Functional walking in paralyzed patients by means of electrical stimulation.
Functional walking in paralyzed patients by means of electrical stimulation.
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通过电刺激使瘫痪患者功能性行走。
DOI：
10.1097/00003086-198305000-00005
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发表时间：
1983
影响因子：
4.2
通讯作者：
R. Kobetic
中科院分区：
文献类型：
--
作者：
E. Marsolais;R. Kobetic
三名部分瘫痪的患者在一家大型康复中心进行了最大程度的康复尝试后仍无法行走。一名36岁的男子患有横断面脊髓炎，一名57岁的男子中风，第三名患者，一名35岁的男子，遭受了创伤性脑损伤。3例患者髋关节不能屈曲，有内收肌痉挛，髋关节和膝关节伸展无力，踝关节缺乏背屈。根据需要，将计时器激活的肌内不锈钢丝电极放置在股四头肌、髋屈肌、伸肌和外展肌。肌肉力量和足部接触评估使用Cybex和克利夫兰退伍军人管理局步态实验室完成。肌内电极植入后，所有3例患者的功能均有所改善，但仍需要一些行走监督。一名患者的膝关节扭矩增加了10倍，从而使他的力量接近正常。无种植体并发症。该研究证明了功能性神经肌肉刺激（FNS）在实验室外对先前不能行走的患者进行步态增强的可行性。进一步的改进将需要开发一种可植入的、多通道的、可编程的微处理器控制的刺激器。
Three partially paralyzed patients were unable to walk even after maximal rehabilitation attempts at a major rehabilitation center. One 36-year-old man had transverse myelitis, a 57-year-old man had had a stroke, and the third patient, a 35-year-old man, had incurred a traumatic brain injury. The three patients were unable to flex the hips, had adductor spasm and weak hip and knee extension, and lacked ankle dorsiflexion. Intramuscular stainless steel wire electrodes activated by timers were placed in the quadriceps, hip flexors, extensors, and abductors, as needed. Muscle force and foot contact evaluations were done using the Cybex and the Cleveland Veterans Administration Gait Laboratory. After implantation of intramuscular electrodes, all three patients had improved function but still desired some supervision in walking. A ten-fold increase in knee torque was noted in one patient, thereby providing him with nearly normal strength. No implant complications were noted. The study demonstrated the feasibility of functional neuromuscular stimulation (FNS) gait augmentation in a previously nonwalking patient outside the laboratory. Further improvements will require the development of an implantable, multichannel, programmable microprocessor-controlled stimulator.