Individualized electrostimulation using a wearable electro suit in a mixed cohort of stroke and spinal cord injury with spasticity: Clinical outcomes and qualitative feedback (Preprint)
Bibliographic record
Abstract
Abstract Background Various forms of electrical stimulation have been integrated into the multimodal management of spasticity. However, high-frequency electrical stimulation can potentially induce muscle fatigue. The Exopulse Mollii Suit (EMS) is a multichannel full-body garment that delivers low-frequency (20 Hz), low-amplitude (20 V), subthreshold sensory stimulation aimed at reducing spasticity. Objective Primarily, we examined the effects of a single session of the EMS on spasticity in 7 participants with chronic stroke or cervical spinal cord injury (SCI), specifically those with upper or lower limb spasticity impacting function and gait who were able to walk with minimal or no assistance (Functional Ambulatory Category scores of 2‐5). We assessed the impact on gait and ambulatory function, as well as user perceptions of usability and acceptability. Methods Participants wore the EMS for 60 minutes, consisting of 30 minutes of standardized goal-directed activities performed in two 15-minute blocks, interspersed with 15-minute rest breaks. Measurements included the Modified Tardieu Scale with surface electromyography for spasticity and functional mobility tests (Functional Ambulatory Category, 10-meter walk test, 5 times sit-to-stand test, and step test). Spatiotemporal gait parameters were quantified using a markerless vision-based motion capture system using the OpenPose BODY25 pose estimation model. Results On the basis of the Modified Tardieu Scale and surface electromyography signals, improvements in spasticity were only observed in 2 participants. However, 4 participants demonstrated faster walking speeds. Improvements in the 5 times sit-to-stand test and step test were noted in 3 and 4 participants, respectively. Spatiotemporal gait parameters revealed improvements in gait symmetry in 6 participants. Qualitative feedback based on the Assistive Technology Usability Questionnaire for People With Neurological Diseases (NATU Quest) returned positive results in 3 participants. Overall outcomes, defined as meeting the individualized goals of each participant, were positive in 4 participants. Conclusions This case series provides preliminary evidence that a single session with the EMS may offer benefits for functional mobility and gait quality for individuals with spasticity resulting from stroke or SCI. To our knowledge, this is the first report examining the effects of the EMS in participants with SCI and the first to include spatiotemporal gait parameters associated with its use. However, the small sample size, variable outcomes, and lack of a control group necessitate caution in interpreting these findings and preclude definitive conclusions regarding the efficacy of the EMS. Larger, controlled trials with repeated sessions of EMS use are required to establish the effectiveness and optimal application of the EMS for spasticity management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".