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The effect of repetitive transcranial magnetic stimulation on immediate and long-term cognitive functions in Alzheimer's dementia and mild cognitive impairment: a meta-analysis. 重复经颅磁刺激对阿尔茨海默氏痴呆和轻度认知障碍患者的即时和长期认知功能的影响:一项荟萃分析
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-12-15 DOI: 10.1186/s12984-025-01777-8
Bojun Wang, Ya Wang, Fenglei Yang, Fang Han, Kuncheng Li, Kai Sun, Peipeng Liang

Background: Alzheimer's dementia (AD) and mild cognitive impairment (MCI) are characterized by progressive cognitive decline. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation technology, has been widely used to improve cognition in AD and MCI. However, the impact of rTMS on immediate and long-term cognitive functions in AD and MCI, as well as the optimal stimulating parameters, need further clarification.

Method: Thirty-one randomized controlled trials were included to examine the effects of rTMS on immediate cognition (post-treatment cognition), while nine trials were specifically used to assess its impact on long-term cognition (follow-up cognition). All participants were tested on at least one of the neuropsychological scales of the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Alzheimer's disease Assessment Scale-Cognitive Section (ADAS-Cog) to evaluate global cognitive outcomes of rTMS. The study followed the guidelines for meta-analysis of intervention studies and assessed the risk of bias of the included studies. Moderator analysis was used to examine factors that might affect treatment effect. Sensitivity analysis was used to evaluate stability of results. Meta-regression analysis was used to assess the interpretability of heterogeneity. Begg's and Egger's test and funnel plot were applied to assess publication bias.

Results: The results demonstrated that rTMS significantly improved immediate cognition (SMD = 0.93, 95% CI = 0.64 to 1.22, p < 0.001) and long-term cognition (SMD = 0.42, 95% CI = 0.13 to 0.70, p = 0.004) across all patients (including AD and MCI). Moderator analysis revealed that targeting dorsolateral prefrontal cortex (DLPFC), using intensities of 80% or less of the motor threshold, total time of 800 min or more and stimulation sessions greater than 20 significantly enhanced immediate cognitive performance than their counterparts. In contrast, stimulation frequency, duration/session and patient type showed no significant impact on immediate cognition. For long-term cognition, differences in stimulation protocols had no influence on treatment effect for all patients.

Conclusion: rTMS had a positive effect on immediate and long-term cognition in AD and MCI, stimulation region, intensity, total time and number of sessions significantly improve immediate cognition. These findings suggest that rTMS has potential as a promising adjunctive treatment for AD and MCI.

背景:阿尔茨海默氏痴呆(AD)和轻度认知障碍(MCI)以进行性认知能力下降为特征。重复经颅磁刺激(rTMS)是一种无创脑刺激技术,已广泛用于改善AD和MCI患者的认知能力。然而,rTMS对AD和MCI患者的即时和长期认知功能的影响,以及最佳刺激参数,需要进一步明确。方法:采用31项随机对照试验研究rTMS对即时认知(治疗后认知)的影响,9项试验专门评估rTMS对长期认知(随访认知)的影响。所有参与者都接受了至少一项神经心理学量表的测试,包括迷你精神状态检查(MMSE)、蒙特利尔认知评估(MoCA)和阿尔茨海默病评估量表-认知部分(ADAS-Cog),以评估rTMS的整体认知结果。本研究遵循干预研究荟萃分析指南,对纳入研究的偏倚风险进行评估。采用调节因子分析来考察可能影响治疗效果的因素。采用敏感性分析评价结果的稳定性。meta回归分析用于评估异质性的可解释性。采用Begg’s和Egger’s检验和漏斗图评估发表偏倚。结果:rTMS显著改善AD和MCI患者的即时认知(SMD = 0.93, 95% CI = 0.64 ~ 1.22, p)。结论:rTMS对AD和MCI患者的即时认知和长期认知均有积极作用,刺激区域、刺激强度、总时间和刺激次数均显著改善即时认知。这些发现表明,rTMS有潜力作为一种有希望的辅助治疗AD和MCI。
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引用次数: 0
The effects of unilateral nostril breathing on brain functional network activity: a pilot study. 单侧鼻孔呼吸对脑功能网络活动的影响:一项初步研究。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-12-15 DOI: 10.1186/s12984-025-01782-x
David E White, Usman Ghani, Mangor Pedersen, Christian Thoma, Christi Essex, Daniel Shepherd, Georgina Burns, Toby S Waterstone, K L T Roos, Denise Taylor, Imran K Niazi

