Overview
The objective of this study is to develop Neuro-Intermuscular Coordination Enhancement (NICE) rehabilitation, a novel neuromuscular control signal-guided strategy that visually guides stroke patients to individually activate groups of synergistic muscles through human-machine interaction. Ultimately, the development will lead to better clinical motor recovery, better quality of life, and lowered healthcare costs associated with the impairment.
Description
Stroke is the leading cause of severe long-term disability, affecting 9.4 million Americans. Each year around 800,000 people suffer a stroke even in the USA. Chronic upper extremity motor impairment is a major contributing factor to disability; functional use of the affected UE in daily life is a key factor for increased independence, return to work, and overall quality of life. Thus, effective and innovative treatment to address long-term disability is both a major public health need and an economic necessity.
The study will develop an innovative human-machine interaction platform to target and improve inter-joint coordination and motor function by enhancing muscular coordination in the UE. This study, in total, 38 chronic stroke survivors will be randomly assigned into two rehabilitation strategies either neuromuscular-coordination guided exercise (NICE; therapy group) or force-guided exercise (control group). The inclusion criteria primarily consist of: (1) having experienced an ischemic or hemorrhagic stroke at least 6 months prior (chronic stroke); (2) being between 21 and 80 years of age; (3) not having received botulinum toxin treatment in the affected arm within the past 3 months; and (4) having no cognitive impairments that would affect task comprehension or the ability to provide informed consent.
This study will evaluate the effects of both rehabilitation exercises on muscle coordination, standardized clinical scores, kinetics, and electroencephalogram.
Eligibility
Inclusion Criteria:
- Ischemic or hemorrhagic stroke
- Aged between 21 and 80 years
- Not receiving botulinum toxin on the impaired arm within 3 months
- MAS ≤ 3 around elbow and shoulder
Exclusion Criteria:
- have an orthopedic disorder involving upper limbs;
- cognitive impairment sufficient to interfere with informed consent or successful completion of the protocol (Montreal Cognitive Assessment (MoCA) score =\< 26);
- a history of another neurologic disease;
- anesthesia of joint position sense in upper limbs;
- are pregnant or have a chance that they might be (self-reported);
