TY - JOUR
T1 - Exoskeleton-assisted gait in chronic stroke: An EMG and functional near-infrared spectroscopy study of muscle activation patterns and prefrontal cortex activity
AU - Caliandro, Pietro
AU - Molteni, F
AU - Simbolotti, C
AU - Guanziroli, E
AU - Iacovelli, C
AU - Reale, G
AU - Giovannini, Silvia
AU - Padua, Luca
PY - 2020
Y1 - 2020
N2 - Objectives: Gait impairment dramatically affects stroke patients' functional independence. The Ekso™ is a wearable powered exoskeleton able to improve over-ground gait abilities, but the relationship between the cortical gait control mechanisms and lower limbs kinematics is still unclear. Our aims are: to assess whether the Ekso™ induces an attention-demanding process with prefrontal cortex activation during a gait task; to describe the relationship between the gait-induced muscle activation pattern and the prefrontal cortex activity.\r\n\r\nMethods: We enrolled 22 chronic stroke patients and 15 matched controls. We registered prefrontal cortex (PFC) activity with functional Near-Infrared Spectroscopy (fNIRS) and muscle activation with surface-electromyography (sEMG) during an over-ground gait task, performed with and without the Ekso™.\r\n\r\nResults: We observed prefrontal cortex activation during normal gait and a higher activation during Ekso-assisted walking among stroke patients. Furthermore, we found that muscle hypo-activation and co-activation of non-paretic limb are associated to a high prefrontal metabolism.\r\n\r\nConclusions: Among stroke patients, over-ground gait is an attention-demanding task. Prefrontal activity is modulated both by Ekso-assisted tasks and muscle activation patterns of non-paretic lower limb. Further studies are needed to elucidate if other Ekso™ settings induce different cortical and peripheral effects.\r\n\r\nSignificance: This is the first study exploring the relationship between central and peripheral mechanisms during an Ekso-assisted gait task.
AB - Objectives: Gait impairment dramatically affects stroke patients' functional independence. The Ekso™ is a wearable powered exoskeleton able to improve over-ground gait abilities, but the relationship between the cortical gait control mechanisms and lower limbs kinematics is still unclear. Our aims are: to assess whether the Ekso™ induces an attention-demanding process with prefrontal cortex activation during a gait task; to describe the relationship between the gait-induced muscle activation pattern and the prefrontal cortex activity.\r\n\r\nMethods: We enrolled 22 chronic stroke patients and 15 matched controls. We registered prefrontal cortex (PFC) activity with functional Near-Infrared Spectroscopy (fNIRS) and muscle activation with surface-electromyography (sEMG) during an over-ground gait task, performed with and without the Ekso™.\r\n\r\nResults: We observed prefrontal cortex activation during normal gait and a higher activation during Ekso-assisted walking among stroke patients. Furthermore, we found that muscle hypo-activation and co-activation of non-paretic limb are associated to a high prefrontal metabolism.\r\n\r\nConclusions: Among stroke patients, over-ground gait is an attention-demanding task. Prefrontal activity is modulated both by Ekso-assisted tasks and muscle activation patterns of non-paretic lower limb. Further studies are needed to elucidate if other Ekso™ settings induce different cortical and peripheral effects.\r\n\r\nSignificance: This is the first study exploring the relationship between central and peripheral mechanisms during an Ekso-assisted gait task.
KW - Rehabilitation
KW - Stroke
KW - Rehabilitation
KW - Stroke
UR - https://publicatt.unicatt.it/handle/10807/167514
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85085745177&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85085745177&origin=inward
U2 - 10.1016/j.clinph.2020.04.158
DO - 10.1016/j.clinph.2020.04.158
M3 - Article
SN - 1388-2457
VL - 131
SP - 1775
EP - 1781
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
IS - 8
ER -