A Portable, Neurostimulation-Integrated, Force Measurement Platform for the Clinical Assessment of Plantarflexor Central Drive
Plantarflexor central drive is a promising biomarker of neuromotor impairment; however, routine clinical assessment is hindered by the unavailability of force measurement systems with integrated neurostimulation capabilities. In this study, we evaluate the accuracy of a portable, neurostimulation-in...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-01-01
|
| Series: | Bioengineering |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2306-5354/11/2/137 |
| _version_ | 1797298893874003968 |
|---|---|
| author | Ashley N. Collimore Jonathan T. Alvarez David A. Sherman Lucas F. Gerez Noah Barrow Dabin K. Choe Stuart Binder-Macleod Conor J. Walsh Louis N. Awad |
| author_facet | Ashley N. Collimore Jonathan T. Alvarez David A. Sherman Lucas F. Gerez Noah Barrow Dabin K. Choe Stuart Binder-Macleod Conor J. Walsh Louis N. Awad |
| author_sort | Ashley N. Collimore |
| collection | DOAJ |
| description | Plantarflexor central drive is a promising biomarker of neuromotor impairment; however, routine clinical assessment is hindered by the unavailability of force measurement systems with integrated neurostimulation capabilities. In this study, we evaluate the accuracy of a portable, neurostimulation-integrated, plantarflexor force measurement system we developed to facilitate the assessment of plantarflexor neuromotor function in clinical settings. Two experiments were conducted with the Central Drive System (CEDRS). To evaluate accuracy, experiment #1 included 16 neurotypical adults and used intra-class correlation (ICC<sub>2,1</sub>) to test agreement of plantarflexor strength capacity measured with CEDRS versus a stationary dynamometer. To evaluate validity, experiment #2 added 26 individuals with post-stroke hemiparesis and used one-way ANOVAs to test for between-limb differences in CEDRS’ measurements of plantarflexor neuromotor function, comparing neurotypical, non-paretic, and paretic limb measurements. The association between paretic plantarflexor neuromotor function and walking function outcomes derived from the six-minute walk test (6MWT) were also evaluated. CEDRS’ measurements of plantarflexor neuromotor function showed high agreement with measurements made by the stationary dynamometer (ICC = 0.83, <i>p</i> < 0.001). CEDRS’ measurements also showed the expected between-limb differences (<i>p</i>’s < 0.001) in maximum voluntary strength (Neurotypical: 76.21 ± 13.84 ft-lbs., Non-paretic: 56.93 ± 17.75 ft-lbs., and Paretic: 31.51 ± 14.08 ft-lbs.), strength capacity (Neurotypical: 76.47 ± 13.59 ft-lbs., Non-paretic: 64.08 ± 14.50 ft-lbs., and Paretic: 44.55 ± 14.23 ft-lbs.), and central drive (Neurotypical: 88.73 ± 1.71%, Non-paretic: 73.66% ± 17.74%, and Paretic: 52.04% ± 20.22%). CEDRS-measured plantarflexor central drive was moderately correlated with 6MWT total distance (r = 0.69, <i>p</i> < 0.001) and distance-induced changes in speed (r = 0.61, <i>p</i> = 0.002). CEDRS is a clinician-operated, portable, neurostimulation-integrated force measurement platform that produces accurate measurements of plantarflexor neuromotor function that are associated with post-stroke walking ability. |
| first_indexed | 2024-03-07T22:41:44Z |
| format | Article |
| id | doaj.art-77dee0cc231f46ff9986fd0a81a2aeca |
| institution | Directory Open Access Journal |
| issn | 2306-5354 |
| language | English |
| last_indexed | 2024-03-07T22:41:44Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Bioengineering |
| spelling | doaj.art-77dee0cc231f46ff9986fd0a81a2aeca2024-02-23T15:07:55ZengMDPI AGBioengineering2306-53542024-01-0111213710.3390/bioengineering11020137A Portable, Neurostimulation-Integrated, Force Measurement Platform for the Clinical Assessment of Plantarflexor Central DriveAshley N. Collimore0Jonathan T. Alvarez1David A. Sherman2Lucas F. Gerez3Noah Barrow4Dabin K. Choe5Stuart Binder-Macleod6Conor J. Walsh7Louis N. Awad8Department of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USAHarvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USAHarvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USAHarvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USADepartment of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USAHarvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USADepartment of Physical Therapy, University of Delaware, Newark, DE 19716, USAHarvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USADepartment of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USAPlantarflexor central drive is a promising biomarker of neuromotor impairment; however, routine clinical assessment is hindered by the unavailability of force measurement systems with integrated neurostimulation capabilities. In this study, we evaluate the accuracy of a portable, neurostimulation-integrated, plantarflexor