Abstract
In many post-stroke cases, patients show dysfunctions in movement, cognition, sense, and language, depending on the damaged area of the brain. Active and repetitive physical rehabilitation centered on the stroke-affected side is essential for effective and rapid neurological recovery of upper extremity dysfunction due to hemiplegia. A symmetric upper extremity trainer is utilized to assist the patient body, depending upon the degree of hemiplegia. In this study, we developed a novel balance handle as a symmetric upper extremity trainer capable of extension, flexion, pronation, and supination of the upper extremity. We collected the surface electromyogram (sEMG) signal data while the subjects were playing a serious game and recorded the electroencephalogram (EEG) signal data while the subjects were performing basic movements with the balance handle, to analyze the effectiveness of the device as an assistive tool for rehabilitation. The triceps brachii were activated during the extension movements, whereas the biceps brachii and deltoid muscles were activated during the flexion movements. With the balance handle, the peak event-related desynchronization (ERD) values were relatively lower while showing higher peak event-related synchronization (ERS) values compared to other types of operating methods, such as hand gripping and gamepad operation. Movement intention of tilting the balance handle for the α and β waves was clearly distinguished from the other tasks. These data demonstrated the potential of various applications using the developed proof-of-concept upper extremity trainer to bring out an excellent rehabilitative effect not only through muscle growth but also via identification of large movement intentions inducing brain activation exercise.
Highlights
The spherical balance ball positioned at the center between the arm holders was designed to calculate its slope through an inertial measurement unit (IMU) sensor and send the data through a Bluetooth module that did not interfere with the user movement
Ten adults in their twenties with no experience of a damaged upper extremity participated in the experimental tests to perform three operations: hand gripping, gamepad operation, and operation of the symmetric upper extremity trainer similar to the Oddball Paradigm, to compare the movement intention according to the operation methods for the serious game content (Figure 3)
The normality of each data group was verified to compare the movement intention according to the operating method, and the two-way analysis of variance (ANOVA) was performed with a statistical significance level of 0.05
Summary
A commendable outcome, in recent years, of the enormous advancement in medical science is the continuous decrease in mortality rate of stroke [1]. Recent studies have attempted to associate the rehabilitation equipment used to improve or treat physical abilities with serious games, applying game elements such as fun and challenge Such programs are considered to increase the patients’ intention to rehabilitate and effectively recovers the physical abilities by reducing the rejection or boredom of treatment that patients may have [11]. In order to analyze the activation of the motor cortex quantitatively, the signals measured by the symmetrical upper extremity trainer were compared with other types of operating methods for serious games, such as hand gripping and gamepad. The difference between the groups according to the operating methods was compared by verifying the normality and performing the two-way analysis of variance (ANOVA)
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