Background: Unilateral nostril breathing (UNB) has a history linked to ancient yogic traditions where it is believed to affect both physical and mental states however the mechanism(s) by which this technique potentially influences brain electrical activity remains poorly explored.

Methods: In this pilot study we investigated the influence of pressurised device-regulated UNB on brain functional network activity in healthy awake individuals to test its suitability for later use in hypothesis-driven clinical trials. Baseline bilateral EEG data were acquired, and then dominant/nondominant nostril UNB protocols were used to assess changes in brain network functional connectivity signal coherence, and phase lag index.

Results: Changes in functional connectivity were detected only when comparing right to left UNB, with the following networks demonstrating changes: the Default Mode Network which included reduced alpha and increased beta wave activity; the Salience Network, which included increased gamma wave activity; the Auditory Network, which included increased gamma and delta wave activity; and the Left Brain Region, which included reduced delta wave activity.

Conclusions: This study revealed that device-regulated pressurised left/right UNB changed brain FC in awake healthy individuals in several brain networks. Nasal cycle dominance was found to play no role in UNB influencing brain FC; rather, nasal morphology (left/right side) seems to be the controlling factor. Further investigations are needed to verify our results and apply them to clinical populations.

背景:单侧鼻孔呼吸(UNB)的历史与古代瑜伽传统有关,人们认为它会影响身体和精神状态,但这种技术潜在影响脑电活动的机制仍未得到充分探讨。方法:在这项初步研究中,我们调查了加压装置调节的UNB对健康清醒个体脑功能网络活动的影响,以测试其在假设驱动的临床试验中的适用性。获取基线双侧脑电图数据,然后采用优势/非优势鼻孔UNB协议评估脑网络功能连通性、信号相干性和相位滞后指数的变化。结果:仅在比较左、右UNB时才检测到功能连通性的变化,以下网络表现出变化:默认模式网络包括α波活动减少和β波活动增加;突出网络,包括增加的伽马波活动;听觉网络,包括增加的伽马波和德尔塔波活动;以及左脑区域,其中包括减少的δ波活动。结论:本研究揭示了设备调节的压力左/右UNB在几个脑网络中改变了清醒健康个体的脑FC。鼻循环优势在UNB对脑FC的影响中没有作用;相反,鼻形态(左/右)似乎是控制因素。需要进一步的调查来验证我们的结果并将其应用于临床人群。
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引用次数: 0
Overground robotic walker use in the home and community: a six-month prospective cohort study. 在家庭和社区使用的地面机器人行走器:一项为期六个月的前瞻性队列研究。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-12-13 DOI: 10.1186/s12984-025-01812-8
Alicia J Hilderley, Christa M Diot, Hua Shen, Sean P Dukelow, Kelly A Larkin-Kaiser, Adam Kirton, Elizabeth G Condliffe

Background: Outcomes following long-term use of overground robotic walkers have not been studied, even though children with mobility impairments are using these devices for extended periods. We aimed to evaluate the impacts of six months of overground robotic walker use in the home and community.

Methods: An observational cohort study was conducted with a volunteer sample of 171 participants with mobility impairments who privately obtained an overground robotic walker. Participant-initiated overground robotic walker use in the home and community was evaluated over six-months. The primary outcome of functional ability was assessed by parent report using the Gillette Functional Assessment Questionnaire (FAQ). Secondary outcome measures were parent-reported physical activity, positive affect, sleep disturbance, and bowel movement frequency. Questionnaires were sent digitally at baseline (when users received device use training), and then 1-Month, 3-Months and 6-Months later. The device tracked monthly usage, specifically number of steps, minutes of use, average cadence (steps/minute), and the number of times the device was used.

