the functional independence measure (FIM). For each outcome measure, mean change was calculated every 3 months. The results were that impairments according to SIAS did not significantly change in the TS group. In contrast, SIAS significantly worsened in the control group. There was a significant difference between the two groups. In each term of SIAS, affected lower extremity scores, abdominal muscle strength, function of visuospatial perception, and so forth. in the TS group were better than those in the control group. Independence according to FIM did not change significantly in the TS group. In contrast, FIM significantly worsened in the control group. There was also a significant difference between the two groups. In conclusion, TS was considered to suppress the impairments of lower limbs and to exert a favorable effect on cerebral function for post-stroke patients.

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Aquatic Therapy for improving Lower Limbs Function in Post-stroke Survivors: A Systematic Review with Meta-Analysis

Topics in Stroke Rehabilitation ◽

10.1080/10749357.2021.1929011 ◽

2021 ◽

pp. 1-17

Author(s):

Mahboubeh Ghayour Najafabadi ◽

Ardalan Shariat ◽

Jan Dommerholt ◽

Azadeh Hakakzadeh ◽

Amin Nakhostin-Ansari ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Lower Limbs ◽

Stroke Survivors ◽

Aquatic Therapy ◽

Post Stroke

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Comparison of the curative effect and prognosis of stereotactic drainage and conservative treatment for moderate and small basal ganglia haemorrhage

BMC Neurology ◽

10.1186/s12883-021-02293-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xin Huang ◽

Lai Jiang ◽

Shaojun Chen ◽

Gang Li ◽

Wanxi Pan ◽

...

Keyword(s):

Basal Ganglia ◽

Large Scale ◽

Neurological Function ◽

Lower Limbs ◽

Control Group ◽

Roc Curve Analysis ◽

Curative Effect ◽

Nihss Score ◽

Haematoma Volume ◽

Experimental Group

Abstract Background Minimally invasive surgery has achieved good results in the treatment of cerebral haemorrhage.However, no large-scale clinical study has demonstrated that surgical treatment of cerebral haemorrhages less than 30 ml can improve the curative effect. Our study explored the efficacy and complication of stereotactic drainage based on the amount of cerebral hemorrhage (15-30 ml) in hypertensive basal ganglia. Method Sixty patients with hypertensive basal ganglia haemorrhages were divided into a control group and an experimental group with 30 patients in each group. Patients in the control group were treated conservatively. In contrast, those in the experimental group received stereotactic drainage, and urokinase was injected into the haematoma cavity after the operation. The haematoma volume at admission and 1, 3, 7 and 30 days after treatment and National Institute of Health stroke scale(NIHSS) score data were recorded. Complications after treatment in the two groups of data were compared and analysed. Result No significant differences in age, sex, time of treatment after onset, admission blood pressure, admission haematoma volume or admission NIHSS score were noted between these two groups (P > 0.05). After treatment, significant differences in haematoma volume were noted between the two groups on the 1st, 3rd, 7th and 30th days after treatment (P < 0.05). The amount of hematoma of patients in the experimental group was significantly reduced compared with that in the control group, and the NIHSS scores were significantly different on the 3rd, 7th and 30th days after treatment. The neurological deficit scores of patients in the experimental group were significantly reduced compared with those in the control group, and the incidence of pulmonary infection and venous thrombosis in the lower limbs of patients in the experimental group were significantly reduced (P < 0.05). ROC curve analysis showed that stereotactic drainage affected the early neurological function of patients with small and medium basal ganglia haemorrhages. Conclusion For patients with small and medium basal ganglia haemorrhages, stereotactic drainage can be used due to the faster drainage speed of haematomas after operation, which is beneficial to the recovery of neurological function and reduce complications.

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Feasibility of a specific task-oriented training versus its combination with manual therapy on balance and mobility in people post stroke at the chronic stage: study protocol for a pilot randomised controlled trial

Pilot and Feasibility Studies ◽

10.1186/s40814-021-00886-0 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Kristina Traxler ◽

Franz Schinabeck ◽

Eva Baum ◽

Edith Klotz ◽

Barbara Seebacher

Keyword(s):

