Minimal handgrip force is needed for transcutaneous electrical stimulation to improve hand functions of patients with severe spinal cord injury.
Minimal handgrip force is needed for transcutaneous electrical stimulation to improve hand functions of patients with severe spinal cord injury.
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DOI：
10.1038/s41598-022-11306-5
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发表时间：
2022-05-11
影响因子：
4.6
通讯作者：
中科院分区：
文献类型：
--
作者：
在非盲研究中，脊髓刺激可增强脊髓损伤（SCI）后运动功能的恢复。为了确定训练与经皮脊髓电刺激 (tSCS) 相结合，无论是否使用丁螺环酮 (busp) 进行全身血清素能治疗，是否可以改善 SCI 后严重手麻痹个体的手功能，我们在一项双盲、假对照、交叉研究中评估了 10 名受试者。所有治疗（busp、tSCS 和 Busp 加 tSCS）均降低了肌张力和痉挛频率。当单独使用或与 tSCS 联合使用时，丁螺环酮对握力或手灵巧度没有任何明显的影响。相比之下，在基线评估时残余握力在 0.1–1.5 N 范围内的 10 名受试者中，有 5 名受试者接受 6 周 tSCS 后，握力、正弦力产生和握力释放率显着改善。在 tSCS 和丁螺环酮治疗后 2-5 个月，残留握力的受试者手部功能持续改善。我们得出的结论是，tSCS 与训练相结合可以提高残余握力大于 0.1 N 的 SCI 受试者的手部力量和手部灵活性。丁螺环酮没有显着改善手部功能，也没有增加刺激效果。
Spinal cord stimulation enhanced restoration of motor function following spinal cord injury (SCI) in unblinded studies. To determine whether training combined with transcutaneous electrical spinal cord stimulation (tSCS), with or without systemic serotonergic treatment with buspirone (busp), could improve hand function in individuals with severe hand paralysis following SCI, we assessed ten subjects in a double-blind, sham-controlled, crossover study. All treatments—busp, tSCS, and the busp plus tSCS—reduced muscle tone and spasm frequency. Buspirone did not have any discernible impact on grip force or manual dexterity when administered alone or in combination with tSCS. In contrast, grip force, sinusoidal force generation and grip-release rate improved significantly after 6 weeks of tSCS in 5 out of 10 subjects who had residual grip force within the range of 0.1–1.5 N at the baseline evaluation. Improved hand function was sustained in subjects with residual grip force 2–5 months after the tSCS and buspirone treatment. We conclude that tSCS combined with training improves hand strength and manual dexterity in subjects with SCI who have residual grip strength greater than 0.1 N. Buspirone did not significantly improve the hand function nor add to the effect of stimulation.
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