Annu Int Conf IEEE Eng Med Biol Soc. 2022 Jul;2022:5144-5147. doi: 10.1109/EMBC48229.2022.9871316.
Balance Dysfunction (BDF) is a severe conse-quence of Traumatic Brain Injury (TBI) that significantly increases the falls risk. However, the neuromuscular mecha-nisms of the BDF are not adequately researched. Therefore, in this study, our objective was to investigate the effects of a Computerized Biofeedback-based Balance Intervention (CBBI) on the muscle coactivation patterns in a group of TBI participants. This study presents the findings from 13 TBI individuals randomized into the Intervention group (TBI - INT, N=6) and Control group (TBI-CTL, N=7). Using a computerized posturography platform (Neurocom Balance Master) during baseline and follow-up assessment visits, the participant's pos-tural response to anterior-posterior balance perturbations were recorded in a multimodal setup including electroencephalogra-phy (EEG), electromyography (EMG), and the platform sway in terms of center of pressure (COP). The muscle responses were recorded from lower-limb muscles, including tibialis an-terior (TA) and gastrocnemius (GAST), whose coactivation was computed using a metric called Co-Contraction Index (CCI). Clinical outcome measures such as Berg Balance Scale (BBS), 10 Meter Walk Test (10MWT), and Timed Up-and-Go (TUG) tests were used to evaluate functional balance and mobility. The comparison of CCI values across time points (baseline and follow-up) revealed a significant decrease (p<0.01) in the TBI-INT group but not TBI-CTL. The intervention-related changes in CCI correlated with the changes in BBS score (from baseline to follow-up). These preliminary findings demonstrate that the CBBI training may help postural stability by facilitating the coactivation between muscles involved in postural control. Clinical relevance- The current knowledge of changes in the neuromuscular response to balance perturbation in TBI is limited. Our study opens the possibility of using the muscle CCI metric to evaluate the muscle response in individuals with impaired balance.
平衡功能障碍（BDF）是创伤性脑损伤（TBI）的严重后果，显著增加了跌倒的风险。然而，BDF 的神经肌肉机制尚未得到充分研究。因此，在这项研究中，我们的目的是研究基于计算机生物反馈的平衡干预（CBBI）对一组 TBI 参与者肌肉协同激活模式的影响。本研究介绍了 13 名 TBI 个体随机分为干预组（TBI-INT，N=6）和对照组（TBI-CTL，N=7）的研究结果。在基线和随访评估期间，使用计算机平衡测试平台（Neurocom Balance Master），在包括脑电图（EEG）、肌电图（EMG）和平台摆动的多模态设置下记录参与者对前后平衡扰动的姿势反应，以压力中心（COP）表示。肌肉反应是从下肢肌肉（包括胫骨前肌（TA）和腓肠肌（GAST））记录的，其协同激活使用称为协同收缩指数（CCI）的指标来计算。使用 Berg 平衡量表（BBS）、10 米步行测试（10MWT）和计时起立行走测试（TUG）等临床结果测量来评估功能性平衡和移动性。CCI 值在时间点（基线和随访）的比较显示，TBI-INT 组的 CCI 值显著降低（p<0.01），而 TBI-CTL 组没有。CCI 的干预相关变化与 BBS 评分的变化（从基线到随访）相关。这些初步发现表明，CBBI 训练可以通过促进参与姿势控制的肌肉协同激活来帮助提高姿势稳定性。临床相关性-目前对 TBI 中平衡扰动的神经肌肉反应变化的了解有限。我们的研究为使用肌肉 CCI 指标评估平衡受损个体的肌肉反应开辟了可能性。
