Implanted functional electrical stimulation system for mobility in paraplegia: a follow-up case report.

R Kobetic, R J Triolo, J P Uhlir, C Bieri, M Wibowo, G Polando, E B Marsolais, J A Davis, K A Ferguson
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引用次数: 160

Abstract

A 16-channel functional electrical stimulation (FES) system has been implanted in a person with T10 paraplegia for over a year. The system consists of two eight-channel radio frequency controlled receiver-stimulators delivering stimuli through a network of 14 epimysial and two intramuscular electrodes. Using this system and a walker for support, the subject was able to stand up for 8 min and walk regularly for 20 m. The standing duration was limited by arm fatigue since upper extremities supported an average of 25% of body weight. This was due to suboptimal hip extension and some undesired recruitment of rectus femoris and sartorius with stimulation of quadriceps electrodes. The left quadriceps exhibited rapid fatigue that limited walking distance and duration. The metabolic energy requirements were well within the aerobic limits of the sedentary paraplegic population. At one-year follow-up evaluation all electrodes are functional except one intramuscular electrode. The implant caused no adverse physiological effects and the individual reported health benefits such as increased energy and overall fitness as a result of the FES system use. With further improvements in muscle response through innovative surgical techniques, the 16-channel implanted FES system can be a viable addition to exercise and mobility function in persons with paraplegia.

植入功能性电刺激系统改善截瘫患者的活动能力:1例随访报告。
一种16通道功能性电刺激(FES)系统已被植入一名T10截瘫患者体内一年多。该系统由两个8通道射频控制的接收器-刺激器组成,通过14个外膜和两个肌内电极组成的网络传递刺激。使用该系统和助行器作为支撑,受试者能够站立8分钟并定期步行20米。由于上肢平均支撑体重的25%,站立时间受到手臂疲劳的限制。这是由于髋关节伸展不理想以及股四头肌电极刺激时股直肌和缝阔肌的一些不期望的重新募集。左股四头肌表现出快速疲劳,限制了步行距离和持续时间。代谢能量需求完全在久坐截瘫人群的有氧极限之内。在一年的随访评估中,除一个肌内电极外,所有电极功能正常。植入物没有造成不良的生理影响,并且个体报告了健康益处,例如由于使用FES系统而增加了能量和整体健康。随着创新手术技术对肌肉反应的进一步改善,16通道植入FES系统可以成为截瘫患者运动和活动功能的可行补充。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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