{"title":"肌电图（EMG）触发的经皮脊髓和髋关节刺激对慢性中风患者的步态康复：一项随机对照试验。","authors":"Mami Tani, Tomofumi Yamaguchi, Kaoru Honaga, Yoko Takahashi, Hidemi Kono, Yuhei Murakami, Reina Isayama, Koshiro Haruyama, Yuji Fujino, Tadamitsu Matsuda, Issei Fukunaga, Masaaki Hori, Akira Tanuma, Futoshi Wada, Kozo Hatori, Toshiyuki Fujiwara","doi":"10.1186/s12984-025-01690-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Transcutaneous spinal stimulation has been applied to gait rehabilitation for persons with neurological diseases. The authors developed electromyography-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation and called this system FAST walk. This study aimed to assess the effect of FAST walk in a randomized, controlled trial.</p><p><strong>Methods: </strong>All participants were randomly allocated to three groups: FAST walk combined with treadmill gait training (FAST walk); spinal stimulation combined with treadmill gait training (spinal stim); and treadmill gait training (treadmill). Participants performed two sets of 15-min treadmill gait training with 5-min intervals in the FAST walk, spinal stim, and treadmill groups. Gait training was performed twice weekly for a total of 10 sessions. The primary outcome was 10-m walking time. The secondary outcomes were the time symmetry index (TSI) with gait analysis and spinal reciprocal inhibition on the conditioned-test H reflex study.</p><p><strong>Results: </strong>Twenty persons with chronic stroke participated in this study, and 17 persons completed this study. For the primary outcome, there was no significant interaction between time and intervention in 10-m walking time on two-way analysis of covariance (ANCOVA) (P = 0.382, η<sup>2</sup> = 0.064). For the FAST walk group, 10-m walking time improved significantly at post and post-4w (P = 0.024 and 0.022, respectively). In the other groups, no significant improvements in 10-m walking time were seen at post and post-4w compared with before. There was also no significant between-group difference in the 10-m walking time.</p><p><strong>Conclusions: </strong>The newly developed electromyography-triggered transcutaneous spinal cord and hip stimulation, FAST walk, is safe and may improve the gait speed of persons with chronic stroke. We did not, however, find a significant between-group difference among the FAST walk, spinal stim, and treadmill gait groups.</p><p><strong>Trial registration: </strong>Japan Registry of Clinical Trial (JRCT registration ID: jRCTs032180289).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"154"},"PeriodicalIF":5.2000,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232820/pdf/","citationCount":"0","resultStr":"{\"title\":\"Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trial.\",\"authors\":\"Mami Tani, Tomofumi Yamaguchi, Kaoru Honaga, Yoko Takahashi, Hidemi Kono, Yuhei Murakami, Reina Isayama, Koshiro Haruyama, Yuji Fujino, Tadamitsu Matsuda, Issei Fukunaga, Masaaki Hori, Akira Tanuma, Futoshi Wada, Kozo Hatori, Toshiyuki Fujiwara\",\"doi\":\"10.1186/s12984-025-01690-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Transcutaneous spinal stimulation has been applied to gait rehabilitation for persons with neurological diseases. The authors developed electromyography-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation and called this system FAST walk. This study aimed to assess the effect of FAST walk in a randomized, controlled trial.</p><p><strong>Methods: </strong>All participants were randomly allocated to three groups: FAST walk combined with treadmill gait training (FAST walk); spinal stimulation combined with treadmill gait training (spinal stim); and treadmill gait training (treadmill). Participants performed two sets of 15-min treadmill gait training with 5-min intervals in the FAST walk, spinal stim, and treadmill groups. Gait training was performed twice weekly for a total of 10 sessions. The primary outcome was 10-m walking time. The secondary outcomes were the time symmetry index (TSI) with gait analysis and spinal reciprocal inhibition on the conditioned-test H reflex study.