Development of an upper extremity FES system for individuals with C4 tetraplegia.
Development of an upper extremity FES system for individuals with C4 tetraplegia.
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DOI：
10.1109/86.547926
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发表时间：
1996-12-01
期刊：
影响因子：
--
通讯作者：
Betz, R R
中科院分区：
文献类型：
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作者：
Smith, B T;Mulcahey, M J;Betz, R R
应用功能性电刺激(FES)为C4四肢瘫痪患者提供上肢功能的研究正在进行中。在这项研究中，设计了一种FES系统，允许一名完全性C4四肢瘫痪患者利用对侧肩部位置协调刺激的外侧或掌侧抓握与刺激的手臂运动。该系统包括植入肌肉的经皮肌内电极，用于握手和松开手、旋后、屈肘、伸展和手臂内收。由于周围神经的丧失，移位和随后刺激瘫痪的背阔肌提供屈肘，移位和刺激瘫痪的尺侧腕伸肌提供前臂旋后。悬挂的吊衣提供了肩关节的稳定性。受试者使用位置传感器检测到的对侧肩部运动，按比例控制刺激。控制受刺激的手的握持和释放与受刺激的手臂运动相结合，因此手对嘴的活动可以通过对侧肩膀的一次运动来完成。通过这个系统，受试者能够抓住放在手中的牛奶盒，然后从嘴里举起和放下它，用一根短吸管喝水。他还可以用改装的勺子挖出半固体物质，然后把它从工作面上抬起来放到嘴里吃。受试者需要帮助才能将牛奶盒或勺子放在他的手中，并将盘子放在可以铲起的位置。需要进行进一步的调查，以产生必要的手臂运动，以便能够在没有援助的情况下完成这些任务，并扩大利用FES系统可能开展的活动范围。
The application of functional electrical stimulation (FES) to provide upper extremity function for individuals with C4 tetraplegia is under investigation. In this study, a FES system was designed that allowed one individual with complete C4 tetraplegia to coordinate stimulated lateral or palmar prehension with stimulated arm movements using contralateral shoulder position. The system consisted of percutaneous intramuscular electrodes implanted to muscles for hand grasp and release, supination, elbow flexion, and extension and arm adduction. Due to peripheral denervation, transposition and subsequent stimulation of the paralyzed latissimus dorsi muscle provided elbow flexion and transfer and stimulation of the paralyzed extensor carpi ulnaris muscle provided forearm supination. A suspended sling provided shoulder joint stability. The subject controlled stimulation proportionally using contralateral shoulder motion sensed by a position transducer. Control of stimulated hand grasp and release were coupled with stimulated arm motions so that hand-to-mouth activities could be accomplished with one motion of the contralateral shoulder. With this system, the subject was able to grasp a milk carton placed in the hand and lift and lower it from his mouth to drink from a short straw. He could also scoop a semisolid substance with an adapted spoon and lift and lower it from the work surface to his mouth to eat. The subject required assistance to place the milk carton or spoon in his hand and position the plate for scooping. Further investigation is needed to generate the necessary arm movements to make completion of these tasks possible without assistance and to expand the range of activities possible with the FES system.