A Portable, Neurostimulation-Integrated, Force Measurement Platform for the Clinical Assessment of Plantarflexor Central Drive

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Author(s)Collimore, Ashley N.
Author(s)Alvarez, Jonathan T.
Author(s)Sherman, David A.
Author(s)Gerez, Lucas F.
Author(s)Barrow, Noah
Author(s)Choe, Dabin K.
Author(s)Binder-Macleod, Stuart
Author(s)Walsh, Conor J.
Author(s)Awad, Louis N.
Date Accessioned2024-04-05T20:06:55Z
Date Available2024-04-05T20:06:55Z
Publication Date2024-01-30
DescriptionThis article was originally published in Bioengineering. The version of record is available at: https://doi.org/10.3390/bioengineering11020137. © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
AbstractPlantarflexor central drive is a promising biomarker of neuromotor impairment; however, routine clinical assessment is hindered by the unavailability of force measurement systems with integrated neurostimulation capabilities. In this study, we evaluate the accuracy of a portable, neurostimulation-integrated, plantarflexor force measurement system we developed to facilitate the assessment of plantarflexor neuromotor function in clinical settings. Two experiments were conducted with the Central Drive System (CEDRS). To evaluate accuracy, experiment #1 included 16 neurotypical adults and used intra-class correlation (ICC2,1) to test agreement of plantarflexor strength capacity measured with CEDRS versus a stationary dynamometer. To evaluate validity, experiment #2 added 26 individuals with post-stroke hemiparesis and used one-way ANOVAs to test for between-limb differences in CEDRS’ measurements of plantarflexor neuromotor function, comparing neurotypical, non-paretic, and paretic limb measurements. The association between paretic plantarflexor neuromotor function and walking function outcomes derived from the six-minute walk test (6MWT) were also evaluated. CEDRS’ measurements of plantarflexor neuromotor function showed high agreement with measurements made by the stationary dynamometer (ICC = 0.83, p < 0.001). CEDRS’ measurements also showed the expected between-limb differences (p’s < 0.001) in maximum voluntary strength (Neurotypical: 76.21 ± 13.84 ft-lbs., Non-paretic: 56.93 ± 17.75 ft-lbs., and Paretic: 31.51 ± 14.08 ft-lbs.), strength capacity (Neurotypical: 76.47 ± 13.59 ft-lbs., Non-paretic: 64.08 ± 14.50 ft-lbs., and Paretic: 44.55 ± 14.23 ft-lbs.), and central drive (Neurotypical: 88.73 ± 1.71%, Non-paretic: 73.66% ± 17.74%, and Paretic: 52.04% ± 20.22%). CEDRS-measured plantarflexor central drive was moderately correlated with 6MWT total distance (r = 0.69, p < 0.001) and distance-induced changes in speed (r = 0.61, p = 0.002). CEDRS is a clinician-operated, portable, neurostimulation-integrated force measurement platform that produces accurate measurements of plantarflexor neuromotor function that are associated with post-stroke walking ability.
SponsorThis research was funded by the Boston University Ignition Award, the National Institutes of Health (5F31HD106777). This project was also supported by the National Institutes of Health (NIH) Blueprint for Neuroscience Research and by the following NIH institutes: the National Institute of Child Health and Human Development (NICHD) and the National Institute of Neurological Disorders and Stroke (NINDS/BRAIN) through grant U54EB033664, subproject #15922.
CitationCollimore, Ashley N., Jonathan T. Alvarez, David A. Sherman, Lucas F. Gerez, Noah Barrow, Dabin K. Choe, Stuart Binder-Macleod, Conor J. Walsh, and Louis N. Awad. 2024. "A Portable, Neurostimulation-Integrated, Force Measurement Platform for the Clinical Assessment of Plantarflexor Central Drive" Bioengineering 11, no. 2: 137. https://doi.org/10.3390/bioengineering11020137
ISSN2306-5354
URLhttps://udspace.udel.edu/handle/19716/34250
Languageen_US
PublisherBioengineering
dc.rightsAttribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
Keywordsmuscle strength
Keywordsactivation
Keywordsburst superimposition
Keywordsneuromuscular
Keywordsstroke
Keywordsgait
TitleA Portable, Neurostimulation-Integrated, Force Measurement Platform for the Clinical Assessment of Plantarflexor Central Drive
TypeArticle
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