Influences of the biofeedback content on robotic post-stroke gait rehabilitation: electromyographic vs joint torque biofeedback

[Background] Add-on robot-mediated therapy has proven to be more effective than conventional therapy alone in post-stroke gait rehabilitation. Such robot-mediated interventions routinely use also visual biofeedback tools. A better understanding of biofeedback content effects when used for robotic lo...

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Autores: Tamburella, Federica, Moreno, Juan Camilo, Herrera Valenzuela, Diana S., Pisotta, Iolanda, Iosa, Marco, Cincotti, Febo, Mattia, Donatella, Pons Rovira, José Luis, Molinari, Marco
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:digital.csic.es:10261/187026
Acceso en línea:http://hdl.handle.net/10261/187026
Access Level:acceso abierto
Palabra clave:Stroke
Rehabilitation
Robot
Biomechanics
Electromyography
Biofeedback
Top-down approach
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spelling Influences of the biofeedback content on robotic post-stroke gait rehabilitation: electromyographic vs joint torque biofeedbackTamburella, FedericaMoreno, Juan CamiloHerrera Valenzuela, Diana S.Pisotta, IolandaIosa, MarcoCincotti, FeboMattia, DonatellaPons Rovira, José LuisMolinari, MarcoStrokeRehabilitationRobotBiomechanicsElectromyographyBiofeedbackTop-down approach[Background] Add-on robot-mediated therapy has proven to be more effective than conventional therapy alone in post-stroke gait rehabilitation. Such robot-mediated interventions routinely use also visual biofeedback tools. A better understanding of biofeedback content effects when used for robotic locomotor training may improve the rehabilitation process and outcomes.[Methods] This randomized cross-over pilot trial aimed to address the possible impact of different biofeedback contents on patients’ performance and experience during Lokomat training, by comparing a novel biofeedback based on online biological electromyographic information (EMGb) versus the commercial joint torque biofeedback (Rb) in sub-acute non ambulatory patients. 12 patients were randomized into two treatment groups, A and B, based on two different biofeedback training. For both groups, study protocol consisted of 12 Lokomat sessions, 6 for each biofeedback condition, 40 min each, 3 sessions per week of frequency. All patients performed Lokomat trainings as an add-on therapy to the conventional one that was the same for both groups and consisted of 40 min per day, 5 days per week. The primary outcome was the Modified Ashworth Spasticity Scale, and secondary outcomes included clinical, neurological, mechanical, and personal experience variables collected before and after each biofeedback training.[Results] Lokomat training significantly improved gait/daily living activity independence and trunk control, nevertheless, different effects due to biofeedback content were remarked. EMGb was more effective to reduce spasticity and improve muscle force at the ankle, knee and hip joints. Robot data suggest that Rb induces more adaptation to robotic movements than EMGb. Furthermore, Rb was perceived less demanding than EMGb, even though patient motivation was higher for EMGb. Robot was perceived to be effective, easy to use, reliable and safe: acceptability was rated as very high by all patients.[Conclusions] Specific effects can be related to biofeedback content: when muscular-based information is used, a more direct effect on lower limb spasticity and muscle activity is evidenced. In a similar manner, when biofeedback treatment is based on joint torque data, a higher patient compliance effect in terms of force exerted is achieved. Subjects who underwent EMGb seemed to be more motivated than those treated with Rb.This work has been partially supported by the European Commission with grant ICT-2009-247935 BETTER (Brain-Neural Computer Interaction for Evaluation and Testing of Physical Therapies in Stroke Rehabilitation of Gait Disorders) and Spanish Ministry of Science with grant Ramón y Cajal 2014–16613, and Italian Ministry of Health (Ricerca Finalizzata).Peer reviewedBioMed CentralEuropean CommissionMinisterio de Economía y Competitividad (España)Ministero della SaluteConsejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]2019201920192019info:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_6501Publisher's versioninfo:eu-repo/semantics/publishedVersionhttp://hdl.handle.net/10261/187026reponame:DIGITAL.CSIC. Repositorio Institucional del CSICinstname:Consejo Superior de Investigaciones Científicas (CSIC)Inglés#PLACEHOLDER_PARENT_METADATA_VALUE##PLACEHOLDER_PARENT_METADATA_VALUE#info:eu-repo/grantAgreement/EC/FP7/247935info:eu-repo/grantAgreement/MINECO/Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016/RYC-2014-16613https://doi.org/10.1186/s12984-019-0558-0Síinfo:eu-repo/semantics/openAccessoai:digital.csic.es:10261/1870262026-05-22T06:33:51Z