force measurement system we developed to facilitate the assessment of plantarflexor neuromotor function in clinical settings. Two experiments were conducted with the Central Drive System (CEDRS). To evaluate accuracy, experiment #1 included 16 neurotypical adults and used intra-class correlation (ICC<sub>2,1</sub>) to test agreement of plantarflexor strength capacity measured with CEDRS versus a stationary dynamometer. To evaluate validity, experiment #2 added 26 individuals with post-stroke hemiparesis and used one-way ANOVAs to test for between-limb differences in CEDRS’ measurements of plantarflexor neuromotor function, comparing neurotypical, non-paretic, and paretic limb measurements. The association between paretic plantarflexor neuromotor function and walking function outcomes derived from the six-minute walk test (6MWT) were also evaluated. CEDRS’ measurements of plantarflexor neuromotor function showed high agreement with measurements made by the stationary dynamometer (ICC = 0.83, <i>p</i> < 0.001). CEDRS’ measurements also showed the expected between-limb differences (<i>p</i>’s < 0.001) in maximum voluntary strength (Neurotypical: 76.21 ± 13.84 ft-lbs., Non-paretic: 56.93 ± 17.75 ft-lbs., and Paretic: 31.51 ± 14.08 ft-lbs.), strength capacity (Neurotypical: 76.47 ± 13.59 ft-lbs., Non-paretic: 64.08 ± 14.50 ft-lbs., and Paretic: 44.55 ± 14.23 ft-lbs.), and central drive (Neurotypical: 88.73 ± 1.71%, Non-paretic: 73.66% ± 17.74%, and Paretic: 52.04% ± 20.22%). CEDRS-measured plantarflexor central drive was moderately correlated with 6MWT total distance (r = 0.69, <i>p</i> < 0.001) and distance-induced changes in speed (r = 0.61, <i>p</i> = 0.002). CEDRS is a clinician-operated, portable, neurostimulation-integrated force measurement platform that produces accurate measurements of plantarflexor neuromotor function that are associated with post-stroke walking ability.https://www.mdpi.com/2306-5354/11/2/137muscle strengthactivationburst superimpositionneuromuscularstrokegait |
| spellingShingle | Ashley N. Collimore Jonathan T. Alvarez David A. Sherman Lucas F. Gerez Noah Barrow Dabin K. Choe Stuart Binder-Macleod Conor J. Walsh Louis N. Awad A Portable, Neurostimulation-Integrated, Force Measurement Platform for the Clinical Assessment of Plantarflexor Central Drive Bioengineering muscle strength activation burst superimposition neuromuscular stroke gait |
| title | A Portable, Neurostimulation-Integrated, Force Measurement Platform for the Clinical Assessment of Plantarflexor Central Drive |
| title_full | A Portable, Neurostimulation-Integrated, Force Measurement Platform for the Clinical Assessment of Plantarflexor Central Drive |
| title_fullStr | A Portable, Neurostimulation-Integrated, Force Measurement Platform for the Clinical Assessment of Plantarflexor Central Drive |
| title_full_unstemmed | A Portable, Neurostimulation-Integrated, Force Measurement Platform for the Clinical Assessment of Plantarflexor Central Drive |
| title_short | A Portable, Neurostimulation-Integrated, Force Measurement Platform for the Clinical Assessment of Plantarflexor Central Drive |
| title_sort | portable neurostimulation integrated force measurement platform for the clinical assessment of plantarflexor central drive |
| topic | muscle strength activation burst superimposition neuromuscular stroke gait |
| url | https://www.mdpi.com/2306-5354/11/2/137 |
| work_keys_str_mv | AT ashleyncollimore aportableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT jonathantalvarez aportableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT davidasherman aportableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT lucasfgerez aportableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT noahbarrow aportableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT dabinkchoe aportableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT stuartbindermacleod aportableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT conorjwalsh aportableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT louisnawad aportableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT ashleyncollimore portableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT jonathantalvarez portableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT davidasherman portableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT lucasfgerez portableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT noahbarrow portableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT dabinkchoe portableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT stuartbindermacleod portableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT conorjwalsh portableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive AT louisnawad portableneurostimulationintegratedforcemeasurementplatformfortheclinicalassessmentofplantarflexorcentraldrive |