Real-time Electromyography-driven Functional Electrical Stimulation Cycling System for Chronic Stroke Rehabilitation

Stroke-induced lower extremity dysfunction has become a severe medical problem nowadays and effective rehabilitation methods are in great demand. In this work, a new real-time Electromyography-driven Functional Electrical Stimulation (FES) cycling system was developed to help chronic stroke patients with lower limb rehabilitation training. To evaluate the feasibility and effectiveness of this system, 3 chronic stroke subjects were recruited and each received 20 training sessions where real-time Electromyography (EMG) was used to interact with the cycling system. During the training, two typical metrics, averaged Area Under Torque (AUT) and maximal EMG amplitude, were adopted to measure the muscle strength changes of hamstring (HS). The training results showed that the two measurements of HS both significantly increased, especially the maximal EMG amplitude in the last trial was twice as much as that in the first trial, indicating paretic limb strength increment and functional recovery, which suggested that our system is effective and helpful in the stroke rehabilitation.

[1]  P. London Injury , 1969, Definitions.

[2]  K. J. Cole,et al.  Strength increases from the motor program: comparison of training with maximal voluntary and imagined muscle contractions. , 1992, Journal of neurophysiology.

[3]  M. Grasso,et al.  Rehabilitation of Walking With Electromyographic Biofeedback in Foot‐Drop After Stroke , 1994, Stroke.

[4]  K Potempa,et al.  Physiological outcomes of aerobic exercise training in hemiparetic stroke patients. , 1995, Stroke.

[5]  Patrick E. Crago,et al.  Stimulus artifact removal in EMG from muscles adjacent to stimulated muscles , 1996, Journal of Neuroscience Methods.

[6]  S. Olney,et al.  Muscle strengthening and physical conditioning to reduce impairment and disability in chronic stroke survivors. , 1999, Archives of physical medicine and rehabilitation.

[7]  T. Perkins,et al.  FES cycling may promote recovery of leg function after incomplete spinal cord injury , 2000, Spinal Cord.

[8]  R. Holt,et al.  Static bicycle training for functional mobility in chronic stroke , 2001 .

[9]  J. Rosene,et al.  Isokinetic Hamstrings:Quadriceps Ratios in Intercollegiate Athletes. , 2001, Journal of athletic training.

[10]  J. Eng Strength Training in Individuals with Stroke. , 2004, Physiotherapy Canada. Physiotherapie Canada.

[11]  Fong-Chin Su,et al.  Effects of a functional electrical stimulation-assisted leg-cycling wheelchair on reducing spasticity of patients after stroke. , 2009, Journal of rehabilitation medicine.

[12]  Fong-Chin Su,et al.  Effect of a bout of leg cycling with electrical stimulation on reduction of hypertonia in patients with stroke. , 2010, Archives of physical medicine and rehabilitation.

[13]  Charles L Rice,et al.  Factors that influence muscle weakness following stroke and their clinical implications: a critical review. , 2012, Physiotherapy Canada. Physiotherapie Canada.

[14]  Ya-Hsin Hsueh,et al.  Cycling exercise with functional electrical stimulation improves postural control in stroke patients. , 2012, Gait & posture.

[15]  E. A. Susanto,et al.  The effects of post-stroke upper-limb training with an electromyography (EMG)-driven hand robot. , 2013, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[16]  Manjunatha Mahadevappa,et al.  Therapeutic effects of functional electrical stimulation on gait, motor recovery, and motor cortex in stroke survivors , 2015 .

[17]  Ju-Young Kim,et al.  The effects of a progressive resistance training program on walking ability in patients after stroke: a pilot study , 2015, Journal of physical therapy science.

[18]  Hwi-young Cho,et al.  Effects of stationary cycling exercise on the balance and gait abilities of chronic stroke patients , 2015, Journal of physical therapy science.

[19]  Raymond Kai-yu Tong,et al.  Wrist Rehabilitation Assisted by an Electromyography-Driven Neuromuscular Electrical Stimulation Robot After Stroke , 2015, Neurorehabilitation and neural repair.