Development of an Apparatus for Bilateral Rhythmical Training of Arm Movement Via Linear and Elliptical Trajectories of Various Directions

Clinical rehabilitation of individuals with various neurological disorders requires a significant number of movement repetitions in order to improve coordination and restoration of appropriate muscle activation patterns. Arm reaching movement is frequently practiced via motorized arm cycling ergometers where the trajectory of movement is circular thus providing means for practicing a single and rather nonfunctional set of muscle activation patterns, which is a significant limitation. We have developed a novel mechanism that in the combination with an existing arm ergometer device enables nine different movement modalities/trajectories ranging from purely circular trajectory to four elliptical and four linear trajectories where the direction of movement may be varied. The main objective of this study was to test a hypothesis stating that different movement modalities facilitate differences in muscle activation patterns as a result of varying shape and direction of movement. Muscle activation patterns in all movement modalities were assessed in a group of neurologically intact individuals in the form of recording the electromyographic (EMG) activity of four selected muscle groups of the shoulder and the elbow. Statistical analysis of the root mean square (RMS) values of resulting EMG signals have shown that muscle activation patterns corresponding to each of the nine movement modalities significantly differ in order to accommodate to variation of the trajectories shape and direction. Further, we assessed muscle activation patterns following the same protocol in a selected clinical case of hemiparesis. These results have shown the ability of the selected case subject to produce different muscle activation patterns as a response to different movement modalities which show some resemblance to those assessed in the group of neurologically intact individuals. The results of the study indicate that the developed device may significantly extend the scope of strength and coordination training in stroke rehabilitation which is in current clinical rehabilitation practice done through arm cycling