Results: Median participant age was 6 years (range 1 to 24), 42.1% were female, 70.8% had a diagnosis of cerebral palsy, and most were not independently ambulatory (97.3% of participants who reported function). Adjusted cumulative link mixed models demonstrated a significant main effect of time for FAQ scores, with increased log odds of a higher FAQ score at each time point (ß=0.86, 95% CI [0.25, 1.46], p = 0.006). The median FAQ score increased from 1 at baseline to 2 at subsequent time points. Adjusted repeated measures linear mixed-effects models demonstrated significant main effects of time for secondary outcomes, with improvements in physical activity scores (ß=0.96, 95% CI [0.21, 1.71], p = 0.012), sleep disturbance scores (ß=-0.82, 95% CI [-1.61, -0.04], p = 0.040), average cadence (steps/minute) (ß=1.86, 95% CI [0.61, 3.11], p = 0.004), and also decreases in the number of times the device was used per month (ß=-0.95, 95% CI [-1.63, -0.26], p = 0.007). Device usage time and total steps per month did not significantly change over time.

Conclusions: Six months of overground robotic walker use resulted in modest, statistically significant improvements in functional ability and secondary outcomes linked to physical inactivity. Device usage time was consistent over time, suggesting feasibility of long-term home and community use.

背景:长期使用地面机器人行走器的结果尚未研究,即使有行动障碍的儿童长时间使用这些设备。我们的目的是评估在家庭和社区使用六个月的地面机器人行走器的影响。方法:对171名有行动障碍的志愿者样本进行了一项观察性队列研究,他们私下获得了一个地上机器人行走器。在六个月的时间里,研究人员对参与者在家庭和社区中主动使用的地面机器人行走器进行了评估。功能能力的主要结局由家长报告评估,使用吉列功能评估问卷(FAQ)。次要结局指标是父母报告的身体活动、积极影响、睡眠障碍和排便频率。问卷在基线时(当用户接受设备使用培训时)以数字方式发送,然后在1个月,3个月和6个月后发送。该设备跟踪每月的使用情况,特别是步数、使用分钟数、平均节奏(步数/分钟)和设备的使用次数。结果:参与者年龄中位数为6岁(范围1至24岁),42.1%为女性,70.8%诊断为脑瘫,大多数不能独立走动(97.3%的参与者报告有功能)。调整后的累积链接混合模型显示时间对FAQ得分有显著的主效应,每个时间点FAQ得分越高的对数赔率越高(ß=0.86, 95% CI [0.25, 1.46], p = 0.006)。中位FAQ得分从基线的1分增加到随后时间点的2分。调整后的重复测量线性混合效应模型显示,时间对次要结果有显著的主要影响,包括体力活动评分(ß=0.96, 95% CI [0.21, 1.71], p = 0.012)、睡眠障碍评分(ß=-0.82, 95% CI [-1.61, -0.04], p = 0.040)、平均步频(步数/分钟)(ß=1.86, 95% CI [0.61, 3.11], p = 0.004)的改善,以及每月使用设备次数的减少(ß=-0.95, 95% CI [-1.63, -0.26], p = 0.007)。设备使用时间和每月总步数没有随时间发生显著变化。结论:6个月的地面机器人助行器使用导致了适度的、统计学上显著的功能能力改善和与缺乏身体活动相关的次要结果。随着时间的推移,设备的使用时间是一致的,这表明长期家庭和社区使用的可行性。
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引用次数: 0
Distinct patterns in neuromuscular adaptation to repeated perturbations in chronic ankle instability. 慢性踝关节不稳定中反复扰动的神经肌肉适应的独特模式。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-12-12 DOI: 10.1186/s12984-025-01838-y
Xiaohan Xu, Joanna Bowtell, William R Young, Daniel T P Fong, Genevieve K R Williams
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引用次数: 0
NeuraLoop: a high bandwidth closed-loop human-machine interface. NeuraLoop:高带宽闭环人机界面。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-12-12 DOI: 10.1186/s12984-025-01815-5
Luis Pelaez Murciego, Elias Thomassen Dam, Hans Henrik Dalgaard, Nikola Jorgovanovic, Matija Strbac, Erika G Spaich, Strahinja Dosen

