Wearable Ultrasound-Imaging-Based Visual Feedback (UVF) Training for Ankle Rehabilitation of Chronic Stroke Survivors: A Proof-of-Concept Randomized Crossover Study

This study investigated the effect of wearable ultrasound-imaging-based visual feedback (UVF) on assisting paretic ankle dorsiflexion training of chronic stroke survivors. Thirty-three participants with unilateral hemiplegia performed maximal isometric contractions on an isokinetic dynamometer in ra...

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Main Authors: Yu-Yan Luo, Chen Huang, Zhen Song, Vaheh Nazari, Arnold Yu-Lok Wong, Lin Yang, Mingjie Dong, Mingming Zhang, Yong-Ping Zheng, Amy Siu-Ngor Fu, Christina Zong-Hao Ma
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Biosensors
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Online Access:https://www.mdpi.com/2079-6374/15/6/365
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author Yu-Yan Luo
Chen Huang
Zhen Song
Vaheh Nazari
Arnold Yu-Lok Wong
Lin Yang
Mingjie Dong
Mingming Zhang
Yong-Ping Zheng
Amy Siu-Ngor Fu
Christina Zong-Hao Ma
author_facet Yu-Yan Luo
Chen Huang
Zhen Song
Vaheh Nazari
Arnold Yu-Lok Wong
Lin Yang
Mingjie Dong
Mingming Zhang
Yong-Ping Zheng
Amy Siu-Ngor Fu
Christina Zong-Hao Ma
author_sort Yu-Yan Luo
collection DOAJ
description This study investigated the effect of wearable ultrasound-imaging-based visual feedback (UVF) on assisting paretic ankle dorsiflexion training of chronic stroke survivors. Thirty-three participants with unilateral hemiplegia performed maximal isometric contractions on an isokinetic dynamometer in randomized conditions with and without UVF that provided by a wearable ultrasound imaging system. Torque parameters (mean, peak, percentage of maximal voluntary contraction) and tibialis anterior muscle thickness were analyzed across different contraction phases. Statistical comparisons were conducted using paired <i>t</i>-tests or Wilcoxon tests. Correlation analyses were performed using Pearson’s or Spearman’s tests. Results demonstrated that UVF significantly improved torque output, as evidence by the increased percentage of maximal voluntary contraction (%MVC) during entire contractions (<i>p</i> = 0.007), increased mean (<i>p</i> ≤ 0.022) and peak (<i>p</i> ≤ 0.044) torque and the %MVC (<i>p</i> ≤ 0.004) during mid and end phases, and larger muscle thickness during mid contraction (<i>p</i> = 0.045). Moderate correlations were found between torque and muscle thickness (r ≥ 0.30, <i>p</i> ≤ 0.049). These findings preliminarily supported the positive outcomes of real-time wearable UVFs in enhancing paretic ankle dorsiflexion strength and force control during isometric contractions in chronic stroke survivors. While the developed and validated new training protocol may potentially serve as a practical adjunct to existing rehabilitation approaches, further investigations emphasizing the functional outcomes and clinical translations are still needed to verify the clinical utility.
