Wearable Myoelectric Interface for Neurorehabilitation (MINT) to Recover Arm Function: a Randomized Controlled Trial.

Area of Science:

• Neurorehabilitation
• Biomedical Engineering
• Motor Control

Background:

• Abnormal muscle co-activation is a common cause of arm impairment following stroke.
• Current rehabilitation strategies may not adequately address this specific issue.

Purpose of the Study:

• To evaluate the feasibility and efficacy of home-based myoelectric interface for neurorehabilitation (MINT) conditioning.
• To determine the optimal number of abnormally co-activating muscles to target for improved arm function.
• To reduce abnormal co-activation and enhance arm function post-stroke.

Main Methods:

• A single-blind, randomized, sham-controlled trial involving chronic stroke survivors with moderate to severe arm impairment.
• Participants were assigned to MINT groups (training 2 or 3 muscles) or a sham control group.
• Training involved customized games at home and in-lab sessions over 6 weeks, with outcome assessment using the Wolf Motor Function Test (WMFT).

Main Results:

• Combined MINT groups showed a significant improvement in WMFT scores (4s), exceeding the minimal clinically important difference.
• The group training 3 muscles simultaneously demonstrated the greatest improvement (6.8s) compared to sham and 2-muscle groups.
• Co-activation decreased by 76% in MINT groups, with reductions significantly correlating with improved arm function and range of motion.

Conclusions:

• Home-based MINT conditioning, particularly the 3-muscle variant, is a feasible and effective approach for stroke neurorehabilitation.
• This method successfully reduces abnormal co-activation, leading to significant improvements in arm movement and overall function.
• Severely impaired participants and those with posterior limb of internal capsule strokes showed specific responses to MINT training.