Background: Myoelectric interfaces have emerged as powerful tools for human-machine interaction (HMI), enabling intuitive control of virtual and physical devices. However, most existing systems are limited by low spatial resolution and unidirectional communication. To address these limitations, we developed NeuraLoop, a wearable, high-bandwidth, bidirectional interface that integrates myoelectric (EMG) signal acquisition and electrotactile stimulation feedback within a single wearable textile-based platform.

Methods: NeuraLoop comprises a flexible matrix of 32 EMG recording and 32 electrotactile stimulation pads controlled by a compact electronic unit. We evaluated the system in two experimental tasks involving ten healthy subjects to demonstrate: (1) online classification of four transient thumb micro-gestures (thumb rightwards, leftwards, upwards, and downwards swipe directions), and (2) closed-loop control of a virtual cursor using micro-gesture commands and spatially encoded tactile feedback. A time-division multiplexing (TDM) strategy was implemented to enable simultaneous stimulation and recording.

Results: The subjects achieved a median success rate of 82% on the first attempt and over 94% within two attempts during online classification with visual feedback. All four micro-gestures were classified with similar accuracy. In the closed-loop control task with tactile feedback, participants navigated a 3 × 4 grid using only electrotactile stimulation, achieving 70% accuracy for exact target hits and 95% when including the hits in the neighboring cells (1 cell distance error).

Conclusions: NeuraLoop demonstrates the feasibility of high-bandwidth, bidirectional HMI using a wearable, textile-based interface. The system enables accurate recognition of subtle micro-gestures and effective delivery of spatially encoded tactile feedback. These capabilities open new possibilities for intuitive control in applications such as prosthetics, rehabilitation, and virtual/augmented reality. Future work will explore multimodal feedback encoding and proportional gesture control.

