A Personalized Multi-Channel FES Controller Based on Muscle Synergies to Support Gait Rehabilitation after Stroke.
A Personalized Multi-Channel FES Controller Based on Muscle Synergies to Support Gait Rehabilitation after Stroke.
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DOI：
10.3389/fnins.2016.00425
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发表时间：
2016
影响因子：
4.3
通讯作者：
Pedrocchi A
中科院分区：
文献类型：
--
作者：
Ferrante S;Chia Bejarano N;Ambrosini E;Nardone A;Turcato AM;Monticone M;Ferrigno G;Pedrocchi A
神经科学文献中大量提出，为了产生各种各样的运动，中枢神经系统（CNS）招募了一组减少的肌肉活动协调模式，定义为肌肉协同作用。最近的神经生理学研究建议通过分析肌肉协同作用来精细地评估患者的损伤，根据损伤的具体性质设计个性化的干预措施，并评估治疗结果。在此范围内，本研究的目的是设计一种个性化的多通道功能性电刺激（FES）步态训练控制器，该控制器整合了三个新方面：(1)FES策略基于健康肌肉协同作用，以模仿中枢神经系统采用的神经解决方案来产生运动；(2) FES策略根据患者的初始运动评估进行个性化设计，并专门用于激活受损的生物力学功能；(3) FES策略准确地映射到改变的步态运动学上，提供了患者意志步态和刺激模式之间的最大同步。对两名慢性脑卒中患者进行了新的干预试验。他们接受了为期4周的干预，包括每周三次30分钟的fes支持的跑步机行走。两例患者在基线时表现为轻度步态障碍（步行速度> 0.8 m/s）。然而，在治疗前，两名患者在运动时仅表现出三种独立的肌肉协同作用，类似于两种不同的步态异常。经处理后，提取的协同作用数变为4个，与生理肌肉协同作用的相似度增加，表明肌肉协调性普遍改善。最初合并的协同作用似乎在运动控制中重新发挥其独特的作用。一名患者的治疗效果更为明显，他实现了临床上重要的动态平衡变化（Mini-Best Test从17增加到22），并获得了非常积极的感知治疗效果（GRC = 4）。治疗也在第二个主题上启动了神经运动再学习过程，但12次治疗不足以达到临床相关的改善。这种将神经科学研究的新理论应用于脑卒中康复的尝试提供了令人鼓舞的结果，值得在更大的临床研究中进一步研究。
It has been largely suggested in neuroscience literature that to generate a vast variety of movements, the Central Nervous System (CNS) recruits a reduced set of coordinated patterns of muscle activities, defined as muscle synergies. Recent neurophysiological studies have recommended the analysis of muscle synergies to finely assess the patient's impairment, to design personalized interventions based on the specific nature of the impairment, and to evaluate the treatment outcomes. In this scope, the aim of this study was to design a personalized multi-channel functional electrical stimulation (FES) controller for gait training, integrating three novel aspects: (1) the FES strategy was based on healthy muscle synergies in order to mimic the neural solutions adopted by the CNS to generate locomotion; (2) the FES strategy was personalized according to an initial locomotion assessment of the patient and was designed to specifically activate the impaired biomechanical functions; (3) the FES strategy was mapped accurately on the altered gait kinematics providing a maximal synchronization between patient's volitional gait and stimulation patterns. The novel intervention was tested on two chronic stroke patients. They underwent a 4-week intervention consisting of 30-min sessions of FES-supported treadmill walking three times per week. The two patients were characterized by a mild gait disability (walking speed > 0.8 m/s) at baseline. However, before treatment both patients presented only three independent muscle synergies during locomotion, resembling two different gait abnormalities. After treatment, the number of extracted synergies became four and they increased their resemblance with the physiological muscle synergies, which indicated a general improvement in muscle coordination. The originally merged synergies seemed to regain their distinct role in locomotion control. The treatment benefits were more evident for one patient, who achieved a clinically important change in dynamic balance (Mini-Best Test increased from 17 to 22) coupled with a very positive perceived treatment effect (GRC = 4). The treatment had started the neuro-motor relearning process also on the second subject, but twelve sessions were not enough to achieve clinically relevant improvements. This attempt to apply the novel theories of neuroscience research in stroke rehabilitation has provided promising results, and deserves to be further investigated in a larger clinical study.
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影响因子：
3.1
作者：
Gandolla M;Ward NS;Molteni F;Guanziroli E;Ferrigno G;Pedrocchi A
通讯作者：
Pedrocchi A
使用肌肉协同作用和多模式界面进行平衡控制训练的工具。
影响因子：
--
作者：
Galeano D;Brunetti F;Torricelli D;Piazza S;Pons JL
通讯作者：
Pons JL
影响因子：
5.7
作者：
Gandolla M;Ferrante S;Molteni F;Guanziroli E;Frattini T;Martegani A;Ferrigno G;Friston K;Pedrocchi A;Ward NS
通讯作者：
Ward NS
影响因子：
3.5
作者：
Franchignoni F;Horak F;Godi M;Nardone A;Giordano A
通讯作者：
Giordano A
DOI：
10.1109/tnsre.2012.2191574
发表时间：
2012-05-01
影响因子：
4.9
作者：
Ambrosini, Emilia;Ferrante, Simona;Pedrocchi, Alessandra
通讯作者：
Pedrocchi, Alessandra