Trial Summary
What is the purpose of this trial?This study will examine the combination of myoelectric computer interface (MyoCI) training with targeted memory reactivation (TMR) in chronic stroke survivors. The study aims to determine whether this training-plus-sleep combination will generalize to improve arm motor function over an extended training protocol in stroke survivors.
Is MyoCI training safe for humans?
The studies on MyoCI training for stroke recovery do not report any safety concerns, suggesting it is generally safe for human use.
34567How is the MyoCI treatment different from other stroke recovery treatments?
MyoCI is unique because it uses a myoelectric computer interface to provide feedback on muscle activation patterns, helping stroke survivors reduce abnormal muscle co-activation and improve arm movement. This approach focuses on retraining muscle activation patterns, which is different from traditional physical therapies that may not specifically target muscle co-activation.
23467What data supports the effectiveness of the treatment MyoCI + Memory Reactivation for Stroke Recovery?
Research shows that Myoelectric Computer Interface (MyoCI) training helps stroke survivors improve arm function by reducing abnormal muscle co-activation, which is a common issue after a stroke. Studies found that participants who underwent MyoCI training experienced improvements in arm movement and function, suggesting that this treatment could be beneficial for stroke recovery.
12346Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications, but it does exclude those who have had spasticity treatment with medications or Botox in the last 3 months.
Eligibility Criteria
This trial is for chronic stroke survivors aged 21 or older with severe to moderate arm motor impairment, who had their first stroke at least 6 months ago. Participants must have some voluntary shoulder and elbow movement but can't join if they have ferromagnetic implants, are in other studies, struggle with English due to aphasia, suffer from substantial pain or visual impairments that affect screen viewing, or have received spasticity treatment recently.Inclusion Criteria
I am 21 years old or older.
I have severe to moderate difficulty moving my arms.
Exclusion Criteria
I have a visual impairment that prevents me from seeing the entire screen.
I have severe arm pain that stops me from participating in activities for 90 minutes a day.
I have received spasticity treatment in the last 3 months.
Participant Groups
The study tests whether combining myoelectric computer interface (MyoCI) training with targeted memory reactivation (TMR) during sleep can improve arm function in people who've had a stroke. It looks at the effects of this combination over an extended period.
4Treatment groups
Experimental Treatment
Placebo Group
Group I: Slow-wave sleep (SWS) only TMRExperimental Treatment1 Intervention
TMR during slow-wave sleep only
Group II: Reduced frequency TMRExperimental Treatment1 Intervention
TMR during only subset of sessions
Group III: All phase TMRExperimental Treatment1 Intervention
TMR during every stage of sleep
Group IV: Sham TMRPlacebo Group1 Intervention
Patients receive no TMR
Find A Clinic Near You
Research locations nearbySelect from list below to view details:
Northwestern UniversityChicago, IL
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Who is running the clinical trial?
Northwestern UniversityLead Sponsor
References
Feasibility of a new application of noninvasive Brain Computer Interface (BCI): a case study of training for recovery of volitional motor control after stroke. [2016]A large proportion of individuals with stroke have persistent deficits for which current interventions have not restored normal motor behavior. Noninvasive brain computer interfaces (BCIs) have potential advantages for restoration of function. There are also potential advantages for combining BCI with functional electrical stimulation (FES). We tested the feasibility of combined BCI + FES for motor learning after stroke.
Myoelectric computer interfaces to reduce co-contraction after stroke. [2021]A significant factor in impaired motor function caused by stroke is the inability to activate muscles independently. While the pathophysiology behind this co-contraction, sometimes called abnormal muscle synergy, is not clear, reducing the co-contraction could improve overall arm function. This pilot study describes the use of a myoelectric-computer interface (MCI) to retrain arm muscle activation and reduce co-contraction. We found that both healthy subjects and stroke survivors with hemiparesis learned to reduce co-contraction with MCI training. Three out of five stroke survivors experienced some improvement in arm function as well. These results suggest that MCIs could provide a novel, relatively inexpensive paradigm for stroke rehabilitation.