背景:肌电界面已经成为人机交互(HMI)的强大工具,可以直观地控制虚拟和物理设备。然而,大多数现有系统都受到低空间分辨率和单向通信的限制。为了解决这些限制,我们开发了NeuraLoop,这是一种可穿戴的、高带宽的双向接口,将肌电(EMG)信号采集和电触觉刺激反馈集成在一个基于纺织品的可穿戴平台上。方法:NeuraLoop由一个由32个肌电记录和32个触电刺激垫组成的柔性矩阵组成,触电刺激垫由一个紧凑的电子单元控制。我们在10名健康受试者的两个实验任务中对该系统进行了评估,以证明:(1)四种瞬态拇指微手势(拇指向右、向左、向上和向下滑动方向)的在线分类,以及(2)使用微手势命令和空间编码触觉反馈对虚拟光标进行闭环控制。采用时分多路复用(TDM)策略,可以同时进行刺激和记录。结果:在视觉反馈的在线分类中,受试者第一次成功率中位数为82%,两次成功率中位数为94%以上。这四种微手势的分类准确率都差不多。在具有触觉反馈的闭环控制任务中,参与者仅使用触觉电刺激导航3 × 4网格,精确命中目标的准确率达到70%,当包括相邻单元的命中时(1单元距离误差),准确率达到95%。结论:NeuraLoop展示了使用可穿戴、基于纺织品的界面实现高带宽、双向人机界面的可行性。该系统能够准确识别细微的微手势,并有效地传递空间编码的触觉反馈。这些功能为假肢,康复和虚拟/增强现实等应用中的直观控制开辟了新的可能性。未来的工作将探索多模态反馈编码和比例手势控制。
{"title":"NeuraLoop: a high bandwidth closed-loop human-machine interface.","authors":"Luis Pelaez Murciego, Elias Thomassen Dam, Hans Henrik Dalgaard, Nikola Jorgovanovic, Matija Strbac, Erika G Spaich, Strahinja Dosen","doi":"10.1186/s12984-025-01815-5","DOIUrl":"10.1186/s12984-025-01815-5","url":null,"abstract":"<p><strong>Background: </strong>Myoelectric interfaces have emerged as powerful tools for human-machine interaction (HMI), enabling intuitive control of virtual and physical devices. However, most existing systems are limited by low spatial resolution and unidirectional communication. To address these limitations, we developed NeuraLoop, a wearable, high-bandwidth, bidirectional interface that integrates myoelectric (EMG) signal acquisition and electrotactile stimulation feedback within a single wearable textile-based platform.</p><p><strong>Methods: </strong>NeuraLoop comprises a flexible matrix of 32 EMG recording and 32 electrotactile stimulation pads controlled by a compact electronic unit. We evaluated the system in two experimental tasks involving ten healthy subjects to demonstrate: (1) online classification of four transient thumb micro-gestures (thumb rightwards, leftwards, upwards, and downwards swipe directions), and (2) closed-loop control of a virtual cursor using micro-gesture commands and spatially encoded tactile feedback. A time-division multiplexing (TDM) strategy was implemented to enable simultaneous stimulation and recording.</p><p><strong>Results: </strong>The subjects achieved a median success rate of 82% on the first attempt and over 94% within two attempts during online classification with visual feedback. All four micro-gestures were classified with similar accuracy. In the closed-loop control task with tactile feedback, participants navigated a 3 × 4 grid using only electrotactile stimulation, achieving 70% accuracy for exact target hits and 95% when including the hits in the neighboring cells (1 cell distance error).</p><p><strong>Conclusions: </strong>NeuraLoop demonstrates the feasibility of high-bandwidth, bidirectional HMI using a wearable, textile-based interface. The system enables accurate recognition of subtle micro-gestures and effective delivery of spatially encoded tactile feedback. These capabilities open new possibilities for intuitive control in applications such as prosthetics, rehabilitation, and virtual/augmented reality. Future work will explore multimodal feedback encoding and proportional gesture control.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":"20"},"PeriodicalIF":5.2,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12817707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inter-segmental coordination patterns in Parkinson's disease are particularly disturbed during preferred walking speed: a data-driven network approach. 帕金森病的节段间协调模式在首选步行速度期间特别受到干扰:数据驱动的网络方法。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-12-12 DOI: 10.1186/s12984-025-01835-1
Karolina Saegner, Robbin Romijnders, Inga Ruff, Julius Welzel, Clint Hansen, Elke Warmerdam, Pedro Conceição, Walter Maetzler
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引用次数: 0
Development and validation of the electrosacrogram (ESG): a digital point-of-care tool for real-time neuro-sacral assessment after spinal cord injury. 骶电图(ESG)的开发和验证:一种用于脊髓损伤后实时神经-骶骨评估的数字护理点工具。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-12-11 DOI: 10.1186/s12984-025-01797-4
Maude Duguay, Jean-Marc Mac-Thiong, Juan-David Cifuentes-Hernandez, Natan Bensoussan, Andréane Richard-Denis

Background: Accurate assessment of neuro-sacral function after spinal cord injury/lesion and cauda equina (SCI+) is essential for diagnosis, prognosis and early management. The current bedside standard, the digital rectal examination (DRE), is subjective, invasive, and examiner dependent. Surface electromyography (s-EMG) offers a quantitative alternative but has lacked point-of-care integration. We developed the ElectroSacroGram (ESG), a bedside digital s-EMG tool enabling real-time objective assessment of sacral somatic function after SCI+. This study aimed to (1) develop the ESG protocol based on clinical consensus; and (2) evaluate its diagnostic performance compared to radiological findings and expert-performed DRE.

