EMG-based vibro-tactile biofeedback training: Effective learning accelerator for children and adolescents with dystonia? A pilot crossover trial

Claudia Casellato, Emilia Ambrosini, Andrea Galbiati, Emilia Biffi, Ambra Cesareo, Elena Beretta, Francesca Lunardini, Giovanna Zorzi, Terence D. Sanger, Alessandra Pedrocchi

Research output: Contribution to journalArticle

Abstract

Background: This study is aimed at better understanding the role of a wearable and silent ElectroMyoGraphy-based biofeedback on motor learning in children and adolescents with primary and secondary dystonia. Methods: A crossover study with a wash-out period of at least 1 week was designed; the device provides the patient with a vibration proportional to the activation of an impaired target muscle. The protocol consisted of two 5-day blocks during which subjects were trained and tested on a figure-8 writing task: their performances (at different levels of difficulty) were evaluated in terms of both kinematics and muscular activations on day 1 and day 5, while the other 3 days were purely used as training sessions. The training was performed with and without using the biofeedback device: the week of use was randomized. Data were collected on 14 subjects with primary and secondary (acquired) dystonia (age: 6-19 years). Results: Results comparing kinematic-based and EMG-based outcome measures pre- and post-training showed learning due to practice for both subjects with primary and secondary dystonia. On top of said learning, an improvement in terms of inter-joint coordination and muscular pattern functionality was recorded only for secondary dystonia subjects, when trained with the aid of the EMG-based biofeedback device. Conclusions: Our results support the hypothesis that children and adolescents with primary dystonia in which there is intact sensory processing do not benefit from feedback augmentation, whereas children with secondary dystonia, in which sensory deficits are often present, exhibit a higher learning capacity when augmented movement-related sensory information is provided. This study represents a fundamental investigation to address the scarcity of noninvasive therapeutic interventions for young subjects with dystonia.

Original languageEnglish
Article number150
Number of pages14
JournalJournal of NeuroEngineering and Rehabilitation
Volume16
Issue number1
DOIs
Publication statusPublished - Nov 27 2019

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Dystonic Disorders
Dystonia
Touch
Cross-Over Studies
Learning
Biomechanical Phenomena
Equipment and Supplies
Biofeedback (Psychology)
Task Performance and Analysis
Electromyography
Vibration
Joints
Outcome Assessment (Health Care)
Muscles

Keywords

  • Biofeedback
  • Dystonia
  • EMG
  • Learning
  • Sensory-motor deficits
  • Wearable devices

ASJC Scopus subject areas

  • Rehabilitation
  • Health Informatics

Cite this

EMG-based vibro-tactile biofeedback training : Effective learning accelerator for children and adolescents with dystonia? A pilot crossover trial. / Casellato, Claudia; Ambrosini, Emilia; Galbiati, Andrea; Biffi, Emilia; Cesareo, Ambra; Beretta, Elena; Lunardini, Francesca; Zorzi, Giovanna; Sanger, Terence D.; Pedrocchi, Alessandra.

In: Journal of NeuroEngineering and Rehabilitation, Vol. 16, No. 1, 150, 27.11.2019.

Research output: Contribution to journalArticle

Casellato, Claudia ; Ambrosini, Emilia ; Galbiati, Andrea ; Biffi, Emilia ; Cesareo, Ambra ; Beretta, Elena ; Lunardini, Francesca ; Zorzi, Giovanna ; Sanger, Terence D. ; Pedrocchi, Alessandra. / EMG-based vibro-tactile biofeedback training : Effective learning accelerator for children and adolescents with dystonia? A pilot crossover trial. In: Journal of NeuroEngineering and Rehabilitation. 2019 ; Vol. 16, No. 1.
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AU - Beretta, Elena

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AB - Background: This study is aimed at better understanding the role of a wearable and silent ElectroMyoGraphy-based biofeedback on motor learning in children and adolescents with primary and secondary dystonia. Methods: A crossover study with a wash-out period of at least 1 week was designed; the device provides the patient with a vibration proportional to the activation of an impaired target muscle. The protocol consisted of two 5-day blocks during which subjects were trained and tested on a figure-8 writing task: their performances (at different levels of difficulty) were evaluated in terms of both kinematics and muscular activations on day 1 and day 5, while the other 3 days were purely used as training sessions. The training was performed with and without using the biofeedback device: the week of use was randomized. Data were collected on 14 subjects with primary and secondary (acquired) dystonia (age: 6-19 years). Results: Results comparing kinematic-based and EMG-based outcome measures pre- and post-training showed learning due to practice for both subjects with primary and secondary dystonia. On top of said learning, an improvement in terms of inter-joint coordination and muscular pattern functionality was recorded only for secondary dystonia subjects, when trained with the aid of the EMG-based biofeedback device. Conclusions: Our results support the hypothesis that children and adolescents with primary dystonia in which there is intact sensory processing do not benefit from feedback augmentation, whereas children with secondary dystonia, in which sensory deficits are often present, exhibit a higher learning capacity when augmented movement-related sensory information is provided. This study represents a fundamental investigation to address the scarcity of noninvasive therapeutic interventions for young subjects with dystonia.

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