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Alterations in Spectral Attributes of Surface Electromyograms after Utilization of a Foot Drop Stimulator during Post-Stroke Gait.


ABSTRACT: A foot drop stimulator (FDS) is a rehabilitation intervention that stimulates the common peroneal nerve to facilitate ankle dorsiflexion at the appropriate time during post-stroke hemiplegic gait. Time-frequency analysis (TFA) of non-stationary surface electromyograms (EMG) and spectral variables such as instantaneous mean frequency (IMNF) can provide valuable information on the long-term effects of FDS intervention in terms of changes in the motor unit (MU) recruitment during gait, secondary to improved dorsiflexion.The aim of this study was to apply a wavelet-based TFA approach to assess the changes in neuromuscular activation of the tibialis anterior (TA), soleus (SOL), and gastrocnemius (GA) muscles after utilization of an FDS during gait post-stroke.Surface EMG were collected bilaterally from the TA, SOL, and GA muscles from six participants (142.9?±?103.3?months post-stroke) while walking without the FDS at baseline and 6?months post-FDS utilization. Continuous wavelet transform was performed to get the averaged time-frequency distribution of band pass filtered (20-300?Hz) EMGs during multiple walking trials. IMNFs were computed during normalized gait and were averaged during the stance and swing phases. Percent changes in the energies associated with each frequency band of 25?Hz between 25 and 300?Hz were computed and compared between visits.Averaged time-frequency representations of the affected TA, SOL, and GA EMG show altered spectral attributes post-FDS utilization during normalized gait. The mean IMNF values for the affected TA were significantly lower than the unaffected TA at baseline (p?=?0.026) and follow-up (p?=?0.038) during normalized stance. The mean IMNF values significantly increased (p?=?0.017) for the affected GA at follow-up during normalized swing. The frequency band of 250-275?Hz significantly increased in the energies post-FDS utilization for all muscles.The application of wavelet-based TFA of EMG and outcome measures (IMNF, energy) extracted from the time-frequency distributions suggest alterations in MU recruitment strategies after the use of FDS in individuals with chronic stroke. This further establishes the efficacy of FDS as a rehabilitation intervention that may promote motor recovery in addition to treating the secondary complications of foot drop due to post-stroke hemiplegia.

SUBMITTER: Pilkar R 

PROVIDER: S-EPMC5581808 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Alterations in Spectral Attributes of Surface Electromyograms after Utilization of a Foot Drop Stimulator during Post-Stroke Gait.

Pilkar Rakesh R   Ramanujam Arvind A   Nolan Karen J KJ  

Frontiers in neurology 20170829


<h4>Background</h4>A foot drop stimulator (FDS) is a rehabilitation intervention that stimulates the common peroneal nerve to facilitate ankle dorsiflexion at the appropriate time during post-stroke hemiplegic gait. Time-frequency analysis (TFA) of non-stationary surface electromyograms (EMG) and spectral variables such as instantaneous mean frequency (IMNF) can provide valuable information on the long-term effects of FDS intervention in terms of changes in the motor unit (MU) recruitment during  ...[more]

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