Methods: In this prospective proof-of-concept diagnostic study at a specialized Level 1 trauma center, 52 adults with suspected SCI + and 21 healthy participants underwent ESG and DRE. ESG quantified sacral motor (resting external anal sphincter tone, maximal voluntary anal contraction (maxVAC), reflex (bulbospongious or bulbocavernosus reflex (BSR)), and sensory (electrical perceptual threshold (EPT)) function using low-intensity electrical stimulation. Clinically relevant DRE parameters were selected by an expert panel. Content validity was assessed using item/scale content validity indices (CVI), agreement with DRE (Cohen's κ) and diagnostic accuracy were calculated against imaging-confirmed spinal lesions.

Results: Normative ESG values were established in healthy participants. Neurologically impaired patients showed reduced maxVAC and BSR amplitudes and elevated EPT. ESG demonstrated excellent content validity (S-CVI = 1.00), strong agreement with DRE for VAC (κ = 0.876) and EPT (κ = 0.881), and high diagnostic accuracy (sensitivity 83.3%, specificity 100%, overall accuracy 86.5%).

Conclusions: ESG enables precise, reproducible evaluation of sacral motor, reflex, and sensory integrity in real-time at bedside. By complementing and objectifying the DRE, it offers a promising precision-medicine tool for early neuro-sacral assessment, enhancing clinical research and improving SCI + diagnosis, for the acute phase and in the context of spinal shock.

背景:准确评估脊髓损伤/病变和马尾(SCI+)后的神经-骶骨功能对诊断、预后和早期治疗至关重要。目前的床边标准,直肠指检(DRE),是主观的,侵入性的,并且依赖于检查者。表面肌电图(s-EMG)提供了一种定量的替代方法,但缺乏点护理整合。我们开发了骶电图(ESG),这是一种床边数字s-EMG工具,可以实时客观地评估SCI+后的骶骨躯体功能。本研究旨在(1)基于临床共识制定ESG方案;(2)将其诊断性能与放射学结果和专家DRE进行比较。方法:在一个专门的一级创伤中心进行的这项前瞻性概念验证诊断研究中,52名疑似SCI +的成年人和21名健康参与者接受了ESG和DRE检查。ESG量化骶骨运动(静息外肛门括约肌张力、最大自愿肛门收缩(maxVAC)、反射(球海绵状反射或球海绵状反射(BSR))和感觉(电知觉阈值(EPT))功能,使用低强度电刺激。临床相关的DRE参数由专家小组选择。采用项目/量表内容效度指数(CVI)评估内容效度,计算与DRE (Cohen’s κ)的一致性以及对影像学证实的脊柱病变的诊断准确性。结果:在健康受试者中建立了规范的ESG值。神经功能受损患者表现为maxVAC和BSR振幅降低和EPT升高。ESG表现出良好的内容效度(S-CVI = 1.00),与DRE的VAC (κ = 0.876)和EPT (κ = 0.881)高度吻合,诊断准确率高(敏感性83.3%,特异性100%,总准确率86.5%)。结论:ESG能够在床边实时精确、可重复地评估骶骨运动、反射和感觉完整性。通过对DRE的补充和客观化,它为早期神经-骶骨评估、加强临床研究和改善脊髓损伤+诊断提供了一种有前景的精准医学工具,适用于急性期和脊髓休克。
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引用次数: 0
EMG-guided human-machine interaction training develops new intermuscular coordination patterns in stroke: a pilot study. 肌电图引导的人机交互训练在中风中发展了新的肌间协调模式:一项试点研究。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-12-11 DOI: 10.1186/s12984-025-01826-2
Gang Seo, Manuel Portilla-Jiménez, Michael Houston, Jeong-Ho Park, Hangil Lee, Sheng Li, Yingchun Zhang, Hyung-Soon Park, Jinsook Roh

Background: Stroke survivors often experience impaired upper extremity motor function due to abnormal muscle synergies. This pilot study evaluated the feasibility and preliminary effectiveness of electromyography-guided human-machine interaction training designed to expand the repertoire of intermuscular coordination patterns and improve upper extremity motor function in chronic stroke survivors.