dc.title.none.fl_str_mv Influences of the biofeedback content on robotic post-stroke gait rehabilitation: electromyographic vs joint torque biofeedback
title Influences of the biofeedback content on robotic post-stroke gait rehabilitation: electromyographic vs joint torque biofeedback
spellingShingle Influences of the biofeedback content on robotic post-stroke gait rehabilitation: electromyographic vs joint torque biofeedback
Tamburella, Federica
Stroke
Rehabilitation
Robot
Biomechanics
Electromyography
Biofeedback
Top-down approach
title_short Influences of the biofeedback content on robotic post-stroke gait rehabilitation: electromyographic vs joint torque biofeedback
title_full Influences of the biofeedback content on robotic post-stroke gait rehabilitation: electromyographic vs joint torque biofeedback
title_fullStr Influences of the biofeedback content on robotic post-stroke gait rehabilitation: electromyographic vs joint torque biofeedback
title_full_unstemmed Influences of the biofeedback content on robotic post-stroke gait rehabilitation: electromyographic vs joint torque biofeedback
title_sort Influences of the biofeedback content on robotic post-stroke gait rehabilitation: electromyographic vs joint torque biofeedback
dc.creator.none.fl_str_mv Tamburella, Federica
Moreno, Juan Camilo
Herrera Valenzuela, Diana S.
Pisotta, Iolanda
Iosa, Marco
Cincotti, Febo
Mattia, Donatella
Pons Rovira, José Luis
Molinari, Marco
author Tamburella, Federica
author_facet Tamburella, Federica
Moreno, Juan Camilo
Herrera Valenzuela, Diana S.
Pisotta, Iolanda
Iosa, Marco
Cincotti, Febo
Mattia, Donatella
Pons Rovira, José Luis
Molinari, Marco
author_role author
author2 Moreno, Juan Camilo
Herrera Valenzuela, Diana S.
Pisotta, Iolanda
Iosa, Marco
Cincotti, Febo
Mattia, Donatella
Pons Rovira, José Luis
Molinari, Marco
author2_role author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv European Commission
Ministerio de Economía y Competitividad (España)
Ministero della Salute
Consejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]
dc.subject.none.fl_str_mv Stroke
Rehabilitation
Robot
Biomechanics
Electromyography
Biofeedback
Top-down approach
topic Stroke
Rehabilitation
Robot
Biomechanics
Electromyography
Biofeedback
Top-down approach
description [Background] Add-on robot-mediated therapy has proven to be more effective than conventional therapy alone in post-stroke gait rehabilitation. Such robot-mediated interventions routinely use also visual biofeedback tools. A better understanding of biofeedback content effects when used for robotic locomotor training may improve the rehabilitation process and outcomes.
publishDate 2019
dc.date.none.fl_str_mv 2019
2019
2019
2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
http://purl.org/coar/resource_type/c_6501
Publisher's version
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10261/187026
url http://hdl.handle.net/10261/187026
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv #PLACEHOLDER_PARENT_METADATA_VALUE#
#PLACEHOLDER_PARENT_METADATA_VALUE#
info:eu-repo/grantAgreement/EC/FP7/247935
info:eu-repo/grantAgreement/MINECO/Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016/RYC-2014-16613
https://doi.org/10.1186/s12984-019-0558-0
Sí
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:DIGITAL.CSIC. Repositorio Institucional del CSIC
instname:Consejo Superior de Investigaciones Científicas (CSIC)
instname_str Consejo Superior de Investigaciones Científicas (CSIC)
reponame_str DIGITAL.CSIC. Repositorio Institucional del CSIC
collection DIGITAL.CSIC. Repositorio Institucional del CSIC
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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