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ORIGINAL ARTICLE   Free accessfree

European Journal of Physical and Rehabilitation Medicine 2018 October;54(5):705-16

DOI: 10.23736/S1973-9087.18.04706-8


lingua: Inglese

Efficacy of the Regent Suit-based rehabilitation on gait EMG patterns in hemiparetic subjects: a pilot study

Luigi IUPPARIELLO 1, Giovanni D’ADDIO 1, 2, Maria ROMANO 3, Paolo BIFULCO 1, 2, Nicola PAPPONE 4, Bernardo LANZILLO 5 , Mario CESARELLI 1, 2

1 Department of Electric Engineering and Information Technologies (DIETI), School of Engineering, Federico II University of Naples, Naples, Italy; 2 Department of Bioengineering, S. Maugeri Foundation, Telese Terme, Benevento, Italy; 3 DMSC, “Magna Graecia” University, Catanzaro, Italy; 4 Department of Orthopedics, S. Maugeri Foundation, Telese Terme, Benevento, Italy; 5 Department of Neurology, S. Maugeri Foundation, Telese Terme, Benevento, Italy

BACKGROUND: The recovery of the functional limb mobility of patients with cerebral damages can take great benefit of the role offered by proprioceptive rehabilitation. Recently have been developed a special Regent Suit (RS) for rehabilitative applications. Actually, there are preliminary studies which describes the effects of RS on gait recovery of stroke patients in acute stage, but none in chronic stage. Moreover, it is known that motor recovery does not always reflect improvements of the muscle activity and coactivity.
AIM: To investigate the effects of proprioceptive stimulation induced by the Regent Suit (RS) on the EMG patterns during gait in post-stroke chronic patients.
DESIGN: Randomized controlled trial.
SETTING: S. Maugeri Foundation, Telese Terme (BN), Italy.
POPULATION: Patients have been randomly assigned into two equal groups of 20 patients: experimental group and traditional group. Further, a control group of 20 healthy subjects have been enrolled.
METHODS: The traditional group attended a rehabilitation program composed by neuro-motor exercises without the RS, the experimental group performed the same rehabilitation program while wearing the RS. The NIH Stroke Scale (NIHSS), the Barthel Index (BI), the Functional Independent Measure (FIM) and the Berg Balance Scale (BBS) have been evaluated. EMG analysis has been performed considering the muscle activation timing over the gait of the soleus, tibialis anterior, semitendinosus and vastus lateralis muscles by decomposing the EMG signals into Gaussian pulses. Then, the symmetry of muscle activation and the muscle synergy patterns over the gait cycle have been assessed.
RESULTS: The proprioceptive stimulation of the RS-based treatment induces higher and remarkable restoration of the normal muscle activation timing, also increasing the muscle symmetry and reducing the pathological muscle coactivation on both affected and non-affected sides.
CONCLUSIONS: These results suggest confirm that a RS-based treatment is more effective than usual care in improving the EMG patterns during locomotion and daily living activities in chronic post-stroke subjects.
CLINICAL REHABILITATION IMPACT: The proprioceptive rehabilitation Regent Suit based has an impact on motor function in stroke patients during gait.

KEY WORDS: Stroke - Locomotion - Rehabilitation

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