Methods: Four chronic stroke survivors with mild-to-moderate upper extremity motor impairment and three age-matched healthy controls participated in a six-week electromyography-guided training intervention. Participants practiced selectively activating one elbow flexor muscle while suppressing another (brachioradialis or biceps brachii). Throughout the course of the intervention, the effect of the training on intermuscular coordination, task performance, and motor function and impairment level of the stroke-affected upper extremity were assessed.

Results: Participants in both the control and stroke groups successfully learned to selectively activate targeted muscles, expanding their repertoire of habitual intermuscular coordination patterns. Stroke survivors demonstrated improvements in force generation, reaching ability, wrist rotation, and clinical measures of upper extremity motor function and spasticity. Participants also reported improved ease in performing daily activities.

Conclusions: This is, to our knowledge, the first study to demonstrate the feasibility of using electromyography-guided human-machine interaction training to expand the repertoire of habitual intermuscular coordination patterns and improve upper extremity motor function in chronic stroke survivors. These findings highlight the potential of electromyography-guided human-machine interaction training as a neurorehabilitation approach to address motor deficits associated with abnormal intermuscular coordination following stroke.

Trial registration: The study was registered at the Clinical Research Information Service of Korea National Institute of Health (KCT0005803).

背景:由于肌肉协同作用异常,中风幸存者经常经历上肢运动功能受损。这项初步研究评估了肌电图引导的人机交互训练的可行性和初步有效性,旨在扩大慢性中风幸存者的肌间协调模式,改善上肢运动功能。方法:四名患有轻中度上肢运动障碍的慢性中风幸存者和三名年龄匹配的健康对照者参加了为期六周的肌电图引导训练干预。参与者练习选择性地激活一侧肘关节屈肌,同时抑制另一侧(肱桡肌或肱二头肌)。在整个干预过程中,评估训练对中风上肢肌间协调、任务表现、运动功能和损伤水平的影响。结果:对照组和中风组的参与者都成功地学会了选择性地激活目标肌肉,扩大了他们习惯性肌肉间协调模式的曲目。中风幸存者在力量产生、伸手能力、手腕旋转以及上肢运动功能和痉挛的临床测量方面表现出改善。参与者还报告说,他们在日常活动中表现得更加轻松。结论:据我们所知,这是第一个证明使用肌电图引导的人机交互训练来扩展习惯性肌间协调模式和改善慢性中风幸存者上肢运动功能的可行性的研究。这些发现强调了肌电图引导的人机交互训练作为一种神经康复方法的潜力,可以解决中风后肌肉间协调异常相关的运动缺陷。试验注册:该研究已在韩国国立卫生研究院临床研究信息服务中心注册(KCT0005803)。
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引用次数: 0
Sonomyography accurately captures joint kinematics during volitional and electrically stimulated motion in healthy adults and an individual with cerebral palsy. 超声能准确地捕捉健康成人和脑瘫患者在意志运动和电刺激运动时的关节运动学。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-12-11 DOI: 10.1186/s12984-025-01784-9
Shriniwas Patwardhan, Noah Rubin, Katharine E Alter, Diane L Damiano, Thomas C Bulea

Background: Despite significant advances in biosignal extraction techniques for studying neuromotor disorders, there remains an unmet need for a method that effectively links muscle structure and dynamics to muscle activation. Addressing this gap could improve the quantification of neuromuscular impairments and pave the way for precision rehabilitation. In this study, we demonstrate the proof of concept of recording multimodal signals from the brain, muscles, and resulting limb kinematics. We also explore the use of ultrasound imaging to extract limb kinematics.

