Article

An electromyography-driven robot system integrated with neuromuscular
electrical stimulation (NMES) was developed to investigate its effectiveness on
post-stroke rehabilitation. METHODS: The performance of this system in assisting
finger flexion/extension with different assistance combinations was evaluated in
five stroke subjects. Then, a pilot study with 20-sessions training was conducted
to evaluate the training's effectiveness.
RESULTS: The results showed that
combined assistance from the NMES-robot could improve finger movement accuracy,
encourage muscle activation of the finger muscles and suppress excessive muscular
activities in the elbow joint. When assistances from both NMES and the robot were
50% of their maximum assistances, finger-tracking performance had the best
results, with the lowest root mean square error, greater range of motion, higher
voluntary muscle activations of the finger joints and lower muscle co-contraction
in the finger and elbow joints. Upper limb function improved after the 20-session
training, indicated by the increased clinical scores of Fugl-Meyer Assessment,
Action Research Arm Test and Wolf Motor Function Test. Muscle co-contraction was
reduced in the finger and elbow joints reflected by the Modified Ashworth Scale.
CONCLUSIONS: The findings demonstrated that an electromyography-driven NMES-robot
used for chronic stroke improved hand function and tracking performance. Further
research is warranted to validate the method on a larger scale. Implications for
Rehabilitation The hand robotics and neuromuscular electrical stimulation (NMES)
techniques are still separate systems in current post-stroke hand rehabilitation.
This is the first study to investigate the combined effects of the NMES and robot
on hand rehabilitation. The finger tracking performance was improved with the
combined assistance from the EMG-driven NMES-robot hand system. The assistance
from the robot could improve the finger movement accuracy and the assistance from
the NMES could reduce the muscle co-contraction on finger and elbow joints. The
upper limb functions were improved on chronic stroke patients after the pilot
study of 20-session hand training with the combined assistance from the
EMG-driven NMES-robot. The muscle spasticity on finger and elbow joints was
reduced after the training.

Langue : ANGLAIS