Research On Stroke Lower Limb Rehabilitation Equipment And Related Diagnosis And Treatment Based On Surface Electromyography And Kinematics Analysis

With the aggravation of society aging,the prevalence of stroke increases continuously.According to a recent investigation,more than 70%of stroke patients have residual motor dysfunction and daily living disorders.Attention has been aroused since the walking dysfunction after stroke will seriously affect the individual life of rehabilitation,ability and overall health of the body.The limb rehabilitation assessment plays a key role in patient diagnosis,rehabilitation planning and rehabilitation treatment evaluation.Specifically,electrophysiological information and kinematics information are the two core contents of quantitative evaluation of lower limb function.Currently,most of the existing electrophysiological-related platforms only provide either a multi-channel acquisition analysis or a neuromuscular electrical stimulation function.Therefore,they cannot realize multi-channel surface electromyography(EMG)and electrical stimulation treatment simultaneously.Indeed,the surface EMG information is of great importance during the treatment process in terms of participation assessment and status indication.By combining the multi-channel surface EMG system with the multi-mode electrical stimulation platform,the efficiency of lower limb rehabilitation could be improved dramatically.From the perspective of kinematic detection technologies,the existing equipment are able to save the hospital resources and relieve social pressure by providing a viable kinematic analysis solution for medical and health services through wearable inertial sensing units.However,the analysis of existing kinematics detection solutions has difficulties in real-time detection of gait phase information in complex road environment.What’s worse,the actual spatial trajectory estimation is still subject to the error of inertial sensors.In such a context,the development of a wearable kinematics detection systems would be able to shed some lights on the lower limb rehabilitation evaluation and real-time intervention methods.According to the literature review,the existing methods mainly focus on the muscle strength,muscular endurance or time series analysis of active antagonist muscles.These methods cannot accurately evaluate multiple pieces of synergy.Since the function of the ankle joint is related to the dynamics and balance control during the gait,the evaluation of the coordination index of the ankle joint muscle group has great practical value for the intervention and recovery of the lower limbs of the stroke.The main research content of this paper includes the following 3 parts:the first two parts focus on electrophysiology and kinematics detection techniques and instruments,and the third part focuses on stroke lower limb rehabilitation analysis evaluation methods using surface electromyography and kinematics methods.(1)Design and implementation of multi-channel surface EMG acquisition and analysis platform:Design and implement multi-channel surface EMG analysis system,the system can complete multi-channel surface Electromyography collection,analysis,storage.The system has passed the verification of electrical safety and related medical industry standards.The system has better consistency with the similar imported equipment in the frequency domain analysis of surface EMG.(2)Development and verification of EMG-triggered neuromuscular electrical stimulation(NMES)treatment system:Based on the surface electromyography signal analysis platform,a new composite electromyography acquisition/neuromuscular stimulation system have been realized and verified.The platform can perform circulating NMES,function NMES and EMG triggered NMES.The system passed relevant medical industry standards as well as electrical safety standards testing.On this basis,the system tested the EMG-triggered neuromuscular electrical stimulation function in stroke patients including:the control group which did not receive EMG-triggered neuromuscular electrical stimulation therapy,and the experimental group that received EMG-triggered neuromuscular electrical stimulation treatment.compared with the control group,the muscle strength and muscular endurance of the target muscle of experimental group were significantly improved.(3)Research on lower limb kinematics measurement technology based on inertial sensor:the design of a novel multi-sensor detection hardware system and multi-sensor fusion kinematics phase detection algorithm.The system can be fixed on the subject’s shoes to facilitate the use of the subject in a clinical or actual living environment,and is also easy to integrate with other treatment systems.In this paper,the existing kinematics detection system is improved:sensor detection system,time phase detection method and error modeling method.The system realizes the detection of spatial information measurement(step size,spatial trajectory)and time information(phase segmentation during gait).The accuracy and robustness of the proposed system were validated in a real-world scenario that consisted of complex ground surfaces,i.e.,varying inclinations.The proposed system demonstrated consistently high performance in detecting toe off(TO)and heel strike(HS)events in indoor and outdoor walking data which was supported by high performance scores.The proposed system showed better performance in detection precision than state-of-the-art real-time GED methods.The distance sensor data integrated in the system is also integrated into the error model by the Kalman filter algorithm.Through walking test,the estimated error of the system on the spatial trajectory(step size)is about 5%.Therefore,the system has practical value in kinematics detection and intervention in clinical and daily life environments.(4)A synergistic analysis method based on muscle synergy for ankle muscle is proposed.Our results suggest a featured muscle synergy structure underlying ankle muscle activation in both healthy and post-stroke subjects.The structure of the featured muscle synergy was robust in the same subjects across different conditions in the healthy group and the post-stroke group.Compared to the stroke group,the synergy patterns of healthy subjects showed better regularity and higher inter-subject similarity.In addition,the results of muscle synergies were indicative of locomotor performance.The innovative quantitative results of this study can help us to better understand ankle muscle activation and will be a reference for clinical assessments and intervention studies.