Exoneuromusculoskeleton for Upper Limb Rehabilitation After Stroke

Mobile Electromyography (EMG)-Driven Exoneuromusculoskeleton for Upper Limb Rehabilitation After Stroke

A new clothing robotic arm was developed for multi-joint coordinated upper limb rehabilitation after stroke. Patients after stroke will be recruited to evaluate the rehabilitation effectiveness of the device assisted upper limb rehabilitation. Both patients with chronic stroke and subacute stroke will be investigated.

A new robotic arm, named mobile exo-neuro-musculo-skeleton, was developed for upper limb rehabilitation. The system integrated the advantages of exoskeleton, soft robot, and neuromuscular electrical stimulation. It is noninvasive, light in weight, comfortable to wear, and can support the motions at the elbow, the wrist and the fingers. The device is a mobile system interfaced with a mobile app by a user.

The device assisted upper limb rehabilitation will be applied to inpatients with subacute stroke. The rehabilitation effects on the motor restoration in the upper limb will be compared with the conventional physical and occupational therapies. The rehabilitation effects of the device assisted training also will be evaluated on patients with chronic stroke. The motor improvements after training will be investigated by comparing the pre- and post- clinical assessments. It is hypothesized that the device assisted upper limb rehabilitation will be effective in both subacute and chronic patients.

Inclusion Criteria:

For the subacute groups:

• Two weeks after the onset of stroke, however less than 0.5 year
• Mini-Mental State Examination (MMSE)>21
• Able to sit up for at least 1 hour
• Fugl-Meyer Assessment (FMA) upper limb <30
• Modified Ashworth Score (MAS) at the elbow, wrist and fingers <3
• Detectable EMG on the target driving muscles (i.e., 3 times of the standard deviation above the baseline)

For the chronic device assisted group:

• At least 0.5 year after the onset of stroke
• Mini-Mental State Examination (MMSE)>21
• Able to sit up for at least 1 hour
• Fugl-Meyer Assessment (FMA) upper limb <30
• Modified Ashworth Score (MAS) at the elbow, wrist and fingers <3
• Detectable EMG on the target driving muscles (i.e., 3 times of the standard deviation above the baseline)

Exclusion Criteria:

Subjects will be excluded if they do not meet the above inclusion criteria, or had the following conditions:

• Currently pregnant
• Dysphasia (language deficiency)
• Post-stroke neglect
• Pacemaker implantation,
• Involved in drug studies, other clinical trials, or concurrent medication/occupational/physical treatments on the upper limb
• The overall medical condition not suitable for the training (e.g., severe cardiac problem, unstable blood pressure, etc.).