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Using Contingent Reinforcement to Augment Muscle Activation After Perinatal Brachial Plexus Injury: A Pilot Study
S V Duff1, B Sargent2, J J Kutch2
1a Department of Physical Therapy, Crean College of Health and Behavioral Sciences , Chapman University , Irvine , California , USA.
Insights
Electromyography-triggered musical video successfully increased muscle activation in children with perinatal brachial plexus injury (PBPI). This reinforcement method shows promise for improving arm function in affected children.
Area of Science:
- Pediatric Rehabilitation
- Neurorehabilitation
- Biomedical Engineering
Background:
- Perinatal brachial plexus injury (PBPI) can impair motor function in infants.
- Developing effective, engaging interventions is crucial for rehabilitation.
- Electromyography (EMG) offers objective measures of muscle activity.
Purpose of the Study:
- To assess the feasibility of using EMG-triggered musical video feedback to enhance muscle activation in children with PBPI.
- To explore the relationship between muscle activation and hand preference in this population.
Main Methods:
- Six infants with PBPI and 13 typically developing (TD) controls participated.
- Biceps muscle activation was measured using surface EMG during baseline and reinforcement conditions.
- Reinforcement involved a musical video triggered by EMG activity above a set threshold.
Main Results:
- Children with PBPI showed significant increases in biceps activation during reinforcement.
- Most participants (all PBPI, most TD) demonstrated increased activation in at least one arm.
- Lower muscle activation was associated with right-hand preference in the PBPI group.
Conclusions:
- Contingent reinforcement via EMG-triggered musical video is a feasible approach to increase muscle activation.
- Further research is needed to optimize training parameters for improved arm function.
Aim:
Examine the feasibility of increasing muscle activation with electromyographically (EMG)-triggered musical-video as reinforcement for children with perinatal brachial plexus injury (PBPI).
Methods:
Six children with PBPI (9.3 ± 6.3 months; 5 female, 1 male) and 13 typically developing (TD) controls (7.8 ± 3.5 months; 4 female, 9 males) participated. The left arm was affected in 5/6 children with PBPI. We recorded the integral (Vs) of biceps activation with surface EMG during two conditions per arm in one session: (1) 100 second (s) baseline without reinforcement and (2) 300 s reinforcement (musical-video triggered to play with biceps activation above threshold [V]). We examined the relation between the mean integral with reinforcement and hand preference.
Results:
Mean biceps activation significantly increased from baseline in the affected arm of the group with PBPI by the 2nd (p < .008) and 3rd (p < .0004) 100 s intervals of reinforcement. Six of 6 children with PBPI and 12/13 TD controls increased activation in at least one arm. A lower integral was linked with hand preference for the unaffected right side in the PBPI group.
Conclusion:
This study supports contingent reinforcement as a feasible method to increase muscle activation. Future work will examine training dose and intensity to increase arm function.
