Khorasani Abed, Hulsizer Joel, Paul Vivek, Gorski Cynthia, Dhaher Yasin Y, Slutzky Marc W
Northwestern University.
University of Texas Southwestern Medical Center.
Res Sq. 2023 Oct 9:rs.3.rs-3398815. doi: 10.21203/rs.3.rs-3398815/v1.
The ability to walk is an important factor in quality of life after stroke. Co-activation of hip adductors and knee extensors has been shown to correlate with gait impairment. We have shown previously that training with a myoelectric interface for neurorehabilitation (MINT) can reduce abnormal muscle co-activation in the arms of stroke survivors.
Here, we extend MINT conditioning to stroke survivors with leg impairment. The aim of this pilot study was to assess the safety and feasibility of using MINT to reduce abnormal co-activation between hip adductors and knee extensors and assess any effects on gait. Nine stroke survivors with moderate to severe gait impairment received six hours of MINT conditioning over six sessions, either in the laboratory or at home.
MINT participants completed a mean of 159 repetitions per session without any adverse events. Further, participants learned to isolate their muscles effectively, resulting in a mean reduction of co-activation of 70% compared to baseline. Moreover, gait speed increased by a mean of 0.15 m/s, more than the minimum clinically important difference. Knee flexion angle increased substantially, and hip circumduction decreased.
MINT conditioning is safe, feasible at home, and enables reduction of co-activation in the leg. Further investigation of MINT's potential to improve leg movement and function after stroke is warranted. Abnormal co-activation of hip adductors and knee extensors may contribute to impaired gait after stroke.
This study was registered at ClinicalTrials.gov (NCT03401762, Registered 15 January 2018, https://clinicaltrials.gov/study/NCT03401762?tab=history&a=4).
行走能力是中风后生活质量的一个重要因素。已表明髋内收肌和膝伸肌的共同激活与步态障碍相关。我们之前已经表明，使用肌电接口进行神经康复训练（MINT）可以减少中风幸存者手臂的异常肌肉共同激活。
在此，我们将MINT训练扩展到有腿部损伤的中风幸存者。这项初步研究的目的是评估使用MINT减少髋内收肌和膝伸肌之间异常共同激活的安全性和可行性，并评估其对步态的任何影响。九名有中度至重度步态障碍的中风幸存者在实验室或家中接受了六个疗程、共六小时的MINT训练。
MINT训练的参与者平均每个疗程完成159次重复，且未出现任何不良事件。此外，参与者学会了有效分离肌肉，与基线相比，共同激活平均减少了70%。而且，步态速度平均提高了0.15米/秒，超过了最小临床重要差异。膝关节屈曲角度大幅增加，髋部环转减少。
MINT训练是安全的，可在家中进行，并且能够减少腿部的共同激活。有必要进一步研究MINT改善中风后腿部运动和功能的潜力。髋内收肌和膝伸肌的异常共同激活可能导致中风后的步态障碍。
本研究已在ClinicalTrials.gov注册（NCT03401762，2018年1月15日注册，https://clinicaltrials.gov/study/NCT03401762?tab=history&a=4）。
