Feasibility of Iterative Learning Control Mediated by Functional Electrical Stimulation for Reaching After Stroke
Feasibility of Iterative Learning Control Mediated by Functional Electrical Stimulation for Reaching After Stroke
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DOI：
10.1177/1545968308328718
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发表时间：
2009-07-01
影响因子：
4.2
通讯作者：
Rogers, E.
中科院分区：
文献类型：
--
作者：
Hughes, A. M.;Freeman, C. T.;Rogers, E.
背景中风后，无法执行涉及伸手的任务是一个常见的问题。有证据支持使用机器人治疗和功能性电刺激（FES）来减少上肢损伤，但目前的系统可能不鼓励参与者做出最大的自愿贡献，因为援助对表现没有反应。Objective.本研究旨在探讨功能性电刺激介导的迭代学习控制（ILC）是否是一种可行的上肢卒中康复干预措施。方法.从社区招募了5名中风后至少6个月上肢功能减退的偏瘫患者。没有与会者退席。干预参与者进行了支持跟踪任务，使用27个不同的轨迹增强响应FES肱三头肌肌肉，与他们的手的运动限制在一个2维平面的机器人。使用了18个1小时的治疗疗程，其中2名参与者接受了额外的7个治疗疗程。结果测量。主要功能结局指标是行动研究手臂测试（ARAT）。损害措施包括上肢Fugl Meyer评估（FMA），运动控制（跟踪准确性）和等长力测试。结果依从性极佳，无不良事件。统计学上显著改善（P
Background. An inability to perform tasks involving reaching is a common problem following stroke. Evidence supports the use of robotic therapy and functional electrical stimulation (FES) to reduce upper limb impairments, but current systems may not encourage maximal voluntary contribution from the participant because assistance is not responsive to performance. Objective. This study aimed to investigate whether iterative learning control (ILC) mediated by FES is a feasible intervention in upper limb stroke rehabilitation. Methods. Five hemiparetic participants with reduced upper limb function who were at least 6 months poststroke were recruited from the community. No participants withdrew. Intervention. Participants undertook supported tracking tasks using 27 different trajectories augmented by responsive FES to their triceps brachii muscle, with their hand movement constrained in a 2-dimensional plane by a robot. Eighteen 1-hour treatment sessions were used with 2 participants receiving an additional 7 treatment sessions. Outcome measures. The primary functional outcome measure was the Action Research Arm Test (ARAT). Impairment measures included the upper limb Fugl Meyer Assessment (FMA), tests of motor control (tracking accuracy), and isometric force. Results. Compliance was excellent and there were no adverse events. Statistically significant improvements were measured (P