Biofeedback systems have been developing rapidly in recent years as rehabilitation methods for hemiplegic stroke patients. To investigate the value of such systems for the rehabilitation of these patients, we complemented the Useful and Ultimate Rehabilitation System PARKO (UR-System-PARKO) with a biofeedback system that had an A-B-A-B design, to see if together, patients saw more improvement in a shorter timespan in the control of the extensor muscles in their hands. The biofeedback system was tested without therapist participation. We evaluated the effectiveness of each training trial by recording electromyography (EMG) signals for the extensor and flexor digitorum muscles. By comparing the EMG values from each trial, we were able to conclude that the training with the UR-System-PARKO became more effective when the biofeedback system was applied. This also demonstrated that, by using a biofeedback system, it would be possible for stroke hemiplegic patients to conduct highly efficient self-rehabilitation.
Abstract After stroke, hemiplegic individuals have difficulty opening their hands by themselves due to paralysis. A finger extensor facilitation technique was therefore developed to increase the activity of the extensor muscle in hemiplegic individuals who cannot open their paralyzed hands by themselves. In our previous study, we created a training device prototype called the "PARKO", that imitates the finger extensor facilitation technique; however, the activity of the extensor muscle using the device was much smaller than that of the finger extensor facilitation technique. In this study, we developed a new finger extensor facilitation training device, the "iPARKO", to increase the activity of the extensor muscle during active training. We thus improved the structure of the PARKO device—including a modified method to apply force to the fingertips—and attached force sensors to the device to monitor these forces. To verify the effectiveness of the iPARKO device, we conducted active training using the device in healthy individuals. Comparing the results of the muscle activities between the PARKO and iPARKO devices among three healthy subjects demonstrated that the iPARKO device increased the mean activity of the extensor muscle by 43.8%, and decreased the mean activity of the flexor muscle by 33.7% when compared with the PARKO device. Additionally, when the iPARKO device was used to apply force to the fingertips, the fingertip forces and normalized values for maximum voluntary contraction of the extensor muscle were revealed in two healthy subjects. In conclusion, the iPARKO device improved the accuracy of imitating manual therapy compared with the PARKO device.
Applying an external force to a person's hyperextended fingertip produces electrical activity of the extensor digitorum muscle even when the hand is not opened by the person. Based on this, a finger extensor facilitation technique has been developed for hemiplegic patients who cannot open the paralyzed hand by themselves. In this study, we developed a finger extensor facilitation training device named "iPARKO" that imitates this technique. We examined the factors that promote activities in the extensor digitorum muscle by conducting active training using iPARKO. Experiments were conducted on a healthy person and a hemiplegic person. It was found that active training using iPARKO leads to activities in the extensor digitorum muscle even in a hemiplegic person who cannot open their hand. In addition, it was found that a hemiplegic person can increase muscle activity by pressing their hand movement and utilizing electromyography biofeedback. The hand movement was clarified as follows: the hemiplegic person pressed the hand against the moving part of the device and pushed the fingertip further into it as a voluntary movement to increase the amount of muscle activity.
Abstract After stroke, hemiplegic individuals have difficulty opening their hands by themselves due to paralysis. A finger extensor facilitation technique was therefore developed to increase the activity of the extensor muscle in hemiplegic individuals who cannot open their paralyzed hands by themselves. In our previous study, we created a training device prototype called the “PARKO”, that imitates the finger extensor facilitation technique; however, the activity of the extensor muscle using the device was much smaller than that of the finger extensor facilitation technique. In this study, we developed a new finger extensor facilitation training device, the “iPARKO”, to increase the activity of the extensor muscle during active training. We thus improved the structure of the PARKO device—including a modified method to apply force to the fingertips—and attached force sensors to the device to monitor these forces. To verify the effectiveness of the iPARKO device, we conducted active training using the device in healthy individuals. Comparing the results of the muscle activities between the PARKO and iPARKO devices among three healthy participants demonstrated that the iPARKO device increased the mean activity of the extensor muscle by 43.8%. Furthermore, the activity of the extensor muscle in two healthy individuals while moving the hand forward with the iPARKO device was 84% and 96% of the maximal voluntary contraction during the hand-opening motion without the iPARKO device.
We have developed a finger extensor facilitation training device “iPARKO”, which imitates the manual treatment method by a therapist. Many hemiplegic stroke patients are unable to open a paralyzed hand. Therefore, they need to strengthen extensor muscle to open their hand by himself or herself. In this paper the effectiveness of iPARKO on healthy persons was verified by two comparative experiments. The extensor muscle activity using iPARKO was approximately 40 % greater than that using our previous device PARKO. Moreover, the extensor muscle activity using iPARKO was approximately 80 % of that at maximum voluntary contraction for opening a hand.
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