Development of a portable electromyography biofeedback device for gait rehabilitation and associated neuromechanical analysis
Date
2021
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
University of Delaware
Abstract
Electromyography Biofeedback (EMG-BFB) is a promising, non-invasive intervention for improving gait but has been limited to laboratory use due to system cost and technical requirements. Translation of findings in gait rehabilitation to practice is limited. mTrigger ®, a cost effective, 2 channel, portable EMG-BFB device that connects to cellphone via Bluetooth provides a potential solution. The overall goal of this work was to repurpose, develop, and test mTrigger in a healthy population. ☐ Aim 1 & 2 repurposed mTrigger for gait rehabilitation; added features such as auditory and haptic biofeedback, success rate, cloud upload and calibration to the mTrigger app to make it more suitable for home and community-based training, and established validity and reliability of mTrigger in healthy participants for overground and treadmill walking, at speeds corresponding to home, limited community, and community ambulators, and normal walking speed. ☐ Aim 3 evaluated biomechanical changes in walking speed, peak ground reaction force measures, step time and step length measures and measures of asymmetry when participants used mTrigger to walk with EMG-BFB of medial gastrocnemius on treadmill at speeds corresponding to 4 increasing activation goals. We found significant increases in speed, peak forward propulsion, step time and step length in healthy participants. ☐ Finally, Aim 4 investigated changes in neural activity of prefrontal cortex (PFC), due to EMG-BFB walking and training using functional near infrared spectroscopy (fNIRS). We found significantly higher PFC oxygenation in EMG-BFB walking compared to normal walking. This indicates higher task-specific PFC demand. Additionally, we found that four, five-minute bouts of training with mTrigger resulted in attenuation of changes in PFC oxygenation between EMG-BFB walking and normal walking, when comparing pre-training and post-training. This indicates less expenditure of cortical resources after training and a possible biomarker for greater automaticity of walking in PFC. ☐ Overall, our results suggest that mTrigger can be used as an EMG-BFB device for gait in healthy adults. These represent the critical first steps towards translation of EMG-BFB gait training from a research methodology to an available, affordable gait rehabilitation regimen in populations suffering from propulsive deficit during gait such as older adults and stroke patients. For the next step, this device should be tested on stroke patients, both overground and on a treadmill. ☐ To summarize we developed and established validity and reliability of a portable-cost effective EMG-BFB device with the focus on increasing plantar flexor muscle activity for gait rehabilitation and increasing speed of walking with added app features that makes it suitable for home and community-based training. Additionally, we carried out neuromechanical analysis to investigate changes in biomechanics of walking and hemodynamic activity of prefrontal cortex. Biomechanical analysis showed that this device increased speed, peak propulsive force, and step length. fNIRS results showed that a short 20-minute training resulted in attenuation of changes in PFC activity indicating more automatic control of gait.
Description
Keywords
Electromyography, Functional near infrared spectroscopy, Gait rehabilitation, Neuroimaging