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Journal of NeuroEngineering and Rehabilitation

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Open Access 01-12-2019 | Stroke | Research

Pathway-specific modulatory effects of neuromuscular electrical stimulation during pedaling in chronic stroke survivors

Authors: Shi-Chun Bao, Wing-Cheong Leung, Vincent C. K. Cheung, Ping Zhou, Kai-Yu Tong

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2019

Abstract

Background

Neuromuscular electrical stimulation (NMES) is extensively used in stroke motor rehabilitation. How it promotes motor recovery remains only partially understood. NMES could change muscular properties, produce altered sensory inputs, and modulate fluctuations of cortical activities; but the potential contribution from cortico-muscular couplings during NMES synchronized with dynamic movement has rarely been discussed.

Method

We investigated cortico-muscular interactions during passive, active, and NMES rhythmic pedaling in healthy subjects and chronic stroke survivors. EEG (128 channels), EMG (4 unilateral lower limb muscles) and movement parameters were measured during 3 sessions of constant-speed pedaling. Sensory-level NMES (20 mA) was applied to the muscles, and cyclic stimulation patterns were synchronized with the EMG during pedaling cycles. Adaptive mixture independent component analysis was utilized to determine the movement-related electro-cortical sources and the source dipole clusters. A directed cortico-muscular coupling analysis was conducted between representative source clusters and the EMGs using generalized partial directed coherence (GPDC). The bidirectional GPDC was compared across muscles and pedaling sessions for post-stroke and healthy subjects.

Results

Directed cortico-muscular coupling of NMES cycling was more similar to that of active pedaling than to that of passive pedaling for the tested muscles. For healthy subjects, sensory-level NMES could modulate GPDC of both ascending and descending pathways. Whereas for stroke survivors, NMES could modulate GPDC of only the ascending pathways.

Conclusions

By clarifying how NMES influences neuromuscular control during pedaling in healthy and post-stroke subjects, our results indicate the potential limitation of sensory-level NMES in promoting sensorimotor recovery in chronic stroke survivors.

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Title: Pathway-specific modulatory effects of neuromuscular electrical stimulation during pedaling in chronic stroke survivors
Authors: Shi-Chun Bao
Wing-Cheong Leung
Vincent C. K. Cheung
Ping Zhou
Kai-Yu Tong
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Stroke
Published in: Journal of NeuroEngineering and Rehabilitation / Issue 1/2019
Electronic ISSN: 1743-0003
DOI: https://doi.org/10.1186/s12984-019-0614-9

At a glance: The STEP trials

Springer Medicine

Pathway-specific modulatory effects of neuromuscular electrical stimulation during pedaling in chronic stroke survivors

Abstract

Background

Method

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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