Therapeutic neural effects of electrical stimulation.
Therapeutic neural effects of electrical stimulation.
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DOI：
10.1109/86.547922
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发表时间：
1996-12-01
期刊：
影响因子：
--
通讯作者：
Kantor, C
中科院分区：
文献类型：
--
作者：
Daly, J J;Marsolais, E B;Kantor, C
使用功能性神经肌肉刺激（FNS）装置可以在不使用该装置时产生持续的治疗效果。临床医生报告了自愿和电辅助神经肌肉功能的变化以及软组织状况的改善。在不完全性脊髓损伤、中风或创伤性脑损伤患者使用运动假体后，可以观察到运动恢复。自愿背屈和整体步态模式的改善有短期（几个小时）和永久性的报道。电刺激上肢屈曲肌上的皮肤，在长达1小时的时间里，脑损伤受试者痉挛的严重程度显著降低，这是通过斜坡和保持肌肉拉伸过程中产生的扭矩变化来测量的。当表面刺激达到足以刺激肌肉的强度时，痉挛的严重程度通常会加重。动物被训练改变h反射的大小来获得奖励。这种操作性条件h反射变化背后的可塑性包括脊髓本身的变化。类似的变化似乎发生在某些运动技能的习得上。目前的研究正在探索人类和动物脊髓损伤后的这种变化，目的是利用调节方法评估损伤后的功能，促进和指导功能恢复。通过对人类和动物的研究，更好地理解神经可塑性的机制，可能有助于我们设计和实施FNS系统，这些系统有可能在受试者的中枢神经系统中产生有益的变化。
The use of a functional neuromuscular stimulation (FNS) device can have therapeutic effects that persist when the device is not in use. Clinicians have reported changes in both voluntary and electrically assisted neuromuscular function and improvements in the condition of soft tissue. Motor recovery has been observed in people with incomplete spinal cord injury, stroke, or traumatic brain injury after the use of motor prostheses. Improvement in voluntary dorsiflexion and overall gait pattern has been reported both in the short term (several hours) and permanently. Electrical stimulation of skin over flexor muscles in the upper limb produced substantial reductions for up to 1 h in the severity of spasticity in brain-injured subjects, as measured by the change in torque generation during ramp-and-hold muscle stretch. There was typically an aggravation of the severity of spasticity when surface stimulation reached intensities sufficient to also excite muscle. Animals were trained to alter the size of the H-reflex to obtain a reward. The plasticity that underlies this operantly conditioned H-reflex change includes changes in the spinal cord itself. Comparable changes appear to occur with acquisition of certain motor skills. Current studies are exploring such changes in humans and animals with spinal cord injuries with the goal of using conditioning methods to assess function after injury and to promote and guide recovery of function. A better understanding of the mechanisms of neural plasticity, achieved through human and animal studies, may help us to design and implement FNS systems that have the potential to produce beneficial changes in the subject's central nervous systems.