Abstract
BACKGROUND: This research aims to improve the control of assistive devices for individuals with hemiparesis after stroke by providing intuitive and proportional motor control. 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 assistive exoskeletonscontrolled via electromyography do not allow for fine force regulation. Current control strategies provide only binary, all-or-nothing control based on a linear threshold of muscle activity. METHODS: In this study, we demonstrate the ability of participants with hemiparesis to finely regulate their muscle activity to proportionally control the position of a virtual bionic arm. Ten stroke survivors and ten healthy, aged-matched controls completed a target-touching task with the virtual bionic arm. We compared the signal-to-noise ratio (SNR) of the recorded electromyography (EMG) signals used to train the control algorithms and the task performance using root mean square error, percent time in target, and maximum hold time within the target window. Additionally, we looked at the correlation between EMG SNR, task performance, and clinical spasticity scores. RESULTS: All stroke survivors were able to achieve proportional EMG control despite limited or no physical movement (i.e., modified Ashworth scale of 3). EMG SNR was significantly lower for the paretic arm than the contralateral nonparetic arm and healthy control arms, but proportional EMG control was similar across conditions for hand grasp. In contrast, proportional EMG control for hand extension was significantly worse for paretic arms than healthy control arms. The participants' age, time since their stroke, clinical spasticity rate, and history of botulinum toxin injections had no impact on proportional EMG control. CONCLUSIONS: It is possible to provide proportional EMG control of assistive devices from a stroke survivor's paretic arm. Importantly, information regulating fine force output is still present in muscle activity, even in extreme cases of spasticity where there is no visible movement. Future work should incorporate proportional EMG control into upper-limb exoskeletons to enhance the dexterity of stroke survivors.