Effect of Physical Therapy on Muscle Synergy Structure during Standing-Up Motion of Hemiplegic Patients

Stroke patients suffer from declined physical ability, and it is important to analyze rehabilitation intervention and clarify its effect on the motion of patients. In this study, the effect of intervention on the standing-up motion of stroke patients is investigated. First, the intervention timing of a physical therapist (PT) is analyzed quantitatively from the muscle activity of upper limbs during therapy. Next, the intervention effect is evaluated based on body kinematics and muscle synergy. In this study, twenty trials are conducted, in which the standing-up motion of hemiplegic patients (n=12) is measured with and without the intervention by a PT. The results show that PTs teach hemiplegic patients the timing of lifting their buttocks during standing-up motion. Furthermore, it has been found that this intervention could improve the standing-up motion, although stroke patients had inadequate muscle synergy structure. In particular, some patients had delayed activation of the synergy and they could only stood up after they moved their center of mass toward their feet. However, the intervention by PTs could induce earlier activation of the synergy. Moreover, the intervention could properly shorten the activation duration of muscle synergy for those who had unusually inappropriate longer activation of synergy. These results imply that disordered and inadequate muscle synergy structure can be improved by proper intervention, and this study contributes to the further development of new rehabilitation methodologies.