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New Neuromuscular Training for Peripheral Nerve Disorders Using an Ankle Joint Hybrid Assistive Limb: A Case Series

Peripheral nerve disorder of the lower extremities causes drop foot and disturbs the daily living activities of patients. The ankle joint hybrid assistive limb (HAL) provides voluntary ankle joint training using surface bioelectrical signals from the muscles of the lower extremities. We investigated...

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Autores principales: Soma, Yuichiro, Tokunaga, Kunihiko, Kubota, Shigeki, Muraoka, Mikio, Watanabe, Shin, Sakai, Michiko, Ohya, Wataru, Arakawa, Daiki, Sasage, Takuma, Yamazaki, Masashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10384348/
https://www.ncbi.nlm.nih.gov/pubmed/37512063
http://dx.doi.org/10.3390/medicina59071251
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author Soma, Yuichiro
Tokunaga, Kunihiko
Kubota, Shigeki
Muraoka, Mikio
Watanabe, Shin
Sakai, Michiko
Ohya, Wataru
Arakawa, Daiki
Sasage, Takuma
Yamazaki, Masashi
author_facet Soma, Yuichiro
Tokunaga, Kunihiko
Kubota, Shigeki
Muraoka, Mikio
Watanabe, Shin
Sakai, Michiko
Ohya, Wataru
Arakawa, Daiki
Sasage, Takuma
Yamazaki, Masashi
author_sort Soma, Yuichiro
collection PubMed
description Peripheral nerve disorder of the lower extremities causes drop foot and disturbs the daily living activities of patients. The ankle joint hybrid assistive limb (HAL) provides voluntary ankle joint training using surface bioelectrical signals from the muscles of the lower extremities. We investigated the neurological effects of ankle joint HAL training in three patients. Sensory nerve action potentials (SNAPs) and compound muscle action potentials (CMAPs) were analyzed for the peroneal and tibial nerves prior to the first ankle joint HAL training session. Integrated surface electromyography EMG signals were recorded before and after the HAL training sessions to evaluate the effects of training for neuromuscular disorders. The patients were hospitalized to receive rehabilitation with HAL training for 2 weeks. The HAL training was performed daily with two 60 min sessions. All cases demonstrated severe neuromuscular impairment according to the result of the CMAP. All integrated EMG measurements of antagonistic muscle activities decreased after the ankle joint HAL training. The manual muscle testing (MMT) scores of each muscle were slightly increased after the HAL intervention for Case 2(tibialis anterior, from 2 to 2+; gastrocnemius muscles, from 2− to 2; extensor digitorum longus, and extensor hallucis longus, from 1 to 3). The MMT scores were also slightly increased except for gastrocnemius muscle for Case 3 (tibialis anterior, extensor digitorum longus, and extensor hallucis longus, from 2− to 2). These two patients demonstrated voluntary muscle contractions and nerve signals in the CMAP before the HAL training. Even though the amplitude of CMAPs was low, the HAL training may provide voluntary ankle joint movements by reducing the antagonistic muscle contraction via computer processing. The HAL training may enhance muscle movement and coordination through motor learning feedback.
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spelling pubmed-103843482023-07-30 New Neuromuscular Training for Peripheral Nerve Disorders Using an Ankle Joint Hybrid Assistive Limb: A Case Series Soma, Yuichiro Tokunaga, Kunihiko Kubota, Shigeki Muraoka, Mikio Watanabe, Shin Sakai, Michiko Ohya, Wataru Arakawa, Daiki Sasage, Takuma Yamazaki, Masashi Medicina (Kaunas) Brief Report Peripheral nerve disorder of the lower extremities causes drop foot and disturbs the daily living activities of patients. The ankle joint hybrid assistive limb (HAL) provides voluntary ankle joint training using surface bioelectrical signals from the muscles of the lower extremities. We investigated the neurological effects of ankle joint HAL training in three patients. Sensory nerve action potentials (SNAPs) and compound muscle action potentials (CMAPs) were analyzed for the peroneal and tibial nerves prior to the first ankle joint HAL training session. Integrated surface electromyography EMG signals were recorded before and after the HAL training sessions to evaluate the effects of training for neuromuscular disorders. The patients were hospitalized to receive rehabilitation with HAL training for 2 weeks. The HAL training was performed daily with two 60 min sessions. All cases demonstrated severe neuromuscular impairment according to the result of the CMAP. All integrated EMG measurements of antagonistic muscle activities decreased after the ankle joint HAL training. The manual muscle testing (MMT) scores of each muscle were slightly increased after the HAL intervention for Case 2(tibialis anterior, from 2 to 2+; gastrocnemius muscles, from 2− to 2; extensor digitorum longus, and extensor hallucis longus, from 1 to 3). The MMT scores were also slightly increased except for gastrocnemius muscle for Case 3 (tibialis anterior, extensor digitorum longus, and extensor hallucis longus, from 2− to 2). These two patients demonstrated voluntary muscle contractions and nerve signals in the CMAP before the HAL training. Even though the amplitude of CMAPs was low, the HAL training may provide voluntary ankle joint movements by reducing the antagonistic muscle contraction via computer processing. The HAL training may enhance muscle movement and coordination through motor learning feedback. MDPI 2023-07-05 /pmc/articles/PMC10384348/ /pubmed/37512063 http://dx.doi.org/10.3390/medicina59071251 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Soma, Yuichiro
Tokunaga, Kunihiko
Kubota, Shigeki
Muraoka, Mikio
Watanabe, Shin
Sakai, Michiko
Ohya, Wataru
Arakawa, Daiki
Sasage, Takuma
Yamazaki, Masashi
New Neuromuscular Training for Peripheral Nerve Disorders Using an Ankle Joint Hybrid Assistive Limb: A Case Series
title New Neuromuscular Training for Peripheral Nerve Disorders Using an Ankle Joint Hybrid Assistive Limb: A Case Series
title_full New Neuromuscular Training for Peripheral Nerve Disorders Using an Ankle Joint Hybrid Assistive Limb: A Case Series
title_fullStr New Neuromuscular Training for Peripheral Nerve Disorders Using an Ankle Joint Hybrid Assistive Limb: A Case Series
title_full_unstemmed New Neuromuscular Training for Peripheral Nerve Disorders Using an Ankle Joint Hybrid Assistive Limb: A Case Series
title_short New Neuromuscular Training for Peripheral Nerve Disorders Using an Ankle Joint Hybrid Assistive Limb: A Case Series
title_sort new neuromuscular training for peripheral nerve disorders using an ankle joint hybrid assistive limb: a case series
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10384348/
https://www.ncbi.nlm.nih.gov/pubmed/37512063
http://dx.doi.org/10.3390/medicina59071251
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