Efficacy of an implanted neuroprosthesis for restoring hand grasp in tetraplegia: A multicenter study
Efficacy of an implanted neuroprosthesis for restoring hand grasp in tetraplegia: A multicenter study
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DOI：
10.1053/apmr.2001.25910
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发表时间：
2001-10-01
影响因子：
4.3
通讯作者：
Wiegner, A
中科院分区：
文献类型：
--
作者：
Peckham, PH;Keith, MW;Wiegner, A
目的：评估一种植入的神经假体，使四肢瘫痪的使用者能够用一只手控制抓握和释放。设计：至少随访3年的多中心队列试验。在植入前和植入后，以及激活和未激活神经假体的情况下，对每个参与者的功能进行比较。设置：三级脊髓损伤（SCI）护理中心，8个在美国，1个在英国，1个在澳大利亚。参与者：51名患有C5或C6 SCI的四肢瘫痪成人。干预：一种植入式神经假体系统，其中通过使用对侧肩部运动控制单臂抓握肌肉的电刺激，并同时进行肌腱转移手术。评估参与者抓握、移动和释放标准化物体的能力;执行日常生活活动（ADL）所需的辅助程度、设备使用情况;以及用户满意度。主要结果测量：捏力;抓握和释放测试; ADL能力测试和ADL评估测试;以及用户满意度调查。结果：在所有可用的50名参与者中，神经假体的捏力明显更大，49名参与者的抓握-释放能力得到改善。所有测试的参与者（49/49）更独立地执行ADL与neuroprosthesis比他们没有it. Home使用的设备定期功能和锻炼的报告超过90%的参与者，和满意度neuroprosthes.Conclusions：的抓地力提供的neuroprosthesis是实质性的和持久的。神经假体是安全的，被用户广泛接受，并为没有类似替代品的人群提供更好的独立性。
Objective: To evaluate an implanted neuroprosthesis that allows tetraplegic users to control grasp and release in 1 hand.Design: Multicenter cohort trial with at least 3 years of follow-up. Function for each participant was compared before and after implantation, and with and without the neuroprosthesis activated.Setting: Tertiary spinal cord injury (SCI) care centers, 8 in the United States, 1 in the United Kingdom, and 1 in Australia.Participants: Fifty-one tetraplegic adults with C5 or C6 SCIs.Intervention: An implanted neuroprosthetic system, in which electric stimulation of the grasping muscles of 1 arm are controlled by using contralateral shoulder movements, and concurrent tendon transfer surgery. Assessed participants' ability to grasp, move, and release standardized objects; degree of assistance required to perform activities of daily living (ADLs), device usage; and user satisfaction.Main Outcome Measures: Pinch force; grasp and release tests; ADL abilities test and ADL assessment test; and user satisfaction survey.Results: Pinch force was significantly greater with the neuroprosthesis in all available 50 participants, and grasp-release abilities were improved in 49. All tested participants (49/49) were more independent in performing ADLs with the neuroprosthesis than they were without it. Home use of the device for regular function and exercise was reported by over 90% of the participants, and satisfaction with the neuroprosthesis was high.Conclusions: The grasping ability provided by the neuroprosthesis is substantial and lasting. The neuroprosthesis is safe, well accepted by users, and offers improved independence for a population without comparable alternatives.