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Technical Brief

Development of an Apparatus for Bilateral Rhythmical Training of Arm Movement Via Linear and Elliptical Trajectories of Various Directions

[+] Author and Article Information
Zlatko Matjačić

University Rehabilitation Institute,
Republic of Slovenia,
Linhartova 51,
Ljubljana SI-1000, Slovenia
e-mail: zlatko.matjacic@ir-rs.si

Matjaž Zadravec, Jakob Oblak

University Rehabilitation Institute,
Republic of Slovenia,
Linhartova 51,
Ljubljana SI-1000, Slovenia

1Corresponding author.

Manuscript received July 17, 2013; final manuscript received May 20, 2014; published online July 21, 2014. Assoc. Editor: William K. Durfee.

J. Med. Devices 8(3), 034559 (Jul 21, 2014) (6 pages) Paper No: MED-13-1174; doi: 10.1115/1.4027796 History: Received July 17, 2013; Revised May 20, 2014

Clinical rehabilitation of individuals with various neurological disorders requires a significant number of movement repetitions in order to improve coordination and restoration of appropriate muscle activation patterns. Arm reaching movement is frequently practiced via motorized arm cycling ergometers where the trajectory of movement is circular thus providing means for practicing a single and rather nonfunctional set of muscle activation patterns, which is a significant limitation. We have developed a novel mechanism that in the combination with an existing arm ergometer device enables nine different movement modalities/trajectories ranging from purely circular trajectory to four elliptical and four linear trajectories where the direction of movement may be varied. The main objective of this study was to test a hypothesis stating that different movement modalities facilitate differences in muscle activation patterns as a result of varying shape and direction of movement. Muscle activation patterns in all movement modalities were assessed in a group of neurologically intact individuals in the form of recording the electromyographic (EMG) activity of four selected muscle groups of the shoulder and the elbow. Statistical analysis of the root mean square (RMS) values of resulting EMG signals have shown that muscle activation patterns corresponding to each of the nine movement modalities significantly differ in order to accommodate to variation of the trajectories shape and direction. Further, we assessed muscle activation patterns following the same protocol in a selected clinical case of hemiparesis. These results have shown the ability of the selected case subject to produce different muscle activation patterns as a response to different movement modalities which show some resemblance to those assessed in the group of neurologically intact individuals. The results of the study indicate that the developed device may significantly extend the scope of strength and coordination training in stroke rehabilitation which is in current clinical rehabilitation practice done through arm cycling.

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Figures

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Fig. 1

Kinematical and mechanical concept of linear–elliptical–circular trainer. Position of the planetary disk is determined by the orientation of the crank, while the orientation of the planetary disk is derived by timing belt and both sprockets.

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Fig. 2

Nine different movement trajectories depend on the position and orientation of planetary disk with respect to the driven crank on one side and the position of attachment of the hand handle

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Fig. 3

Planetary disk can be replaced by reduced disk with three rectangular holes. Figure also demonstrates how reduced disk has to be attached on the crank (smaller sprocket) in order to achieve horizontal linear trajectory with hand handle.

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Fig. 4

A photograph of a neurologically intact subject during movement exercise on the developed prototype of linear–elliptical–circular trainer

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Fig. 5

EMG activities of the selected muscle groups on the left arm in a group of healthy individuals for all nine movement modalities. Group mean values and standard deviations are shown.

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Fig. 6

EMG activity of the selected muscle groups on the more affected arm as assessed in a subject with hemiparesis for all nine movement modalities. Mean values and standard deviations are shown together with the group mean values of the group of neurologically intact individuals.

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