Liu Yanhong, Li Yaowei, Zhang Zan, Huo Benyan, Dong Anqin
School of Electrical and Informatic Engineering, Zhengzhou University, Zhengzhou, China.
The Rehabilitation Department, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Bioeng Biotechnol. 2024 Mar 7;12:1375277. doi: 10.3389/fbioe.2024.1375277. eCollection 2024.
Stroke is the second leading cause of death globally and a primary factor contributing to disability. Unilateral limb motor impairment caused by stroke is the most common scenario. The bilateral movement pattern plays a crucial role in assisting stroke survivors on the affected side to relearn lost skills. However, motion compensation often lead to decreased coordination between the limbs on both sides. Furthermore, muscle fatigue resulting from imbalanced force exertion on both sides of the limbs can also impact the rehabilitation outcomes. In this study, an assessment method based on muscle synergy indicators was proposed to objectively quantify the impact of motion compensation issues on rehabilitation outcomes. Muscle synergy describes the body's neuromuscular control mechanism, representing the coordinated activation of multiple muscles during movement. 8 post-stroke hemiplegia patients and 8 healthy subjects participated in this study. During hand-cycling tasks with different resistance levels, surface electromyography signals were synchronously collected from these participants before and after fatigue. Additionally, a simulated compensation experiment was set up for healthy participants to mimic various hemiparetic states observed in patients. Synergy symmetry and synergy fusion were chosen as potential indicators for assessing motion compensation. The experimental results indicate significant differences in synergy symmetry and fusion levels between the healthy control group and the patient group ( ≤ 0.05), as well as between the healthy control group and the compensation group. Moreover, the analysis across different resistance levels showed no significant variations in the assessed indicators ( > 0.05), suggesting the utility of synergy symmetry and fusion indicators for the quantitative evaluation of compensation behaviors. Although muscle fatigue did not significantly alter the symmetry and fusion levels of bilateral synergies ( > 0.05), it did reduce the synergy repeatability across adjacent movement cycles, compromising movement stability and hindering patient recovery. Based on synergy symmetry and fusion indicators, the degree of bilateral motion compensation in patients can be quantitatively assessed, providing personalized recommendations for rehabilitation training and enhancing its effectiveness.
中风是全球第二大致死原因，也是导致残疾的主要因素。中风引起的单侧肢体运动障碍最为常见。双侧运动模式在帮助中风幸存者患侧重新学习丧失技能方面起着关键作用。然而，运动补偿往往会导致双侧肢体之间的协调性下降。此外，肢体两侧用力不均衡导致的肌肉疲劳也会影响康复效果。在本研究中，提出了一种基于肌肉协同指标的评估方法，以客观量化运动补偿问题对康复效果的影响。肌肉协同描述了人体的神经肌肉控制机制，代表运动过程中多块肌肉的协同激活。8名中风后偏瘫患者和8名健康受试者参与了本研究。在不同阻力水平的手部循环任务中，在疲劳前后同步采集这些参与者的表面肌电信号。此外，为健康参与者设置了模拟补偿实验，以模拟患者中观察到的各种偏瘫状态。选择协同对称性和协同融合作为评估运动补偿的潜在指标。实验结果表明，健康对照组与患者组之间（≤0.05）以及健康对照组与补偿组之间在协同对称性和融合水平上存在显著差异。此外，对不同阻力水平的分析表明，评估指标没有显著变化（>0.05），这表明协同对称性和融合指标可用于定量评估补偿行为。虽然肌肉疲劳没有显著改变双侧协同的对称性和融合水平（>0.05），但它确实降低了相邻运动周期之间的协同重复性，损害了运动稳定性并阻碍了患者恢复。基于协同对称性和融合指标，可以定量评估患者双侧运动补偿的程度，为康复训练提供个性化建议并提高其有效性。
