Hybrid Assistive Neuromuscular Dynamic Stimulation Therapy: A New Strategy for Improving Upper Extremity Function in Patients with Hemiparesis following Stroke.
Hybrid Assistive Neuromuscular Dynamic Stimulation Therapy: A New Strategy for Improving Upper Extremity Function in Patients with Hemiparesis following Stroke.
复制标题
杂交辅助神经肌肉动态刺激疗法：中风后偏瘫患者改善上肢功能的新策略。
DOI：
10.1155/2017/2350137
复制
发表时间：
2017
影响因子：
3.1
通讯作者：
Abe K
中科院分区：
文献类型：
--
作者：
Fujiwara T;Kawakami M;Honaga K;Tochikura M;Abe K
混合辅助神经肌肉动态刺激（HANDS）疗法是一种神经康复治疗方法，通过将闭环肌电图（EMG）控制的神经肌肉电刺激（NMES）与腕手夹板相结合，促进瘫痪上肢（UE）在日常生活中的使用。这种闭环EMG控制的NMES可以与放置在目标肌肉上的表面电极记录的自主产生的EMG幅度的变化成正比地改变其刺激强度。刺激施加到麻痹的手指伸肌。患者在白天佩戴腕-手夹板，并在手臂保持器中携带便携式刺激器8小时。该系统活动8小时，并指导患者尽可能多地使用他们的麻痹手。HANDS治疗3周。患者还被指导在日常生活中练习双手活动。瘫痪性上肢运动功能改善后3周的手治疗。HANDS疗法对上肢运动功能和痉挛状态的功能改善是基于受影响半球的抑制解除和相互抑制的调节。HANDS疗法可能为卒中患者的轻瘫UE的管理提供一个有希望的选择。
Hybrid Assistive Neuromuscular Dynamic Stimulation (HANDS) therapy is one of the neurorehabilitation therapeutic approaches that facilitates the use of the paretic upper extremity (UE) in daily life by combining closed-loop electromyography- (EMG-) controlled neuromuscular electrical stimulation (NMES) with a wrist-hand splint. This closed-loop EMG-controlled NMES can change its stimulation intensity in direct proportion to the changes in voluntary generated EMG amplitudes recorded with surface electrodes placed on the target muscle. The stimulation was applied to the paretic finger extensors. Patients wore a wrist-hand splint and carried a portable stimulator in an arm holder for 8 hours during the daytime. The system was active for 8 hours, and patients were instructed to use their paretic hand as much as possible. HANDS therapy was conducted for 3 weeks. The patients were also instructed to practice bimanual activities in their daily lives. Paretic upper extremity motor function improved after 3 weeks of HANDS therapy. Functional improvement of upper extremity motor function and spasticity with HANDS therapy is based on the disinhibition of the affected hemisphere and modulation of reciprocal inhibition. HANDS therapy may offer a promising option for the management of the paretic UE in patients with stroke.