%0 Journal Article
%T Myoelectric Computer Interface Training for Reducing Co
%A Aparna Singh
%A Camila Limoli
%A Elizabeth Robinson
%A Emily M. Mugler
%A Eric W. Lindberg
%A Goran Tomic
%A Jon Gaide
%A Jungwha Lee
%A Katherine Dalzotto
%A Marc W. Slutzky
%A Murad Alqadi
%A Saad Hameed
%A Tyler Jacobson
%J Neurorehabilitation and Neural Repair
%@ 1552-6844
%D 2019
%R 10.1177/1545968319834903
%X Background. Abnormal muscle co-activation contributes to impairment after stroke. We developed a myoelectric computer interface (MyoCI) training paradigm to reduce abnormal co-activation. MyoCI provides intuitive feedback about muscle activation patterns, enabling decoupling of these muscles. Objective. To investigate tolerability and effects of MyoCI training of 3 muscle pairs on arm motor recovery after stroke, including effects of training dose and isometric versus movement-based training. Methods. We randomized chronic stroke survivors with moderate-to-severe arm impairment to 3 groups. Two groups tested different doses of isometric MyoCI (60 vs 90 minutes), and one group tested MyoCI without arm restraint (90 minutes), over 6 weeks. Primary outcome was arm impairment (Fugl-Meyer Assessment). Secondary outcomes included function, spasticity, and elbow range-of-motion at weeks 6 and 10. Results. Over all 32 subjects, MyoCI training of 3 muscle pairs significantly reduced impairment (Fugl-Meyer Assessment) by 3.3 ¡À 0.6 and 3.1 ¡À 0.7 (P < 10£¿4) at weeks 6 and 10, respectively. Each group improved significantly from baseline; no significant differences were seen between groups. Participants¡¯ lab-based and home-based function also improved at weeks 6 and 10 (P ¡Ü .01). Spasticity also decreased over all subjects, and elbow range-of-motion improved. Both moderately and severely impaired patients showed significant improvement. No participants had training-related adverse events. MyoCI reduced abnormal co-activation, which appeared to transfer to reaching in the movement group. Conclusions. MyoCI is a well-tolerated, novel rehabilitation tool that enables stroke survivors to reduce abnormal co-activation. It may reduce impairment and spasticity and improve arm function, even in severely impaired patients
%K stroke rehabilitation
%K upper extremity
%K co-activation
%K EMG
%K impairment
%K feedback
%K function
%U https://journals.sagepub.com/doi/full/10.1177/1545968319834903