我们会,我们会让你震惊:中风后患者的自适应功能性电刺激与传统功能性电刺激。

IF 1.7 4区 医学 Q4 BIOPHYSICS
Margo C Donlin, Jill S Higginson
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引用次数: 0

摘要

功能性电刺激(FES)通常用于中风后步态康复,以解决步行速度下降、足下垂和向前推进力减弱等问题。然而,并非所有患者在接受刺激后都能获得有临床意义的步态功能改善。此前的研究已经开发出了自适应功能性电刺激(AFES)系统,该系统可在每一步中调整刺激时机和振幅,以提供最佳刺激。这项研究旨在确定新型 AFES 系统对功能性步态结果的影响,并将其与现有 FES 系统的影响进行比较。二十四名中风后慢性偏瘫患者在自适应固定速度跑步机上完成了六次四分钟步行试验,分别在无刺激、现有 FES 系统刺激和 AFES 系统刺激下进行。刺激条件对步行速度、峰值背屈角度或峰值推进力没有明显影响。与固定速度跑步机相比,自适应跑步机的行走速度明显更快,峰值推进力明显更大(p 均小于 0.0001)。不同刺激条件下的背屈刺激时机相似,但与 FES 系统相比,AFES 系统的跖屈刺激时机明显改善(p = 0.0059)。受试者之间和受试者内部的差异很大,一些受试者在行走速度、背屈角峰值和推进力峰值方面获得了有临床意义的改善。然而,并非所有受试者都能从中受益,这表明需要进一步研究哪些受试者对 FES 表现出最佳的瞬时反应,以优化使用 FES 的中风后步态康复。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
We Will, We Will Shock You: Adaptive Versus Conventional Functional Electrical Stimulation in Individuals Post-Stroke.

Functional electrical stimulation (FES) is often used in poststroke gait rehabilitation to address decreased walking speed, foot drop, and decreased forward propulsion. However, not all individuals experience clinically meaningful improvements in gait function with stimulation. Previous research has developed adaptive functional electrical stimulation (AFES) systems that adjust stimulation timing and amplitude at every stride to deliver optimal stimulation. The purpose of this work was to determine the effects of a novel AFES system on functional gait outcomes and compare them to the effects of the existing FES system. Twenty-four individuals with chronic poststroke hemiparesis completed 64-min walking trials on an adaptive and fixed-speed treadmill with no stimulation, stimulation from the existing FES system, and stimulation from the AFES system. There was no significant effect of stimulation condition on walking speed, peak dorsiflexion angle, or peak propulsive force. Walking speed was significantly faster and peak propulsive force was significantly larger on the adaptive treadmill (ATM) than the fixed-speed treadmill (both p < 0.0001). Dorsiflexor stimulation timing was similar between stimulation conditions, but plantarflexor stimulation timing was significantly improved with the AFES system compared to the FES system (p = 0.0059). Variability between and within subjects was substantial, and some subjects experienced clinically meaningful improvements in walking speed, peak dorsiflexion angle, and peak propulsive force. However, not all subjects experienced benefits, suggesting that further research to characterize which subjects exhibit the best instantaneous response to FES is needed to optimize poststroke gait rehabilitation using FES.

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来源期刊
CiteScore
3.40
自引率
5.90%
发文量
169
审稿时长
4-8 weeks
期刊介绍: Artificial Organs and Prostheses; Bioinstrumentation and Measurements; Bioheat Transfer; Biomaterials; Biomechanics; Bioprocess Engineering; Cellular Mechanics; Design and Control of Biological Systems; Physiological Systems.
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