Proportional myoelectric control of a virtual bionic arm in participants with hemiparesis, muscle spasticity, and impaired range of motion.
Caleb J Thomson, Fredi R Mino, Danielle R Lopez and 3 others
PMID 39707399WHAT IT FOUND
Ten stroke survivors with hemiparesis, including four with severe spasticity, controlled a virtual hand by muscle activity.
Grasp control was similar to healthy controls; paretic extension was less accurate. This does not show a physical device helps daily tasks.
Key findings
01All 10 stroke survivors achieved proportional EMG control of a virtual hand, including the 4 with a Modified Ashworth Scale score of 3.
02For grasp, paretic performance was similar to nonparetic and healthy control performance on all three task metrics.
03For extension, paretic performance was worse than healthy control performance on error and time-in-target measures.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only 10 stroke survivors and 10 healthy controls, so the results are preliminary. It tested control of a virtual bionic arm, not a physical hand exoskeleton or orthosis, and did not measure daily activities. Only grasp and extension were tested, not combined or more complex hand movements. The four participants with MAS score 3 show feasibility in severe spasticity, but 10 stroke survivors cannot establish that all patients with MAS 3 can do this. Botulinum toxin analyses were post hoc and divided the stroke group into 4 participants with injections and 6 without. Healthy controls were approximately age-matched, not exactly matched.
Declared interests
Funders named are the National Science Foundation Graduate Research Fellowship Program, the Eunice Kennedy Shriver National Institute of Child Health and Human Development and National Institute of Dental and Craniofacial Research of NIH, and Meta Reality Labs. The supplied text gives no additional author conflict-of-interest disclosures.
The easy way to misread this
Do not conclude that a physical EMG hand exoskeleton improves stroke patients' hand function. This study tested a virtual bionic arm in 10 stroke survivors, and paretic extension control was worse than healthy control performance.