NCT06523335 · University of Houston
Increasing the Repertoire of Intermuscular Co-ordination Post Stroke Through EMG-Guided Human-Machine Interaction
(NICE)
What this study is about
The purposes of this study include: 1. \- To identify whether features of aberrant intermuscular coordination patterns can be used to predict motor impairment after stroke. 2. \- To test whether muscle synergies are malleable to a non-invasive EMG-guided exercise that induces changes in intermuscular coordination of upper extremity muscles after stroke.
View original scientific description
The purposes of this study include: 1. \- To identify whether features of aberrant intermuscular coordination patterns can be used to predict motor impairment after stroke. 2. \- To test whether muscle synergies are malleable to a non-invasive EMG-guided exercise that induces changes in intermuscular coordination of upper extremity muscles after stroke.
Interventions
OTHER
Neuromuscular coordination-guided rehabilitative training
During training exercise, post-stroke participants will be asked to match the targets on the screen. The experimental group will match them by activating a specific set of muscle. During assessment trials, a physical therapist or occupational therapist will rate the functional level of arm impairment using FMA and ARAT.
OTHER
Force strengthening-guided rehabilitative training
During training exercise, post-stroke participants will be asked to match the targets on the screen. The active comparator group will match them by generating isometric force in a desired target direction. During assessment trials, a physical therapist or occupational therapist will rate the functional level of arm impairment using FMA and ARAT.
Primary outcome measures
Change in Fugl-Meyer Assessment (FMA) score
Time frame: before any training, after the 6 weeks of training, respectively, and 1 and 3 months after the last training session, respectively
To measure severity of motor impairment after stroke, FMA will be performed in the human upper extremity. FMA is commonly used to assess severity of motor impairment and motor recovery. The maximum FMA upper extremity motor score is 66 (i.e., 0: complete motor impairment; 66: normal motor performance). Each item is scored on a 3-point scale (0 = cannot perform, 1 = performs partially, 2 = performs fully).
Change in Action Research Arm Test (ARAT) score
Time frame: before any training, after the 6 weeks of training, respectively, and 1 and 3 months after the last training session, respectively
To measure motor function after stroke, ARAT will be performed in the human upper extremity. 19 Items comprising the ARAT are categorized into four subscales (grasp, grip, pinch, and gross movement) and arranged in order of decreasing difficulty, with the most difficult task examined first, followed by the least difficult task. Task performance is rated on a 4-point scale, ranging from 0 (no movement) to 3 (movement performed normally).
Change in intermuscular coordination patterns
Time frame: before any training, after the 6 weeks of training, respectively, and 1 and 3 months after the last training session, respectively
EMGs will be recorded from 12 muscles. To assess whether muscle-synergy guided and/or force-guided exercise induce changes in the composition of intermuscular coordination patterns, non-negative matrix factorization will be applied to EMGs to identify and compare ICoPs. The features from EMG are muscle synergy (motor module) composition and activation profiles.
Who can participate
This study lists these criteria on ClinicalTrials.gov. A study coordinator reviews eligibility during screening — this page does not determine whether you qualify.
Inclusion criteria
- for aged matched healthy group
- Male or female whose age range between 40 and 75
- no known neurological injuries
Exclusion criteria
- for aged matched healthy group
- have an orthopedic disorder involving upper limbs;
- have a history of any neurologic disease;
- have any history of epilepsy of the potential participants and/or their family members;
- are unable to consent;
- are pregnant. Inclusion criteria for stroke group
- male or female hemiparetic chronic stroke survivors;
- age ranging between 40-75 year;
- with single unilateral ischemic or hemorrhagic middle cerebral artery stroke;
- neurologically stable for \>6 months;
- have an expectation that current medication will be maintained without changes for at least 3 months. Stable use of anti-spasticity medication (e.g., baclofen, diazepam, tizanidine) is accepted;
- without severe spasticity (Modified Ashworth (MA) \<4);
- have not received botulinum toxin on the impaired arm within 3 months. Exclusion criteria for stroke group
- have an orthopedic disorder involving upper limbs;
- cognitive impairment sufficient to interfere with informed consent or successful completion of the protocol (Montreal Cognitive Assessment (MoCA) score \< 26);
- a history of another neurologic disease;
- anesthesia of joint position sense in upper limbs;
- are pregnant or have a chance that they might be (self-reported);
Where
- Houston, Texas
Collaborators
Korea Advanced Institute of Science and Technology, The University of Texas Health Science Center, Houston
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Data: ClinicalTrials.gov · synced May 4, 2026 · Source of record for eligibility and locations