Faculty of Frontier Engineering, Institute of Science and Engineering, Kanazawa University, Kanazawa, Ishikawa, 920-1192, Japan.
Laboratory of Neuromuscular Biomechanics, School of Health and Sports Sciences, Chukyo University, Nagoya, Aichi, 470-0393, Japan.
F1000Res. 2021 Mar 16;10:214. doi: 10.12688/f1000research.50951.2. eCollection 2021.
Despite the potential benefits, the effects of Hybrid Assistive Limb (HAL) gait training on changes in neuromuscular activation that accompany functional gains in individuals with spinal muscular atrophy (SMA) type III is not well known. In this article, we quantify the effects of HAL gait training on spatial muscle activity patterns in a patient with SMA type III using multi-channel surface electromyography (SEMG). A 21-years old male (168 cm, 47.8 kg) with spinal muscular atrophy type III, when diagnosed at 18-years old by genetic screening, participated in this case study. Although he presented with forearm distal muscle weakness, atrophy of the intrinsic muscles of the hand, and neuromuscular fatigue, his activities of daily living is independent. The patient underwent a separate, single 33-minute session of both HAL and treadmill gait training. To evaluate the coefficient of variation (CoV) of force and alterations in the SEMG spatial distribution patterns, modified entropy and CoV of root mean square (RMS) were calculated from the vastus lateralis (VL) muscle before and after the intervention of HAL and treadmill gait training. Each training session was separated by a period of one month to avoid cross-over effects. There was a greater decrease in the ΔCoV of force and an increase in the magnitude of whole VL muscle activation from pre-intervention to post-intervention with the HAL gait training as compared to the treadmill gait training. In response to only HAL gait training, the CoV of RMS was higher, and the modified entropy was lower post-intervention than pre-intervention. Our results support the notion that HAL gait training has a positive benefit on motor output not only in the magnitude of SEMG generated but also the patterns of neural activation.
尽管有潜在的益处，但混合辅助肢体（HAL）步态训练对脊髓性肌萎缩症（SMA）III 型患者功能增益伴随的神经肌肉激活变化的影响尚不清楚。在本文中，我们使用多通道表面肌电图（SEMG）定量研究了 HAL 步态训练对 SMA III 型患者空间肌肉活动模式的影响。一名 21 岁的男性（168cm，47.8kg），通过基因筛查在 18 岁时被诊断为 III 型 SMA，参与了这项病例研究。尽管他表现出前臂远端肌肉无力、手部内在肌肉萎缩和神经肌肉疲劳，但他的日常生活活动是独立的。患者接受了单独的、单次 33 分钟的 HAL 和跑步机步态训练。为了评估力的变异系数（CoV）和 SEMG 空间分布模式的变化，在 HAL 和跑步机步态训练前后，从股外侧肌（VL）计算了修改后的熵和 RMS CoV。每次训练间隔一个月，以避免交叉影响。与跑步机步态训练相比，HAL 步态训练后力的ΔCoV 降低更大，整个 VL 肌肉激活幅度增加。与跑步机步态训练相比，仅 HAL 步态训练后，RMS CoV 更高，修改后的熵更低。我们的结果支持这样一种观点，即 HAL 步态训练不仅对 SEMG 产生的幅度，而且对神经激活模式都有积极的益处。
