Modulating and restoring inter-muscular coordination in stroke patients using two-dimensional myoelectric computer interface: a cross-sectional and longitudinal study.
OBJECTIVE
Traditional trainings focus on the improvement of motor function at limb or joint level, while inter-muscular coordination plays an important role in fine motor control and is often ignored. The purpose of this study is to investigate the changes of inter-muscular coordination induced by myoelectric-controlled interface (MCI) and the therapeutic effects of MCI-based inter-muscular coordination training in the stroke patients.


APPROACH
11 stroke patients, 20 young subjects and 13 age-match subjects were recruited to investigate the dimensionality effect of MCI on inter-muscular coordination in evaluation test. A stroke patient participated in 20-day training to test the therapeutic effects as a case study analysis in training test. In both tests, all subjects performed tracking tasks by flexing/extending their elbow according to biofeedback from MCI, and electromyography (EMG) and functional near infrared spectroscopy (fNIRS) were used to simultaneously record the muscle and cortical activations, respectively.


MAIN RESULTS
The significant decreasing activation in antagonist and increasing activation involvement in prefrontal cortex (PFC) and primary motor cortex (M1) were found in all groups with increasing MCI dimensionality. The significant reduction in muscle activation and increase in cortical activation were found in the stroke patient, which was due to a progressive normalization for the patient following training.


SIGNIFICANCE
These findings suggested that two-dimensional MCI should be an effective tool for the stroke patients in directly modulating inter-muscular coordination. Inter-muscular coordination training may restore the ability to coordinate agonist-antagonist muscle for stroke patient and this improvement was accompanied by cortical reorganization.
['Jian|Chuyao|C|', 'Deng|Linchuan|L|', 'Liu|Huihua|H|', 'Yan|Tiebin|T|', 'Wang|Xiaoyun|X|', 'Song|Rong|R|0000-0003-3662-116X']
inter-muscular coordination EMG fNIRS cortical reorganization stroke rehabilitation upper limb