AUTHOR=Ye Sijia , Tao Liang , Gong Shuang , Ma Yehao , Wu Jiajia , Li Wanyi , Kang Jiliang , Tang Min , Zuo Guokun , Shi Changcheng 

TITLE=Upper limb motor assessment for stroke with force, muscle activation and interhemispheric balance indices based on sEMG and fNIRS

JOURNAL=Frontiers in Neurology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1337230

DOI=10.3389/fneur.2024.1337230

ISSN=1664-2295

ABSTRACT=<sec><title>Introduction</title><p>Upper limb rehabilitation assessment plays a pivotal role in the recovery process of stroke patients. The current clinical assessment tools often rely on subjective judgments of healthcare professionals. Some existing research studies have utilized physiological signals for quantitative assessments. However, most studies used single index to assess the motor functions of upper limb. The fusion of surface electromyography (sEMG) and functional near-infrared spectroscopy (fNIRS) presents an innovative approach, offering simultaneous insights into the central and peripheral nervous systems.</p></sec><sec><title>Methods</title><p>We concurrently collected sEMG signals and brain hemodynamic signals during bilateral elbow flexion in 15 stroke patients with subacute and chronic stages and 15 healthy control subjects. The sEMG signals were analyzed to obtain muscle synergy based indexes including synergy stability index (<italic>SSI</italic>), closeness of individual vector (<italic>C<sub>V</sub></italic>) and closeness of time profile (<italic>C<sub>T</sub></italic>). The fNIRS signals were calculated to extract laterality index (<italic>LI</italic>).</p></sec><sec><title>Results</title><p>The primary findings were that <italic>C<sub>V</sub></italic>, <italic>SSI</italic> and <italic>LI</italic> in posterior motor cortex (PMC) and primary motor cortex (M1) on the affected hemisphere of stroke patients were significantly lower than those in the control group (<italic>p</italic> &lt; 0.05). Moreover, <italic>C<sub>V</sub></italic>, <italic>SSI</italic> and <italic>LI</italic> in PMC were also significantly different between affected and unaffected upper limb movements (<italic>p</italic> &lt; 0.05). Furthermore, a linear regression model was used to predict the value of the Fugl-Meyer score of upper limb (FMul) (<italic>R<sup>2</sup></italic> = 0.860, <italic>p</italic> &lt; 0.001).</p></sec><sec><title>Discussion</title><p>This study established a linear regression model using force, <italic>C<sub>V</sub></italic>, and <italic>LI</italic> features to predict FMul scale values, which suggests that the combination of force, sEMG and fNIRS hold promise as a novel method for assessing stroke rehabilitation.</p></sec>