This work highlights the potential of wearable technologoies to monitor muscle activity changes during stroke recovery in acute clinical settings and their importance for motivation and understanding of progression from the survivor’s point of view: ‘I was hopeful that it would show signs of things that are occurring when I couldn’t physically feel it…if you had other scientific evidence that things were happening, even beyond their notion that it would, it gives you a lot of hope. You just have to be patient, and it’s harder to take when someone tells you, but easier to understand if someone actually shows you’.
Aim: Describe the use of wireless sEMG sensors to examine changes in muscle activity during acute and subacute phases of stroke recovery, and understand the participant’s perceptions of sEMG monitoring.
Method: Muscle activity was tracked by five wireless sEMG sensors beginning three days post-stroke and continued through discharge from inpatient rehabilitation. Activity logs were completed each session, and a semi-structured interview occurred at the final session with three- and eight-month follow-up sessions.
Results: The longitudinal monitoring of muscle and movement recovery in the clinic and community was feasible using sEMG sensors. The participant and medical team felt monitoring was unobtrusive, interesting, and motivating for recovery, but desired greater in-session feedback to inform rehabilitation.
Interpretation: This work highlights that barriers in equipment and signal quality still exist, but capitalizing on wearable sensing technology in the clinic holds promise for enabling personalized stroke recovery.
Steele Lab members – Kat, Christina, Nick, and Momona – were invited to present their research about wearable sensors for stroke recovery and device control to the Seattle Young Adult Stroke Survivors (YASS). YASS is a support group for individuals who have experienced a stroke and creates a community to learn, listen, share, and more. Steele lab was one of the first research groups to come and share our work with them.
Our presentation began with background information regarding neurophysiological changes after stroke to provide insight into upper extremity functional impairments – including weakness, loss of dexterity, and abnormal tone. Wearable sensors, such as electromyography (EMG), can provide information regarding muscle function. Many of the listeners were surprised to hear that their own smartphones or watches can act as wearable sensors!
A focus of our research is detecting muscle activity early after stroke using EMG. One member recalled thinking their muscle was firing during their acute recovery but could not see any physical movement. EMG allows us to capture that type of activity and any functional changes throughout recovery, empowering patients and clinicians to track their recovery and adjust their therapy regimen. The crowd was interested in using EMG to evaluate their own muscles, identify which were firing, and guide their rehabilitation.
EMG not only helps us track recovery, but can be paired with consumer technology. Nick demonstrated how using muscle activity from the affected limb can incorporate rehabilitation into daily computer use. EMG signals can simulate pressing keys on a keyboard or moving a mouse cursor, making it easier for people with limited mobility to use technology. YASS members expressed enthusiasm about the increasing commercial availability of such devices so they can buy them and give them a try.
It was a great opportunity to connect with stroke survivors and hear their thoughts on wearable sensors. Thank you to YASS for having us come in and share our research!
The Ability & Innovation Lab is excited to announce that two of our recent grant proposals have been funded! This funding will help to accelerate our mission to improve movement for individuals with neurologic disorders.
Quantifying patient-specific changes in neuromuscular control in cerebral palsy: Funded by the National Institute of Neurological Disorders and Stroke, this research will examine how new measures of neuromuscular control can be used to better predict outcomes after multi-level orthopaedic surgery for individuals with cerebral palsy. We will be working in close partnership with Gillette Children’s Specialty Healthcare, one of the leading institutions in the management of pediatric neurological disorders. This research will address the challenge of identifying the best treatment for each individual. Cerebral palsy is caused by a brain injury and every brain injury is unique. We will be using new measures from muscle synergy analysis (see prior work here) to determine how patient-specific measures of control can be used to predict outcomes after surgery.
Ubiquitous rehabilitation to improve movement after neurologic injury:Funded by the joint NSF-NIH Smart & Connected Health Initiative, this research will work in partnership with the University of Texas at Austin to use flexible electrodes to track and train muscle activity after stroke and other neurologic injuries. We know that more practice and use after brain injury increases long-term recovery and function. This research will investigate new pathways for both motivating patients to re-learn to use their muscle and providing doctors and therapists with the data and insight needed to guide and customize therapy.