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Title: A neuromuscular electrical stimulation (NMES) and robot hybrid system for multi-joint coordinated upper limb rehabilitation after stroke
Authors: Rong, W 
Li, WM 
Pang, MK 
Hu, JY 
Wei, XJ 
Yang, BB 
Wai, HW 
Zheng, XX
Hu, XL 
Issue Date: 2017
Source: Journal of neuroEngineering and rehabilitation, 2017, v. 14, 34, p. 1-13
Abstract: Background: It is a challenge to reduce the muscular discoordination in the paretic upper limb after stroke in the traditional rehabilitation programs. Method: In this study, a neuromuscular electrical stimulation (NMES) and robot hybrid system was developed for multi-joint coordinated upper limb physical training. The system could assist the elbow, wrist and fingers to conduct arm reaching out, hand opening/grasping and arm withdrawing by tracking an indicative moving cursor on the screen of a computer, with the support from the joint motors and electrical stimulations on target muscles, under the voluntary intention control by electromyography (EMG). Subjects with chronic stroke (n = 11) were recruited for the investigation on the assistive capability of the NMES-robot and the evaluation of the rehabilitation effectiveness through a 20-session device assisted upper limb training. Results: In the evaluation, the movement accuracy measured by the root mean squared error (RMSE) during the tracking was significantly improved with the support from both the robot and NMES, in comparison with those without the assistance from the system (P < 0.05). The intra-joint and inter-joint muscular co-contractions measured by EMG were significantly released when the NMES was applied to the agonist muscles in the different phases of the limb motion (P < 0.05). After the physical training, significant improvements (P < 0.05) were captured by the clinical scores, i.e., Modified Ashworth Score (MAS, the elbow and the wrist), Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), and Wolf Motor Function Test (WMFT). Conclusions: The EMG-driven NMES-robotic system could improve the muscular coordination at the elbow, wrist and fingers.
Keywords: Stroke
Robot
Neuromuscular electrical stimulation
Publisher: BioMed Central
Journal: Journal of neuroEngineering and rehabilitation 
ISSN: 1743-0003
DOI: 10.1186/s12984-017-0245-y
Rights: © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
The following publication Rong, W., Li, W. M., Pang, M. K., Hu, J. Y., Wei, X. J., Yang, B. B., … Hu, X. L. (2017). A neuromuscular electrical stimulation (NMES) and robot hybrid system for multi-joint coordinated upper limb rehabilitation after stroke. Journal of Neuroengineering and Rehabilitation, 14, 34, 1-13 is available at https://dx.doi.org/10.1186/s12984-017-0245-y
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