Background/Purpose: 

To determine the feasibility of training with electromyographically (EMG) controlled games to improve control of muscle activation patterns in stroke survivors.

Methods: 

Twenty chronic stroke survivors (>6 months) with moderate hand impairment were randomized to train either unilaterally (paretic only) or bilaterally over 9 one-hour training sessions. EMG signals from the unilateral or bilateral limbs controlled a cursor location on a computer screen for gameplay. The EMG muscle activation vector was projected onto the plane defined by the first 2 principal components of the activation workspace for the nonparetic hand. These principal components formed the x- and y-axes of the computer screen.

Results: 

The recruitment goal (n = 20) was met over 9 months, with no screen failure, no attrition, and 97.8% adherence rate. After training, both groups significantly decreased the time to move the cursor to a novel sequence of targets (P = 0.006) by reducing normalized path length of the cursor movement (P = 0.005), and improved the Wolf Motor Function Test (WMFT) quality score (P = 0.01). No significant group difference was observed. No significant change was seen in the WMFT time or Box and Block Test.

Discussion/Conclusions: 

Stroke survivors could successfully use the EMG-controlled games to train control of muscle activation patterns. While the nonparetic limb EMG was used in this study to create target EMG patterns, the system supports various means for creating target patterns per user desires. Future studies will employ training with the EMG-controlled games in conjunction with functional task practice for a longer intervention duration to improve overall hand function.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: https://links.lww.com/JNPT/A379).

中文翻译：

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使用 EMG 控制游戏作为治疗工具来重新训练中风后手部肌肉激活模式：一项试点研究

背景/目的： 

确定使用肌电图 (EMG) 控制游戏进行训练以改善中风幸存者肌肉激活模式控制的可行性。

方法： 

20 名患有中度手部损伤的慢性中风幸存者（>6 个月）被随机分配到单侧（仅麻痹）或双侧进行 9 个一小时的训练课程。来自单侧或双侧肢体的 EMG 信号控制计算机屏幕上的光标位置以进行游戏。EMG 肌肉激活向量被投影到由非瘫痪手的激活工作空间的前 2 个主成分定义的平面上。这些主要成分构成了计算机屏幕的 x 轴和 y 轴。

结果： 

招募目标（n = 20）在 9 个月内实现，没有筛选失败、没有减员和 97.8% 的依从率。训练后，两组通过减少光标移动的归一化路径长度 (P = 0.005) 显着减少了将光标移动到新的目标序列的时间 (P = 0.006) ，并提高了 Wolf 运动功能测试 (WMFT) 质量得分（P = 0.01）。没有观察到显着的组间差异。在 WMFT 时间或 Box and Block 测试中没有看到显着变化。

讨论/结论： 

中风幸存者可以成功地使用 EMG 控制的游戏来训练对肌肉激活模式的控制。虽然在本研究中使用非麻痹肢体 EMG 来创建目标 EMG 模式，但该系统支持根据用户需求创建目标模式的各种方法。未来的研究将采用 EMG 控制游戏的训练与功能性任务练习相结合，以延长干预持续时间，以改善整体手部功能。

视频摘要可从作者那里获得更多见解（参见视频，补充数字内容 1，可在：https ://links.lww.com/JNPT/A379 获得）。