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从坐到站运动中的肌肉协同的时变特征反映了脑卒中患者的运动障碍。

Temporal Features of Muscle Synergies in Sit-to-Stand Motion Reflect the Motor Impairment of Post-Stroke Patients.

出版信息

IEEE Trans Neural Syst Rehabil Eng. 2019 Oct;27(10):2118-2127. doi: 10.1109/TNSRE.2019.2939193. Epub 2019 Sep 4.

Abstract

Sit-to-stand (STS) motion is an important daily activity, and many post-stroke patients have difficulty performing STS motion. Previous studies found that there are four muscle synergies (synchronized muscle activations) in the STS motion of healthy adults. However, for post-stroke patients, it is unclear whether muscle synergies change and which features primarily reflect motor impairment. Here, we use a machine learning method to demonstrate that temporal features in two muscle synergies that contribute to hip rising and balance maintenance motion reflect the motor impairment of post-stroke patients. Analyzing the muscle synergies of age-matched healthy elderly people ( n = 12 ) and post-stroke patients ( n = 33 ), we found that the same four muscle synergies could account for the muscle activity of post-stroke patients. Also, we were able to distinguish post-stroke patients from healthy people on the basis of the temporal features of these muscle synergies. Furthermore, these temporal features were found to correlate with motor impairment of post-stroke patients. We conclude that post-stroke patients can still utilize the same number of muscle synergies as healthy people, but the temporal structure of muscle synergies changes as a result of motor impairment. This could lead to a new rehabilitation strategy for post-stroke patients that focuses on activation timing of muscle synergies.

摘要

从坐到站(STS)运动是一项重要的日常活动,许多脑卒中后患者难以完成 STS 运动。先前的研究发现,健康成年人的 STS 运动中有四种肌肉协同作用(同步肌肉激活)。然而,对于脑卒中后患者,肌肉协同作用是否发生变化以及哪些特征主要反映运动障碍尚不清楚。在这里,我们使用机器学习方法证明,两个肌肉协同作用中的时间特征有助于髋关节上升和平衡维持运动,反映了脑卒中后患者的运动障碍。通过分析年龄匹配的健康老年人(n=12)和脑卒中后患者(n=33)的肌肉协同作用,我们发现相同的四个肌肉协同作用可以解释脑卒中后患者的肌肉活动。此外,我们能够根据这些肌肉协同作用的时间特征将脑卒中后患者与健康人区分开来。此外,这些时间特征与脑卒中后患者的运动障碍相关。我们的结论是,脑卒中后患者仍然可以像健康人一样使用相同数量的肌肉协同作用,但由于运动障碍,肌肉协同作用的时间结构发生了变化。这可能为脑卒中后患者的康复策略提供新的思路,即专注于肌肉协同作用的激活时间。

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