Clinical experience with functional electrical stimulation-assisted gait with parastep in spinal cord-injured patients
Clinical experience with functional electrical stimulation-assisted gait with parastep in spinal cord-injured patients
复制标题
DOI：
10.1097/00007632-200002150-00018
复制
发表时间：
2000-02-15
期刊：
影响因子：
3
通讯作者：
Dassonville, J
中科院分区：
文献类型：
--
作者：
Brissot, R;Gallien, P;Dassonville, J
研究设计。一种六通道经皮功能性电刺激装置ParaStep方法在脊髓损伤患者中的临床评价。研究这项新技术在能量消耗方面的运动性能，并评价其优点和局限性，特别是在涉及走动的社交活动中。本研究对15例胸椎损伤患者进行了研究。除两名患者外，其余患者均为完全性病变。临床判断患者的步态能力和功能使用情况。从心率、最大摄氧量和乳酸菌来评估能量成本。13名患者完成了训练(平均20次)，并实现了与步行器的独立行走。无休息时平均步行距离为52.8+/-69m，平均速度为0.15+/-0.14m/s。1例不完全损伤的患者在受伤后8个月不能行走，在5次治疗后能够在没有功能性电刺激的情况下行走。术后随访40+/-11个月。5名患者使用功能性电刺激辅助步态作为体育锻炼的手段，但不用于社会活动中的步行。患者体验到了明显的心理益处，生活方式发生了积极的变化。在3名受试者中，采用ParaStep(SigMedics，Inc.，North field，IL)以0.1m/s的速度进行了前进式手臂功率试验和步行试验的生理反应比较，结果显示步态中的心率、最大摄氧量和乳酸血症接近最大功率试验结束时的心率、最大摄氧量和乳酸血症。尽管ParaStep方法操作简单，美容效果良好，但其在日常生活中的移动性应用非常有限，因为它的性能不高，与高代谢成本和心血管紧张有关。然而，它可以被建议作为一种资源，以保持脊髓损伤患者的身心健康。
Study Design. Clinical evaluation of the Parastep method, a six-channel transcutaneous functional electrical stimulation device, in spinal cord-injured patients.Objectives. To investigate the motor performances of this new technique regarding energy expenditure and to evaluate its advantages acid limitations, especially in social activities involving ambulation.Methods. This study was conducted in 15 thoracic spine-injured patients. The lesion was complete except in two patients. The gait ability and the functional use were judged clinically. Energy cost was evaluated from heart rate, peak oxygen uptake, and lactatemia.Results. Thirteen patients completed the training (mean: 20 sessions) and achieved independent ambulation with a walker. The mean walking distance, without rest, was 52.8 +/- 69 m, and the mean speed was 0.15 +/- 0.14 m/sec. One patient with incomplete lesion, who had been nonambulatory for 8 months aft er the injury, became able to walk without functional electrical stimulation after five sessions. The follow-up was 40 +/- 11 months. Five patients pursued using functional electrical stimulation-assisted gait as a means of physical exercise but not for ambulation in social activities. The patients experienced marked psychological benefits, with positive changes in their way of life. In three subjects, a comparison of physiologic responses to exercise between a progressive arm ergometer test and a walking test with the Parastep (Sigmedics, Inc., North field, IL) at a speed of 0.1 m/sec was performed, showing that the heart rate, the peak oxygen uptake, and lactatemia during gait were close to those obtained the end of the maximal test on the ergometer.Conclusions. In spite of its ease of operation and good cosmetic acceptance, the Parastep approach has very limited applications for mobility in daily life, because of its modest performance associated with high metabolic cost and cardiovascular strain. However, it can be proposed as a resource to keep physical and psychological fitness in patients with spinal cord injury.