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© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

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 t-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 (p = 0.007), increased mean (p ≤ 0.022) and peak (p ≤ 0.044) torque and the %MVC (p ≤ 0.004) during mid and end phases, and larger muscle thickness during mid contraction (p = 0.045). Moderate correlations were found between torque and muscle thickness (r ≥ 0.30, p ≤ 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.

Details

Title
Wearable Ultrasound-Imaging-Based Visual Feedback (UVF) Training for Ankle Rehabilitation of Chronic Stroke Survivors: A Proof-of-Concept Randomized Crossover Study
Author
Yu-Yan, Luo 1   VIAFID ORCID Logo  ; Huang, Chen 1 ; Song, Zhen 1   VIAFID ORCID Logo  ; Nazari Vaheh 1 ; Wong, Arnold Yu-Lok 2   VIAFID ORCID Logo  ; Yang, Lin 3   VIAFID ORCID Logo  ; Dong Mingjie 4   VIAFID ORCID Logo  ; Zhang, Mingming 5 ; Yong-Ping, Zheng 6   VIAFID ORCID Logo  ; Fu, Amy Siu-Ngor 7 ; Ma Christina Zong-Hao 6   VIAFID ORCID Logo 

 Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China; [email protected] (Y.-Y.L.); [email protected] (C.H.); [email protected] (Z.S.); [email protected] (V.N.); [email protected] (Y.-P.Z.) 
 Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China; [email protected], Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; [email protected] 
 School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China; [email protected] 
 Faculty of Materials and Manufacturing, Beijing University of Technology, Beijing 100124, China; [email protected] 
 Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen 518000, China; [email protected] 
 Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China; [email protected] (Y.-Y.L.); [email protected] (C.H.); [email protected] (Z.S.); [email protected] (V.N.); [email protected] (Y.-P.Z.), Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China; [email protected] 
 Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; [email protected] 
First page
365
Publication year
2025
Publication date
2025
Publisher
MDPI AG
e-ISSN
20796374
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3223880077
Copyright
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.