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.

中文翻译：

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基于EMG的振动式生物反馈训练：对于患有肌张力障碍的儿童和青少年的有效学习促进剂？跨界试验。

背景技术本研究旨在更好地理解基于可穿戴和静音的ElectroMyoGraphy的生物反馈对原发性和继发性肌张力障碍儿童和青少年运动学习的作用。方法设计了一个交叉研究，其洗脱期至少为1周。该设备为患者提供与受损目标肌肉的激活成比例的振动。该协议包括两个为期5天的练习，在此期间对受试者进行图8写作任务的训练和测试：在第1天和第5天，根据运动学和肌肉激活来评估他们的表现（在不同难度下）而其他三天纯粹用作培训课程。在有或没有使用生物反馈装置的情况下进行了培训：使用的一周是随机的。收集了14名患有原发性和继发性（获得性）肌张力障碍（年龄：6-19岁）的受试者的数据。结果在训练前后比较基于运动学和基于EMG的结局指标的结果表明，对于患有原发性肌张力障碍和继发性肌张力障碍的受试者，由于练习而学习。在上述学习的基础上，在借助基于EMG的生物反馈设备进行训练时，仅针对继发性肌张力障碍受试者记录了关节间协调和肌肉模式功能方面的改善。结论我们的研究结果支持以下假设：具有完整感觉处理的原发性肌张力障碍的儿童和青少年不能从反馈增强中受益，而继发性肌张力障碍的儿童通常存在感觉缺陷，提供增强的与运动有关的感官信息时，具有较高的学习能力。这项研究代表了一项基础研究，旨在解决肌张力障碍年轻受试者无创治疗干预措施的匮乏问题。