In clinical practice, acute post-stroke paresis of the extremities fundamentally complicates timely rehabilitation of motor functions; however, recently, residual and distorted musculoskeletal signals have been used to initiate feedback-driven solutions for establishing motor rehabilitation. Here, we investigate the possibilities of basic hand gesture recognition in acute stroke patients with hand paresis using a novel, acute stroke, four-component multidomain feature set (ASF-4) with feature vector weight additions (ASF-14NP, ASF-24P) and supervised learning algorithms trained only by surface electromyography (sEMG). A total of 19 (65.9 ± 12.4 years old; 12 men, seven women) acute stroke survivors (12.4 ± 6.3 days since onset) with hand paresis (Brunnstrom stage 4 ± 1/4 ± 1, SIAS 3 ± 1/3 ± 2, FMA-UE 40 ± 20) performed 10 repetitive hand movements reflecting basic activities of daily living (ADLs): rest, fist, pinch, wrist flexion, wrist extension, finger spread, and thumb up. Signals were recorded using an eight-channel, portable sEMG device with electrode placement on the forearms and thenar areas of both limbs (four sensors on each extremity). Using data preprocessing, semi-automatic segmentation, and a set of extracted feature vectors, support vector machine (SVM), linear discriminant analysis (LDA), and k-nearest neighbors (k-NN) classifiers for statistical comparison and validity (paired t-tests, p-value < 0.05), we were able to discriminate myoelectrical patterns for each gesture on both paretic and non-paretic sides. Despite any post-stroke conditions, the evaluated total accuracy rate by the 10-fold cross-validation using SVM among four-, five-, six-, and seven-gesture models were 96.62%, 94.20%, 94.45%, and 95.57% for non-paretic and 90.37%, 88.48%, 88.60%, and 89.75% for paretic limbs, respectively. LDA had competitive results using PCA whereas k-NN was a less efficient classifier in gesture prediction. Thus, we demonstrate partial efficacy of the combination of sEMG and supervised learning for upper-limb rehabilitation procedures for early acute stroke motor recovery and various treatment applications.

We introduce a hybrid deep learning model for recognizing hand gestures from electromyography (EMG) signals in subacute stroke patients: the one-dimensional convolutional long short-term memory neural network (CNN-LSTM). The proposed network was trained, tested, and cross-validated on seven hand gesture movements, collected via EMG from 25 patients exhibiting clinical features of paresis. EMG data from these patients were collected twice post-stroke, at least one week apart, and divided into datasets A and B to assess performance over time while balancing subject-specific content and minimizing training bias. Dataset A had a median post-stroke time of 16.0 ± 8.6 days, while dataset B had a median of 19.2 ± 13.7 days. In classification tests based on the number of gesture classes (ranging from two to seven), the hybrid model achieved accuracies ranging from 85.66% to 82.27% in dataset A and from 88.36% to 81.69% in dataset B. To address the limitations of deep learning with small datasets, we developed a novel bilateral data fusion approach that incorporates EMG signals from the non-paretic limb during training. This approach significantly enhanced model performance across both datasets, as evidenced by improvements in sensitivity, specificity, accuracy, and F1-score metrics. The most substantial gains were observed in the three-gesture subset, where classification accuracy increased from 73.01% to 78.42% in dataset A, and from 77.95% to 85.69% in dataset B. In conclusion, although these results may be slightly lower than those of traditional supervised learning algorithms, the combination of bilateral data fusion and the absence of feature engineering offers a novel perspective for neurorehabilitation, where every data segment is critically significant.

In myoelectrical pattern recognition (PR), the feature extraction methods for stroke-oriented applications are challenging and remain discordant due to a lack of hemiplegic data and limited knowledge of skeletomuscular function. Additionally, technical and clinical barriers create the need for robust, subject-independent feature generation while using supervised learning (SL). To the best of our knowledge, we are the first study to investigate the brute-force analysis of individual and combinational feature vectors for acute stroke gesture recognition using surface electromyography (EMG) of 19 patients. Moreover, post-brute-force singular vectors were concatenated via a Fibonacci-like spiral net ranking as a novel, broadly applicable concept for feature selection. This semi-brute-force navigated amalgamation in linkage (SNAiL) of EMG features revealed an explicit classification rate performance advantage of 10–17% compared to canonical feature sets, which can drastically extend PR capabilities in biosignal processing.

Rehabilitation of upper extremity (UE) impairments after stroke requires regular evaluation, with standard methods typically being time–consuming and relying heavily on manual assessment by therapists. In our study, we propose automating these assessments using electromyography (EMG) as a core indicator of muscle activity, correlating passive and active EMG signals with clinical motor impairment scores. UE motor function in 25 patients was evaluated using the Fugl–Meyer Assessment for UE (FMA–UE), the Modified Ashworth Scale (MAS), and the Brunnstrom Recovery Stages (BRS). EMG data were processed via feature extraction and linear discriminant analysis (LDA), with 10-fold cross–validation for binary classification based on clinical score thresholds. The LDA classifier accurately distinguished impairment categories, achieving area under the receiver operating characteristic curve (AUC–ROC) scores of 0.897 ± 0.272 for FMA–UE > 33, 0.981 ± 0.103 for FMA–UE > 44, 0.890 ± 0.262 for MAS > 0, 0.968 ± 0.130 for BRS > 3, and 0.987 ± 0.085 for BRS > 4. Notably, resting–state EMG alone yielded comparable classification performance. These findings demonstrate that EMG–driven assessments can reliably classify motor impairment levels, offering a pathway to objective clinical scoring that can streamline rehabilitation workflows, reduce therapists’ manual burden, and prioritize patient recovery over assessment procedures.