Methods: We collected data from three healthy volunteers and one individual with cerebral palsy during single degree-of-freedom ankle and wrist movements. Participants performed range of motion (ROM) tasks at approximately 1-second intervals, either volitionally or through functional electrical stimulation. We simultaneously recorded electroencephalography, surface electromyography (EMG), continuous ultrasound imaging, and motion capture data. Joint kinematics were computed from ultrasound imaging using a technique called sonomyography (SMG), and we evaluated the technical feasibility of estimating joint kinematics from both sonomyography and surface EMG signals.

Results: The technical feasibility study evaluated joint angle prediction using EMG and SMG under volitional (FES-OFF) and electrically stimulated (FES-ON) conditions. Root mean squared error (RMSE) between predicted and measured joint angles was computed for multiple methods of extracting kinematics from EMG and SMG. EMG-based RMSE ranged from 0.34 to 0.57 (FES-OFF) and 0.43-0.51 (FES-ON). SMG-based RMSE ranged from 0.10 to 0.25 across all conditions and methods. Linear regression analysis produced R 2 values between 0.31 and 0.81 depending on joint, condition, and method. No significant RMSE difference was found between FES-ON and FES-OFF conditions within SMG. SMG RMSE values were also comparable to previously reported values (10-25%) in prior literature.

Conclusion: Our findings suggest that sonomyography can be used as a noninvasive method for estimating joint kinematics when the joint movement is driven either by volition or by functional electrical stimulation. This technique can potentially be be useful in evaluating altered muscle dynamics and driving assistive and rehabilitation devices in individuals with neuromotor disorders such as cerebral palsy.

背景:尽管用于研究神经运动障碍的生物信号提取技术取得了重大进展,但仍然需要一种有效地将肌肉结构和动力学与肌肉激活联系起来的方法。解决这一差距可以改善神经肌肉损伤的量化,并为精确康复铺平道路。在这项研究中,我们证明了记录来自大脑、肌肉和肢体运动学的多模态信号的概念。我们还探讨了使用超声成像提取肢体运动学。方法:我们收集了3名健康志愿者和1名脑瘫患者单自由度踝关节和手腕运动的数据。参与者以大约1秒的间隔进行活动范围(ROM)任务,可以是自愿的,也可以是通过功能性电刺激。同时记录脑电图、表面肌电图(EMG)、连续超声成像和运动捕捉数据。关节运动学是利用超声成像技术(SMG)计算的,我们评估了从超声和表面肌电信号估计关节运动学的技术可行性。结果:技术可行性研究评估了在自主(FES-OFF)和电刺激(FES-ON)条件下使用肌电图和SMG预测关节角度的可行性。对肌电图和关节图的运动学提取方法,计算了预测关节角与实测关节角的均方根误差(RMSE)。基于肌电图的RMSE范围为0.34 ~ 0.57 (FES-OFF)和0.43 ~ 0.51 (FES-ON)。在所有条件和方法中,基于smg的RMSE范围为0.10到0.25。线性回归分析产生的R2值在0.31和0.81之间,这取决于关节、条件和方法。在SMG中,FES-ON和FES-OFF条件之间没有发现显著的均方根误差差异。SMG RMSE值也与先前文献中报道的值(10-25%)相当。结论:我们的研究结果表明,当关节运动是由意志或功能性电刺激驱动时,声纳图可以作为一种无创的方法来估计关节运动学。这项技术可以潜在地用于评估肌肉动力学的改变,并在神经运动障碍(如脑瘫)患者中驱动辅助和康复设备。
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引用次数: 0
Monitoring wheelchair propulsion patterns: feasibility and validity of using wearable sensors. 监测轮椅推进模式:使用可穿戴传感器的可行性和有效性。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-12-10 DOI: 10.1186/s12984-025-01823-5
Ramin Fathian, Aminreza Khandan, Nasim Rahmanifar, Chester Ho, Hossein Rouhani
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引用次数: 0
期刊
Journal of NeuroEngineering and Rehabilitation
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