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spelling doaj-art-dd0286f533b94c91b883f96d13f058b52025-08-20T03:27:17ZengMDPI AGBiosensors2079-63742025-06-0115636510.3390/bios15060365Wearable Ultrasound-Imaging-Based Visual Feedback (UVF) Training for Ankle Rehabilitation of Chronic Stroke Survivors: A Proof-of-Concept Randomized Crossover StudyYu-Yan Luo0Chen Huang1Zhen Song2Vaheh Nazari3Arnold Yu-Lok Wong4Lin Yang5Mingjie Dong6Mingming Zhang7Yong-Ping Zheng8Amy Siu-Ngor Fu9Christina Zong-Hao Ma10Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, ChinaDepartment of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, ChinaDepartment of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, ChinaDepartment of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, ChinaResearch Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, ChinaSchool of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, ChinaFaculty of Materials and Manufacturing, Beijing University of Technology, Beijing 100124, ChinaDepartment of Biomedical Engineering, Southern University of Science and Technology, Shenzhen 518000, ChinaDepartment of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, ChinaDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, ChinaDepartment of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, ChinaThis study investigated the effect of wearable ultrasound-imaging-based visual feedback (UVF) on assisting paretic ankle dorsiflexion training of chronic stroke survivors. Thirty-three participants with unilateral hemiplegia performed maximal isometric contractions on an isokinetic dynamometer in randomized conditions with and without UVF that provided by a wearable ultrasound imaging system. Torque parameters (mean, peak, percentage of maximal voluntary contraction) and tibialis anterior muscle thickness were analyzed across different contraction phases. Statistical comparisons were conducted using paired <i>t</i>-tests or Wilcoxon tests. Correlation analyses were performed using Pearson’s or Spearman’s tests. Results demonstrated that UVF significantly improved torque output, as evidence by the increased percentage of maximal voluntary contraction (%MVC) during entire contractions (<i>p</i> = 0.007), increased mean (<i>p</i> ≤ 0.022) and peak (<i>p</i> ≤ 0.044) torque and the %MVC (<i>p</i> ≤ 0.004) during mid and end phases, and larger muscle thickness during mid contraction (<i>p</i> = 0.045). Moderate correlations were found between torque and muscle thickness (r ≥ 0.30, <i>p</i> ≤ 0.049). These findings preliminarily supported the positive outcomes of real-time wearable UVFs in enhancing paretic ankle dorsiflexion strength and force control during isometric contractions in chronic stroke survivors. While the developed and validated new training protocol may potentially serve as a practical adjunct to existing rehabilitation approaches, further investigations emphasizing the functional outcomes and clinical translations are still needed to verify the clinical utility.https://www.mdpi.com/2079-6374/15/6/365muscle trainingstroketibialis anteriorultrasound imagingvisual feedback
spellingShingle Yu-Yan Luo
Chen Huang
Zhen Song
Vaheh Nazari
Arnold Yu-Lok Wong
Lin Yang
Mingjie Dong
Mingming Zhang
Yong-Ping Zheng
Amy Siu-Ngor Fu
Christina Zong-Hao Ma
Wearable Ultrasound-Imaging-Based Visual Feedback (UVF) Training for Ankle Rehabilitation of Chronic Stroke Survivors: A Proof-of-Concept Randomized Crossover Study
Biosensors
muscle training
stroke
tibialis anterior
ultrasound imaging
visual feedback
title Wearable Ultrasound-Imaging-Based Visual Feedback (UVF) Training for Ankle Rehabilitation of Chronic Stroke Survivors: A Proof-of-Concept Randomized Crossover Study
title_full Wearable Ultrasound-Imaging-Based Visual Feedback (UVF) Training for Ankle Rehabilitation of Chronic Stroke Survivors: A Proof-of-Concept Randomized Crossover Study
title_fullStr Wearable Ultrasound-Imaging-Based Visual Feedback (UVF) Training for Ankle Rehabilitation of Chronic Stroke Survivors: A Proof-of-Concept Randomized Crossover Study
title_full_unstemmed Wearable Ultrasound-Imaging-Based Visual Feedback (UVF) Training for Ankle Rehabilitation of Chronic Stroke Survivors: A Proof-of-Concept Randomized Crossover Study
title_short Wearable Ultrasound-Imaging-Based Visual Feedback (UVF) Training for Ankle Rehabilitation of Chronic Stroke Survivors: A Proof-of-Concept Randomized Crossover Study
title_sort wearable ultrasound imaging based visual feedback uvf training for ankle rehabilitation of chronic stroke survivors a proof of concept randomized crossover study
topic muscle training
stroke
tibialis anterior
ultrasound imaging
visual feedback
url https://www.mdpi.com/2079-6374/15/6/365
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