Posture shifting after spinal cord injury using functional neuromuscular stimulation--a computer simulation study.
Posture shifting after spinal cord injury using functional neuromuscular stimulation--a computer simulation study.
复制标题
使用功能性神经肌肉刺激进行脊髓损伤后的姿势转变——计算机模拟研究。
DOI：
10.1016/j.jbiomech.2010.12.020
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发表时间：
2011
影响因子：
2.4
通讯作者：
Triolo,RonaldJ
中科院分区：
文献类型：
--
作者：
Audu,MusaL;Nataraj,Raviraj;Gartman,StevenJ;Triolo,RonaldJ
使用躯干、骨盆和下肢（LE）的解剖学启发的肌肉骨骼模型，探讨了脊髓损伤（SCI）患者通过功能性神经肌肉刺激（FNS）影响站立姿势变化的能力。该模型跟踪了远离直立姿势的向前和侧向移动的轨迹。向两个肩部施加力以表示上肢（UE）与辅助装置（例如，步行者）。通过动态优化确定了UE力<10%体重（BW）时执行移位动作所需的肌肉激励。检查了九组肌肉，以最大限度地控制移动姿势。双侧腰大肌和外斜肌的纳入导致前移的相对UE作用力最小（0.119，平均UE作用力=45.3N × 5.4%BW）。对于侧向移位，包括双侧腰大肌和背阔肌的集合产生最佳性能（0.025，平均UE作用力=27.8N × 3.3%BW）。然而，在两种动作中，单独添加双侧腰大肌在总体最佳性能方面具有优势。这项研究表明，适当激活躯干和LE的特定肌肉可以使SCI患者以最小的上身努力改变他们的站立姿势，随后增加伸展和站立工作量。
The ability for individuals with spinal cord injury (SCI) to affect changes in standing posture with functional neuromuscular stimulation (FNS) was explored using an anatomically inspired musculoskeletal model of the trunk, pelvis and lower extremities (LE). The model tracked trajectories for anteriorly and laterally shifting movements away from erect stance. Forces were applied to both shoulders to represent upper extremity (UE) interaction with an assistive device (e.g., a walker). The muscle excitations required to execute shifting maneuvers with UE forces <10% body-weight (BW) were determined via dynamic optimization. Nine muscle sets were examined to maximize control of shifting posture. Inclusion of the Psoas and External Obliques bilaterally resulted in the least relative UE effort (0.119, mean UE effort=45.3N≡5.4% BW) for anterior shifting. For lateral shifting, the set including the Psoas and Latissimus Dorsi bilaterally yielded the best performance (0.025, mean UE effort=27.8N≡3.3% BW). However, adding the Psoas alone bilaterally competed favorably in overall best performance across both maneuvers. This study suggests suitable activation to specific muscles of the trunk and LE can enable individuals with SCI to alter their standing postures with minimal upper-body effort and subsequently increase reach and standing work volume.