Modulation of locomotor-like EMG activity in subjects with complete and incomplete spinal cord injury.
Modulation of locomotor-like EMG activity in subjects with complete and incomplete spinal cord injury.
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发表时间：
1995
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通讯作者：
B. Dobkin;S. Harkema;P. Requejo;V. Edgerton
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作者：
B. Dobkin;S. Harkema;P. Requejo;V. Edgerton
跑步机训练与部分体重支持（BWS）被提倡作为一种策略，以提高脊髓损伤（SCI）患者的步行。临床报告尚未检查可能在训练期间调节腿部肌电图（EMG）输出的感觉输入范围。在被动，手动辅助踩在跑步机上与部分BWS，我们发现类似的有节奏的肌电图活动在屈肌和伸肌的下肢的受试者谁有慢性，完全的胸脊髓损伤和受试者谁有不完全的病变，导致最小的运动控制和无法走动。EMG爆发在时间上与步进周期的特定阶段同步，并且其振幅和持续时间通过改变跑步机速度和肢体负载水平来调节。站立结束时的髋关节伸展通常会引起髋关节不自主的屈曲，从而启动摆动阶段。当不完全SCI的受试者尝试意志步进时，与被动辅助步进期间观察到的相比，某些肌肉中的EMG爆发具有类似的波形，但幅度和持续时间更大。这表明，在模型中的猫后，胸椎横断，外周感觉输入，与有节奏的运动可以增强输出的腰骶神经回路，有助于步样肌电活动，即使在没有脊髓上下行的影响。应注意在体重支持的跑步机训练的康复过程中优化感觉输入的操作。
Treadmill training with partial body weight support (BWS) is being advocated as a strategy to enhance walking in patients with spinal cord injury (SCI). Clinical reports have not examined the range of sensory inputs that might modulate electromyographic (EMG) output in the legs during training. During passive, manually assisted stepping on a treadmill with partial BWS, we found similar rhythmical EMG activity in the flexor and extensor muscles of the lower extremities in subjects who had chronic, complete thoracic spinal cord injuries and in subject who had incomplete lesions that resulted in minimal motor control and an inability to ambulate. The EMG bursts were temporally synchronized to specific phases of the step cycle, and their amplitudes and durations were modulated by varying the treadmill speed and the level of limb loading. Hip extension at the end of stance often induced involuntary hip flexion that initiated the swing phase. When the incomplete SCI subjects attempted volitional stepping, the EMG bursts in some muscles had a similar waveform but greater amplitude and duration compared to that observed during passive, assisted stepping. This suggests that, as in the model of the cat after a thoracic spinal transection, peripheral sensory inputs that are associated with rhythmical locomotion can enhance the output of lumbosacral neural circuits that contribute to step-like EMG activity, even in the absence of supraspinal descending influences. Attention should be given to optimizing the manipulation of sensory inputs during rehabilitation efforts with body weight supported treadmill training.