Abstract
Muscle synergies are hypothesized to reflect connections among motoneurons in the spinal cord activated by central commands and sensory feedback. Robotic rehabilitation of upper limb in post-stroke subjects has shown promising results in terms of improvement of arm function and motor control achieved by reassembling muscle synergies into a set more similar to that of healthy people. However, in stroke survivors the potentially neurophysiological changes induced by robot-mediated learning versus usual care have not yet been investigated. We quantified upper limb motor deficits and the changes induced by rehabilitation in 32 post-stroke subjects through the movement analysis of two virtual untrained tasks of object placing and pronation. The sample analyzed in this study is part of a larger bi-center study and included all subjects who underwent kinematic analysis and were randomized into robot and usual care groups. Post-stroke subjects who followed robotic rehabilitation showed larger improvements in axial-to-proximal muscle synergies with respect to those who underwent usual care. This was associated to a significant improvement of the proximal kinematics. Both treatments had negative effects in muscle synergies controlling the distal district. This study supports the definition of new rehabilitative treatments for improving the neurophysiological recovery after stroke.
Highlights
Muscle synergies are hypothesized to reflect connections among motoneurons in the spinal cord activated by central commands and sensory feedback
The recruited sample consisted of 32 persons in both chronic (> 3 months post stroke, mean (95%CI) [months], Robot Group (RG) 22.4 (5.5–39.3), Usual Care Group (UCG) 65.8 (24.5–107.2), P = 0.46) and sub-acute (< = 3 months post stroke, RG 1.4 (0.7–2.2), UCG 1.8 (1.1–2.5), P = 0.31) stage of post-stroke[24,25] recovery (Fig. 1)
Lesions were located in the brainstem (N = 2 RG, N = 4 UCG), frontal lobe (9 RG, UCG), parietal lobe (7 RG, UCG), temporal lobe (0 RG, 2 UCG), occipital lobe (0 RG, 1 UCG), internal capsule (2 RG, 1 UCG), thalamus (1 RG, 1 UCG) and basal ganglia (2 RG, 0 UCG)
Summary
Muscle synergies are hypothesized to reflect connections among motoneurons in the spinal cord activated by central commands and sensory feedback. Robotic rehabilitation of upper limb in poststroke subjects has shown promising results in terms of improvement of arm function and motor control achieved by reassembling muscle synergies into a set more similar to that of healthy people. Post-stroke subjects who followed robotic rehabilitation showed larger improvements in axial-to-proximal muscle synergies with respect to those who underwent usual care. This was associated to a significant improvement of the proximal kinematics. Randomized control trials (RCTs) have been carried out to clarify if robot-assisted therapy is able to produce better effects compared to usual care in terms of motor function improvement of the upper limb. The results suggest that these treatments show similar effectiveness in Scientific Reports | (2021) 11:5323
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