Randomised Controlled Trial ◽

Ankle Joint ◽

Manual Therapy ◽

Controlled Trial ◽

Daily Activities ◽

Control Group ◽

Chronic Stage ◽

Post Stroke ◽

Randomised Controlled ◽

Task Oriented

Abstract Background Large studies have shown that stroke is among the most relevant causes of acquired adult disability. Walking and balance impairment in stroke survivors often contribute to a restriction in daily activities and social participation. Task-oriented training (TOT) is an effective treatment strategy and manual therapy (MT) is used successfully to enhance ankle joint flexibility in this population. No study, however, has compared TOT against its combination with MT in a randomised controlled trial. Aims of this pilot study are therefore to explore the feasibility of a full-scale RCT using predefined feasibility criteria. Secondary aims are to explore the preliminary effects of specific TOT with a combined specific TOT-MT versus a control group in people post stroke. Methods This is a protocol of a 4-week prospective randomised controlled parallel pilot trial in people post stroke at the chronic stage with limited upper ankle joint mobility and an impairment in balance and mobility. At a German outpatient therapy centre using 1:1:1 allocation, 36 patients will be randomised into one of three groups: 15-min talocrural joint MT plus 30-min specific TOT (group A), 45-min specific TOT (group B), and controls (group C). Training will be goal-oriented including tasks that are based on daily activities and increased in difficulty utilising predefined progression criteria based on patients’ skill levels. Interventions will be provided face-to-face 2 times per week, for 4 weeks, in addition to 20-min concurrent x4 weekly home-based training sessions. Data will be collected by blinded assessors at baseline, post-intervention and 4-week follow-up. The primary outcome will be feasibility assessed by recruitment, retention and adherence rates, compliance, adverse events, falls and the acceptability of the intervention. Secondary outcomes will be walking speed, single and dual tasking functional mobility, ankle range of motion, disability and health-related quality of life. Discussion Feasibility provided, results from this study will be used to calculate the sample size of a larger randomised controlled trial to investigate the effects of specific TOT and specific TOT-MT compared to a post stroke control group. Trial registration German Clinical Trials Register, DRKS00023068. Registered on 21.09.2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023068.

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Motor disability in patients with multiple sclerosis: transcranial magnetic stimulation study

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-020-00255-3 ◽

2020 ◽

Vol 56 (1) ◽

Author(s):

Anssam Bassem Mohy ◽

Aqeel Kareem Hatem ◽

Hussein Ghani Kadoori ◽

Farqad Bader Hamdan

Keyword(s):

Transcranial Magnetic Stimulation ◽

Lower Limb ◽

Magnetic Stimulation ◽

Motor Evoked Potential ◽

Invasive Procedure ◽

Single Pulse ◽

Lower Limbs ◽

Control Group ◽

Conduction Time ◽

Motor Disability

Abstract Background Transcranial magnetic stimulation (TMS) is a non-invasive procedure used in a small targeted region of the brain via electromagnetic induction and used diagnostically to measure the connection between the central nervous system (CNS) and skeletal muscle to evaluate the damage that occurs in MS. Objectives The study aims to investigate whether single-pulse TMS measures differ between patients with MS and healthy controls and to consider if these measures are associated with clinical disability. Patients and methods Single-pulse TMS was performed in 26 patients with MS who hand an Expanded Disability Status Scale (EDSS) score between 0 and 9.5 and in 26 normal subjects. Different TMS parameters from upper and lower limbs were investigated. Results TMS disclosed no difference in all MEP parameters between the right and left side of the upper and lower limbs in patients with MS and controls. In all patients, TMS parameters were different from the control group. Upper limb central motor conduction time (CMCT) was prolonged in MS patients with pyramidal signs. Upper and lower limb CMCT and CMCT-f wave (CMCT-f) were prolonged in patients with ataxia. Moreover, CMCT and CMCT-f were prolonged in MS patients with EDSS of 5–9.5 as compared to those with a score of 0–4.5. EDSS correlated with upper and lower limb cortical latency (CL), CMCT, and CMCT-f whereas motor evoked potential (MEP) amplitude not. Conclusion TMS yields objective data to evaluate clinical disability and its parameters correlated well with EDSS.

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Potential Effects of a Modified Mediterranean Diet on Body Composition in Lipoedema

Nutrients ◽

10.3390/nu13020358 ◽

2021 ◽

Vol 13 (2) ◽

pp. 358

Author(s):

Laura Di Renzo ◽

Giulia Cinelli ◽

Lorenzo Romano ◽

Samanta Zomparelli ◽

Gemma Lou De Santis ◽

...

Keyword(s):

Body Composition ◽

Mediterranean Diet ◽

Diet Therapy ◽

Lower Limbs ◽

Control Group ◽

Quality Of Life Scale ◽

Life Scale ◽

Daily Physical Activities ◽

Subcutaneous Adipose

Lipoedema is a subcutaneous adipose tissue disease characterized by the increase in the amount and structure of fat mass (FM) in specific areas, causing pain and discomfort. 95% of patients fail to lose weight in the lipoedema areas. The study was conducted to evaluate body composition and general health status modification in a group of lipoedema patients (LIPPY) and a control group (CTRL) after four weeks of a modified Mediterranean diet therapy (mMeD). A total of 29 subjects were included in the data analysis, divided in two groups: 14 LIPPY and 15 CTRL. After the mMeD, both groups significantly decreased their weight and body mass index; the CTRL also showed a reduction of all the circumferences and all FM’s compartments. LIPPY showed a decrease of FM in upper and lower limbs. No significant differences in Δ% between the groups were observed for the lean mass (LM). In LIPPY, an increase in the patients’ ability to perform various daily physical activities related to the loss of arms’ and legs’ fat was observed. According to the European Quality of Life scale, the possibility for LIPPY subjects to perform simple daily activities with less fatigue, pain and anxiety is highlighted. Further long-term studies are recommended to confirm the mMeD as a good strategy for Lipoedema treatment.

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