Reducing Abnormal Muscle Coactivation After Stroke Using a Myoelectric-Computer Interface: A Pilot Study. [2021]Background A significant factor in impaired movement caused by stroke is the inability to activate muscles independently. Although the pathophysiology behind this abnormal coactivation is not clear, reducing the coactivation could improve overall arm function. A myoelectric computer interface (MCI), which maps electromyographic signals to cursor movement, could be used as a treatment to help retrain muscle activation patterns. Objective To investigate the use of MCI training to reduce abnormal muscle coactivation in chronic stroke survivors. Methods A total of 5 healthy participants and 5 stroke survivors with hemiparesis participated in multiple sessions of MCI training. The level of arm impairment in stroke survivors was assessed using the upper-extremity portion of the Fugl-Meyer Motor Assessment (FMA-UE). Participants performed isometric activations of up to 5 muscles. Activation of each muscle was mapped to different directions of cursor movement. The MCI specifically targeted 1 pair of muscles in each participant for reduction of coactivation. Results Both healthy participants and stroke survivors learned to reduce abnormal coactivation of the targeted muscles with MCI training. Out of 5 stroke survivors, 3 exhibited objective reduction in arm impairment as well (improvement in FMA-UE of 3 points in each of these patients). Conclusions These results suggest that the MCI was an effective tool in directly retraining muscle activation patterns following stroke.
The effect of myoelectric computer interface training on arm kinematics and function after stroke. [2020]Abnormal co-activation patterns of arm muscles is a substantial cause of impaired arm function after stroke. We designed a myoelectric computer interface (MCI) training paradigm to help stroke survivors reduce this abnormal coactivation. Here, we evaluated the effects of MCI training on function and arm kinematics in 32 chronic stroke survivors. We compared the effects of training duration and isometric vs. movement-based training conditions in 3 different groups. All groups reduced abnormal co-activation in targeted muscles, and showed reduced arm impairment after 6 weeks of training. They also showed improvements in arm kinematics as well as functional scores. Moreover, the gains persisted, though most were reduced, at one month after training stopped. These results suggest that MCI training holds promise to improve arm function after stroke.
Restoration of Upper Limb Function After Chronic Severe Hemiplegia: A Case Report on the Feasibility of a Brain-Computer Interface-Triggered Functional Electrical Stimulation Therapy. [2021]Functional electrical stimulation therapy (FEST) is a state-of-the-art treatment for retraining motor function after neurological injuries. Recent literature suggests that FEST can be further improved with brain-computer interface (BCI) technology. In this case study, we assessed the feasibility of using BCI-triggered FEST (BCI-FEST) to restore upper limb function in a 57-yr-old man with severe left hemiplegia resulting from a stroke 6 yrs before enrollment in the study. The intervention consisted of two blocks of forty 1-hr BCI-FEST sessions, with three sessions delivered weekly. During therapy, a single-channel BCI was used to trigger the stimulation programmed to facilitate functional movements. The measure of the feasibility of the BCI-FEST included assessing the implementation and safety of the intervention. Clinical improvements were assessed using (a) Functional Independence Measure, (b) Action Research Arm Test, (c) Toronto Rehabilitation Institute - Hand Function Test, and (d) Fugl-Meyer Assessment Upper Extremity test. Upon completion of 80 therapy sessions, 14-, 17-, and 18-point changes were recorded on Action Research Arm Test, Fugl-Meyer Assessment Upper Extremity test, and Toronto Rehabilitation Institute - Hand Function Test, respectively. The participant also indicated improvement as demonstrated by his ability to perform various day-to-day tasks. The results suggest that BCI-FEST is safe and viable.
Myoelectric Computer Interface Training for Reducing Co-Activation and Enhancing Arm Movement in Chronic Stroke Survivors: A Randomized Trial. [2020]Abnormal muscle co-activation contributes to impairment after stroke. We developed a myoelectric computer interface (MyoCI) training paradigm to reduce abnormal co-activation. MyoCI provides intuitive feedback about muscle activation patterns, enabling decoupling of these muscles.
Myoelectric interface training enables targeted reduction in abnormal muscle co-activation. [2023]Abnormal patterns of muscle co-activation contribute to impaired movement after stroke. Previously, we developed a myoelectric computer interface (MyoCI) training paradigm to improve stroke-induced arm motor impairment by reducing the abnormal co-activation of arm muscle pairs. However, it is unclear to what extent the paradigm induced changes in the overall intermuscular coordination in the arm, as opposed to changing just the muscles trained with the MyoCI. This study examined the intermuscular coordination patterns of thirty-two stroke survivors who participated in 6 weeks of MyoCI training.