Developing A Portable, Neurostimulation-Integrated, Force Measurement Platform

My colleagues and I have a new paper published in Bioengineering.

New Stroke Rehabilitation Technology for Measurement of Ankle Muscle Function

Embarking on a quest to enhance our understanding and treatment of neuromotor impairments, particularly those resulting from strokes, our team developed an innovative tool: the CEntral DRive System. CEDRS for short. This portable neurostimulation-integrated force measurement system is designed to bring the precision of the laboratory into real-world clinical settings, making it a potential game-changer for patients and healthcare providers alike. Our development and validation of this groundbreaking device included two experiments, each revealing critical insights into the system's accuracy and clinical applicability.

The Drive Behind The Innovation

The device is motivated by the crucial gap in current clinical practices for assessing muscle function and central nervous system drive, especially in individuals recovering from a stroke. Traditional methods like the device shown in the image below, while reliable, often remain confined to specialized settings due to their size and complexity. This limitation sparked our pursuit to create a more accessible, yet equally precise, tool that could seamlessly integrate into various rehabilitation environments, thereby broadening the scope of neuromotor function assessment.

Experimental set-up of superimposed electrical stimulation for assessment of plantarflexor muscle activation in a computerized dynamometer

Experiment 1: Establishing CEDRS’s Accuracy

Our initial experiment was a foundational step to ensure that CEDRS could stand toe-to-toe with established clinical equipment in measuring plantarflexor strength. Involving 16 neurotypical adults, the experiment was a litmus test for CEDRS's precision. The findings were promising:

  1. CEDRS's measurements closely aligned with those from the traditional stationary dynamometer, affirming its accuracy.

  2. The introduction of an adjustment equation further refined these measurements, enhancing their reliability.

  3. The strong agreement between the two devices underscored CEDRS's potential as a trustworthy tool for clinical assessments.

Central Drive System device and accuracy as compared to gold-standard computerized dynamometer

Experiment 2: Validating in Individuals after Stroke

Our second experiment was where theory met practice. We ventured into the clinical realm, applying CEDRS to assess individuals with post-stroke hemiparesis. This phase involved 26 participants, aiming to dissect the nuances of neuromotor function between their affected and unaffected limbs. The outcomes were again promising:

  1. We observed marked disparities in plantarflexor strength and central drive across paretic, non-paretic, and neurotypical limbs, highlighting the profound impact of stroke on muscle function.

  2. The correlation between the central drive of the paretic limb and walking functionality hinted at the potential of central drive as a meaningful biomarker for neuromotor impairment.

  3. The practicality of CEDRS in clinical settings was evidenced by the successful and efficient completion of assessments among participants with stroke, suggesting its feasibility for widespread clinical use.

CEDRS validation post-stroke and association between muscle activation and walking speed

Reflections and Path Forward for improving clinical assessment of muscle inhibition.

Our exploration through these experiments not only validated CEDRS's efficacy but also illuminated its potential to revolutionize how we assess and approach rehabilitation for neuromotor impairments. By offering a precise, portable, and user-friendly platform, CEDRS paves the way for more personalized and effective rehabilitation strategies, potentially transforming the recovery journeys of countless individuals affected by stroke and other neuromotor conditions.

As we look to the future, CEDRS and similar technologies hold huge potential for the field of rehabilitation science. Our ongoing mission is to refine these tools further, explore their applications in various clinical scenarios, and ultimately contribute to a world where advanced, accessible rehabilitation is not the exception but the norm.

The Full Text

The full paper is available online at Bioengineering.

You can also reach out to me on ResearchGate.

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