J Neuroeng Rehabil
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Clinical Trial
Quantitative evaluation for spasticity of calf muscle after botulinum toxin injection in patients with cerebral palsy: a pilot study.
Cerebral palsy (CP) is the most common pediatric disease to cause motor disability. Two common symptoms in CP are spasticity and contracture. If this occurred in the ankle plantar flexors of children with CP, it will impair their gait and active daily living profoundly. Most children with CP receive botulinum toxin type A (BoNT-A) injection to reduce muscle tone, but a knowledge gap exists in the understanding of changes of neural and non-neural components of spasticity after injection. The purpose of this study was to determine if our device for quantitative modified Tardieu approach (QMTA) is a valid method to assess spasticity of calf muscles after botulinum toxin injection. ⋯ Our device for QMTA can objectively measure the changes in spasticity of the gastrocnemius muscle in children with cerebral palsy after BoNT-A injection.
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Most prosthetic myoelectric control studies have concentrated on low density (less than 16 electrodes, LD) electromyography (EMG) signals, due to its better clinical applicability and low computation complexity compared with high density (more than 16 electrodes, HD) EMG signals. Since HD EMG electrodes have been developed more conveniently to wear with respect to the previous versions recently, HD EMG signals become an alternative for myoelectric prostheses. The electrode shift, which may occur during repositioning or donning/doffing of the prosthetic socket, is one of the main reasons for degradation in classification accuracy (CA). ⋯ The results demonstrated that the CSP features significantly improved the robustness against electrode shift for myoelectric control with respect to the commonly used features.
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Wearable sensor systems can provide data for at-home gait analyses and input to controllers for rehabilitation devices but they often have reduced estimation accuracy compared to laboratory systems. The goal of this study is to evaluate a portable, low-cost system for measuring ground reaction forces and ankle joint torques in treadmill walking and calf raises. ⋯ The proposed sensor system provided accurate estimates for five of the six components of the ground reaction kinetics during walking at 1.0 and 1.5 m/s and one of the six components during the calf raise task. The normalized root mean square error of the predictions of the ground reaction forces were similar to published studies using commercial devices. The proposed system of low-cost sensors can provide useful estimations of ankle joint torque for both walking and calf raises for future studies in mobile gait analysis.
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Direct brain control of overground walking in those with paraplegia due to spinal cord injury (SCI) has not been achieved. Invasive brain-computer interfaces (BCIs) may provide a permanent solution to this problem by directly linking the brain to lower extremity prostheses. To justify the pursuit of such invasive systems, the feasibility of BCI controlled overground walking should first be established in a noninvasive manner. To accomplish this goal, we developed an electroencephalogram (EEG)-based BCI to control a functional electrical stimulation (FES) system for overground walking and assessed its performance in an individual with paraplegia due to SCI. ⋯ This proof-of-concept study demonstrates for the first time that restoring brain-controlled overground walking after paraplegia due to SCI is feasible. Further studies are warranted to establish the generalizability of these results in a population of individuals with paraplegia due to SCI. If this noninvasive system is successfully tested in population studies, the pursuit of permanent, invasive BCI walking prostheses may be justified. In addition, a simplified version of the current system may be explored as a noninvasive neurorehabilitative therapy in those with incomplete motor SCI.
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Case Reports Comparative Study
Comparison of eye tracking, electrooculography and an auditory brain-computer interface for binary communication: a case study with a participant in the locked-in state.
In this study, we evaluated electrooculography (EOG), an eye tracker and an auditory brain-computer interface (BCI) as access methods to augmentative and alternative communication (AAC). The participant of the study has been in the locked-in state (LIS) for 6 years due to amyotrophic lateral sclerosis. He was able to communicate with slow residual eye movements, but had no means of partner independent communication. We discuss the usability of all tested access methods and the prospects of using BCIs as an assistive technology. ⋯ In this case study, the partner based communication was possible due to the good care provided and the proficiency achieved by the interlocutors. To ease the transition from a low-tech AAC method to a BCI once control over all muscles is lost, it must be simple to operate. For persons, who rely on AAC and are affected by a progressive neuromuscular disease, we argue that a complementary approach, combining BCIs and standard assistive technology, can prove valuable to achieve partner independent communication and ease the transition to a purely BCI based approach. Finally, we provide further evidence for the importance of a user-centered approach in the design of new assistive devices.