Understanding motor control in the lower extremity in severely impaired stroke patients

Status

Active, not recruiting

Phases

Unknown

Study type

Observational

Source

NL-OMON

Registry ID

NL-OMON22674

Enrollment

Registered

2020-12-09

Start date

2021-02-01

Completion date

Unknown

Last updated

2024-02-28

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Stroke

Interventions

None listed

Eligibility

Inclusion criteria

Inclusion criteria: • Chronic stroke • Above 18 years • Able to provide informed consent • Unilateral ischemic or haemorrhagic stroke • Hemiparetic lower extremity • Motricity index =18 and =75. There is at least palpable contraction and maximal full movement, but weaker than the other side.

Exclusion criteria

Exclusion criteria: • Premorbid disability of lower extremity • Progressive neurological diseases like, dementia or Parkinson • Severe cognitive impairment, unable to follow simple instructions. • Skin lesions at the hemiparetic leg • Contraindication for mobilization like lower limb fracture

Design outcomes

Primary

Measure	Time frame
The main outcome parameter in the current study is muscle activity of the nine lower limb muscles measured with (HD-)sEMG (High Density surface electromyography). The muscle activity will be measured during maximal voluntary contractions (MVC) measurements in both single joint and a multi-joint tasks, for both the affected and non-affected leg. Different parameters will be used to evaluate the muscle activity in severely affected stroke patients. The parameters are based on frequency, amplitude and timing. These parameters will be further elaborated in the statistical analysis. Muscles that will be measured with sEMG during movement of the lower extremity are: •Quadriceps femoris (Rectus femoris, vastus lateralis) •Gluteus maximus •Hamstring (biceps femoris, semitendinosus) •Tibialis anterior •Peroneus •Triceps surae (gastrocnemius medialis and soleus) From these muscles the vastus lateralis and tibialis anterior will be measured with HD- sEMG. The HD-sEMG set up will allow for inference of bipolar sEMG to match the bipolar sEMG data acquired from the other muscles listed above. In other words, the vastus lateralis and tibialis anterior muscle activity data can be analysed using the ‘normal’ bipolar sEMG signals, similar as for the remaining muscles, as well as the spatial bipolar HD-sEMG signals.	—

Measure

Time frame

The main outcome parameter in the current study is muscle activity of the nine lower limb muscles measured with (HD-)sEMG (High Density surface electromyography). The muscle activity will be measured during maximal voluntary contractions (MVC) measurements in both single joint and a multi-joint tasks, for both the affected and non-affected leg. Different parameters will be used to evaluate the muscle activity in severely affected stroke patients. The parameters are based on frequency, amplitude and timing. These parameters will be further elaborated in the statistical analysis. Muscles that will be measured with sEMG during movement of the lower extremity are: •Quadriceps femoris (Rectus femoris, vastus lateralis) •Gluteus maximus •Hamstring (biceps femoris, semitendinosus) •Tibialis anterior •Peroneus •Triceps surae (gastrocnemius medialis and soleus) From these muscles the vastus lateralis and tibialis anterior will be measured with HD- sEMG. The HD-sEMG set up will allow for inference of bipolar sEMG to match the bipolar sEMG data acquired from the other muscles listed above. In other words, the vastus lateralis and tibialis anterior muscle activity data can be analysed using the ‘normal’ bipolar sEMG signals, similar as for the remaining muscles, as well as the spatial bipolar HD-sEMG signals.

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Secondary

Measure	Time frame
In addition to sEMG, isometric force in the hip, knee and ankle extensors and flexors will be measured. This represents the single joint measurements. The sEMG signals will be related to the generated force. Along with the force obtained from the single joint MVC tasks the force will also be measured in multi-joint tasks. Both the sEMG and the force will be measured. As secondary analysis concerning the sEMG data, muscle activity measured with both HD-sEMG and bipolar sEMG will be compared based on similar parameters as for the main study parameters. Suitable outcome measures and threshold calculations methods will be identified and based on with both sEMG and HD-sEMG measurements.	—

Measure

Time frame

In addition to sEMG, isometric force in the hip, knee and ankle extensors and flexors will be measured. This represents the single joint measurements. The sEMG signals will be related to the generated force. Along with the force obtained from the single joint MVC tasks the force will also be measured in multi-joint tasks. Both the sEMG and the force will be measured. As secondary analysis concerning the sEMG data, muscle activity measured with both HD-sEMG and bipolar sEMG will be compared based on similar parameters as for the main study parameters. Suitable outcome measures and threshold calculations methods will be identified and based on with both sEMG and HD-sEMG measurements.

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Contacts

Public ContactCindy Rikhof

Roessingh Research and Development

c.rikhof@rrd.nl0880875777

Outcome results