No approaches extensively explored how to avoid pathological movement reinforcement associated with electromyography-controlled rehabilitation in unilateral stroke patients with motor impairments of the upper limb.
This project will explore the problem focusing on the methodological development of a physiological measure to assess in a quantitative way the quality of the muscle patterns.
Specifically, it aims to define a physiological-evidence-based global index adaptable to the specific need of each patient and stable among rehabilitative training sessions to (a) quantitative assess the quality of the movement, i.e. of the muscular pattern, to ultimately identify pathological synergies and define the strategy to discourage them, (b) to detect and monitor their changes among consecutive rehabilitative training sessions.
The project will explore pathological synergies during simple rehabilitative exercises in stroke patients and how they change properties of the EMG signal, reflecting, therefore, alterations in upper limb muscle synergy structure caused by stroke.
The global index, which will be defined in the project, could be integrated into a tool (device) potentially usable by patients at home for evaluating by themselves the quality of movements. Promising results can be exploited in the designing of new effective and efficient treatments based on physiological information coming from the muscular pattern of each patient.
This research project takes place in the context of the technology-based approaches to support the post-stroke motor rehabilitation of the upper limb. The expected results of the project, indeed, might be useful in the designing of new effective and efficient treatments based on physiological information coming from the muscular pattern of each patient.
EMG information collected during the hand movements or movement attempts will be used to estimate in real-time a physiological global index. It will be able to assess the quality of synergies constructed by the patient to perform the rehabilitative task and monitor it to discourage the pathological synergies and ultimately to reinforce time by time more "correct" synergies.
In some ways, the project will increase the current opportunities to maximize the recovery of the hand movement in stroke patients since it will return more quantitative monitoring of patients' condition and improvement during the process of regaining motor abilities.
From a scientific perspective, the project will provide new myoelectric features to quantitatively and qualitatively assess the muscular activity after stroke, increasing the current knowledge in the field and promoting the development of customized rehabilitative strategies.
From a clinical perspective, the research activity will provide a tool to monitor the recovery and the effectiveness of the therapy using the estimated global index as the measure for pathological synergies. Once the index has been defined to evaluate which synergy is considered pathological, the same index could be applied in the evaluation of the efficacy of other rehabilitative treatments for the upper limb.
From a technical perspective, in an exploratory manner, the global index defined in the proposal could be integrated into a tool (device) potentially usable by patients at home for evaluating by themselves the quality of movements.