PROPORTIONAL ELECTROMYOGRAPHIC CONTROL OF A BIONIC ARM IN A PARTICIPANT WITH CHRONIC HEMIPARESIS, MUSCLE SPASTICITY, AND IMPAIRED RANGE OF MOTION: A CASE STUDY.

Abstract

The long-term goal of this research is to restore intuitive and proportional motor control to stroke patients with an assistive exoskeleton. Stroke is the leading cause of disability in the United States, with 80% of stroke-related disability coming in the form of hemiparesis, presented as weakness or paresis on half of the body. Current electromyographic-(EMG)-controlled assistive exoskeletons do not allow for fine force regulation. That is, current control strategies provide only binary, all-or-nothing, control based on a linear threshold of EMG activity. In this case study with one hemiparetic stroke patient, we show that state-of-the-art EMG control algorithms can provide proportional control of a bionic arm despite weak and spastic muscle activity. The participant completed a virtual target-touching exercise with an EMG-controlled bionic arm by attempting to grasp (close) or extend (open) their hand. The participant completed the task under two conditions, with EMG from their paretic arm and with EMG from their healthy, contralateral arm. For grasping, there was no statistical difference in task performance for the paretic and healthy arms, but there was a significant decrease in the EMG signal-to-noise ratio for the paretic arm. For extension, there was a significant decrease in both task performance and EMG signal-to-noise ratio for the paretic arm. Despite these differences, the participant was still able to complete the target-touching task with the paretic arm. These preliminary results show it is possible, for at least some patients, to provide proportional control of assistive devices using weak and spastic EMG. Importantly, information regulating fine force output is still present in EMG despite a visually immobile arm due to hemiparesis. Future work will validate these findings with additional stroke patients with varying presentations of hemiparesis and move into controlling upper-limb exoskeletons.