Restoration of gait by functional electrical stimulation in paraplegic patients: a modified programme of treatment
Restoration of gait by functional electrical stimulation in paraplegic patients: a modified programme of treatment
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通过功能性电刺激恢复截瘫患者的步态：改进的治疗方案
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发表时间：
1995
期刊：
影响因子：
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通讯作者：
S. Hesse
中科院分区：
文献类型：
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作者：
M. Maležič;S. Hesse
功能电刺激对临床完全截瘫患者站立和步态的恢复在治疗过程和刺激参数上进行了修改。通过用主动刺激站立代替最初的循环肌肉强化，4例T3-11病变患者在10-17天内开始电刺激行走。他们走路不带踝足矫形器。在0.75-0.97米的步幅范围内，它们的步态速度从非常缓慢到悠闲健康的步态不等。在步态摇摆阶段，已经建立的四头肌站立和腓神经下肢屈曲的刺激被应用。几周后，腓神经的刺激频率从20赫兹增加到60赫兹，肢体屈曲的减少得以恢复。肌电图和运动学测量显示，踝关节的直接反应以及反射介导的髋关节、膝关节和踝关节屈曲反应得到改善。同时，为了减少疲劳，四头肌的刺激频率降低到16赫兹。
Restoration of standing and of gait by functional electrical stimulation in clinically complete paraplegic patients was modified in the course of treatment and in the stimulation parameters. By substituting an initial cyclic muscle strengthening with an active stimulated standing, four patients with T3–11 lesions started walking with electrical stimulation in 10–17 days. They walked without ankle–foot orthoses. With a satisfactory stride length of 0.75–0.97 m, their gait velocity ranged from very slow to that of a leisurely healthy gait. Already established stimulation of the quadriceps muscles for standing and of the peroneal nerves for lower limb flexion during the swing phase of gait was applied. Diminished limb flexion after several weeks was restored by an increase of the stimulation frequency of the peroneal nerve from 20 to 60 Hz. EMG and kinesiological measurements displayed an improved direct response of the ankle as well as of the reflex mediated hip, knee and ankle flexion response. At the same time stimulation frequency was reduced to 16 Hz for the quadriceps muscles in order to reduce fatigue.