</p><p><strong>Results: </strong>Twenty persons with chronic stroke participated in this study, and 17 persons completed this study. For the primary outcome, there was no significant interaction between time and intervention in 10-m walking time on two-way analysis of covariance (ANCOVA) (P = 0.382, η<sup>2</sup> = 0.064). For the FAST walk group, 10-m walking time improved significantly at post and post-4w (P = 0.024 and 0.022, respectively). In the other groups, no significant improvements in 10-m walking time were seen at post and post-4w compared with before. There was also no significant between-group difference in the 10-m walking time.</p><p><strong>Conclusions: </strong>The newly developed electromyography-triggered transcutaneous spinal cord and hip stimulation, FAST walk, is safe and may improve the gait speed of persons with chronic stroke. We did not, however, find a significant between-group difference among the FAST walk, spinal stim, and treadmill gait groups.</p><p><strong>Trial registration: </strong>Japan Registry of Clinical Trial (JRCT registration ID: jRCTs032180289).</p>\",\"PeriodicalId\":16384,\"journal\":{\"name\":\"Journal of NeuroEngineering and Rehabilitation\",\"volume\":\"22 1\",\"pages\":\"154\"},\"PeriodicalIF\":5.2000,\"publicationDate\":\"2025-07-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232820/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of NeuroEngineering and Rehabilitation\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1186/s12984-025-01690-0\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of NeuroEngineering and Rehabilitation","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1186/s12984-025-01690-0","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 0
摘要
背景：经皮脊髓刺激已被应用于神经系统疾病患者的步态康复。作者开发了肌电图触发的经皮脊髓和髋关节刺激，用于步态康复，并将该系统称为FAST步行。本研究旨在通过一项随机对照试验来评估FAST步行的效果。方法：所有参与者随机分为三组：FAST步行联合跑步机步态训练（FAST步行）；脊髓刺激联合跑步机步态训练（脊髓刺激）；和跑步机步态训练（跑步机）。在快速步行组、脊髓刺激组和跑步机组中，参与者进行了两组15分钟的跑步机步态训练，每组间隔5分钟。步态训练每周进行两次，共10次。主要终点为10米步行时间。次要结果是时间对称指数（TSI）与步态分析和条件反射试验H反射研究的脊柱互反抑制。结果：20例慢性脑卒中患者参与本研究，17例完成本研究。对于主要结局，双向协方差分析（ANCOVA）显示10 m步行时间与干预之间无显著交互作用（P = 0.382, η = 0.064）。快速步行组在步行后和步行后的10 m步行时间显著提高（P分别为0.024和0.022）。在其他组中，与之前相比，在10米步行时间后和后4w没有明显改善。10米步行时间组间差异无统计学意义。结论：新开发的肌电触发经皮脊髓和髋关节刺激法FAST步行是安全的，可以提高慢性脑卒中患者的步态速度。然而，我们没有发现快速步行组、脊髓刺激组和跑步机步态组之间有显著的组间差异。试验注册：日本临床试验注册中心（JRCT注册ID: jRCTs032180289）。
Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trial.
Background: Transcutaneous spinal stimulation has been applied to gait rehabilitation for persons with neurological diseases. The authors developed electromyography-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation and called this system FAST walk. This study aimed to assess the effect of FAST walk in a randomized, controlled trial.
Methods: All participants were randomly allocated to three groups: FAST walk combined with treadmill gait training (FAST walk); spinal stimulation combined with treadmill gait training (spinal stim); and treadmill gait training (treadmill). Participants performed two sets of 15-min treadmill gait training with 5-min intervals in the FAST walk, spinal stim, and treadmill groups. Gait training was performed twice weekly for a total of 10 sessions. The primary outcome was 10-m walking time. The secondary outcomes were the time symmetry index (TSI) with gait analysis and spinal reciprocal inhibition on the conditioned-test H reflex study.
Results: Twenty persons with chronic stroke participated in this study, and 17 persons completed this study. For the primary outcome, there was no significant interaction between time and intervention in 10-m walking time on two-way analysis of covariance (ANCOVA) (P = 0.382, η2 = 0.064). For the FAST walk group, 10-m walking time improved significantly at post and post-4w (P = 0.024 and 0.022, respectively). In the other groups, no significant improvements in 10-m walking time were seen at post and post-4w compared with before. There was also no significant between-group difference in the 10-m walking time.
Conclusions: The newly developed electromyography-triggered transcutaneous spinal cord and hip stimulation, FAST walk, is safe and may improve the gait speed of persons with chronic stroke. We did not, however, find a significant between-group difference among the FAST walk, spinal stim, and treadmill gait groups.
Trial registration: Japan Registry of Clinical Trial (JRCT registration ID: jRCTs032180289).
期刊介绍：
Journal of NeuroEngineering and Rehabilitation considers manuscripts on all aspects of research that result from cross-fertilization of the fields of neuroscience, biomedical engineering, and physical medicine & rehabilitation.
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