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dc.contributor.authorCurado, Marco Rocha
dc.contributor.authorGarcia-Cossio, Eliana
dc.contributor.authorBroetz, Doris
dc.contributor.authorAgostini, Manuel
dc.contributor.authorCho, Woosang
dc.contributor.authorLima-Brasil, Fabricio
dc.contributor.authorYilmaz, Oezge
dc.contributor.authorLiberati, Giulia
dc.contributor.authorLepski, Guilherme
dc.contributor.authorBirbaumer, Niels
dc.contributor.authorRamos-Murguialday, Ander
dc.date.accessioned2016-04-26T15:31:41Z
dc.date.available2016-04-26T15:31:41Z
dc.date.issued2015-10-23
dc.identifier.citationPLOS ONE, Vol. 10, Issue 10 (2015) e0140161en
dc.identifier.issn1932-6203en
dc.identifier.urihttp://hdl.handle.net/11556/222
dc.description.abstractBackground Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Methods Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Results Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001). Conclusions Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their recruitment after BMI training. This study suggests that changes in upper arm-forearm synergies contribute to stroke motor recovery, and provides candidacy guidelines for similar BMI-based clinical practice.en
dc.description.sponsorshipGerman Federal Ministry of Education and Research (BMBF), Deutsche Forschungsgemeinschaft (DFG), European Research Council, European Union Information and Communication Technologies Framework Programme 7 (ICT-FP7), TECNALIA, Baden Wuerttemberg Stiftung, Natural Science Foundation of China, Volkswagen Stiftung, CAPES (Coordination for the Improvement of Higher Level -or Education-Personnel, Brazil), CNPq (Brazilian National Counsel of Technological and Scientific Development), DAAD (Deutscher Akademischer Austauschdienst), Interuniversity Center for the Research in Cognitive Processing of Natural and Artificial Systems (ECoNa), Sapienza University of Romeen
dc.language.isoengen
dc.publisherPUBLIC LIBRARY SCIENCE, 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USAen
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.titleResidual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Trainingen
dc.typearticleen
dc.identifier.doi10.1371/journal.pone.0140161en
dc.isiYesen
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/FP7/231724/EU/HUman behavioral Modeling for enhancing learning by Optimizing hUman-Robot interaction/HUMOURen
dc.rights.accessRightsopenAccessen
dc.subject.keywordsUPPER-EXTREMITYen
dc.subject.keywordsUPPER-LIMBen
dc.subject.keywordsCORTICAL DAMAGEen
dc.subject.keywordsRECOVERYen
dc.subject.keywordsPOSTSTROKEen
dc.subject.keywordsHEMIPARESISen
dc.subject.keywordsSYNERGIESen
dc.subject.keywordsSURVIVORSen
dc.subject.keywordsBCIen
dc.subject.keywordsEMGen


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