权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Clinical Study on Driving a Cycling Wheel Chair in Hemiplegics

偏瘫患者驾驶自行车轮椅的临床研究

基本信息

批准号：
15300193
负责人：
SEKI Kazunori
金额：
$ 8.32万
依托单位：
Tohoku University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2005
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-15300193/
关键词：
Cycling wheel chair Stroke Hemiplegia H reflex Motor evoked potential (MEP)EMG Virtual reality

项目摘要

The aim of this study is to establish clinical usefulness of the newly developed cycling wheel chair for hemiplegics. Details are as below.1. Change of neurophysiological parameters during pedaling movement : We easured H reflex and motor evoked potential (MEP) from the opposite (palytic) leg muscles during pedaling by one leg (healthy leg) in the healthy and hemiplegic subjects. Decrase of the amplitude of H reflex and increase of MEP were observed in the healthy subjects. On the other hand, in the hemiplegic patients, though H reflex did not show any change MEP clearly increased during pedaling movement. It was suggested that active pedaling by one leg could augment excitability of motor cortex rather than inhibition of spinal motor neuron.2. Change of leg muscle activity during driving the cycling wheel chair in hemiplegics : We measured EMG activities from both leg muscles during driving the cycling wheel chair in non-ambulatory severe hemiplegics. The muscles in the paralytic lowe … More r limb showed significant activities during pedaling compared with isometric voluntary contraction. This result indicates driving the cycling wheel chair can induce some activities in the paralytic leg muscles even in the patients with severe hemiplegia.3. Development of training machine with virtual reality (VR) : The equipment for driving training with VR systems and a recumbent type ergometer that can measure rotation torque in each leg were developed. We used them for functional training in hemiplegic stroke patients. These apparatus provided some useful parameters to measure the skill of driving the cycling wheel chair quantitatively.4. Practical usefulness of cycling wheel chair for locomotion : Change of physical and mental activities after use of cycling wheel chair was measured in some institutes. Driving the cycling wheel chair did not affect cardio-pulmonary function. In this point of view cycling wheel chair is as safe as standard type wheel chair. I the cases of elderly disabled who use an institute, physical and mental activities increased and the distance of locomotion in a day remarkably extended when driving the cycling wheel chair comparing with the standard type wheel chair. Walking speed in three subjects improved after training using the cycling wheel chair.Clinical usefulness and safety of cycling wheel chair and background mechanism of clinical effect on pedaling movement were revealed to some extent through this study. Extension of clinical application of cycling wheel chair not only for hemiplegics but also for lots of disabled is necessary in the future. Less

这项研究的目的是确定新开发的偏瘫自行车轮椅的临床实用性。具体情况如下1.踏板运动过程中神经生理参数的变化：对健康受试者和偏瘫受试者进行一侧(健侧腿)踏板时对侧(瘫痪)腿肌的H反射和运动诱发电位(MEP)的测定。健康人H反射波幅降低，MEP升高。偏瘫患者的H反射虽无明显变化，但踏板运动时MEP明显升高。提示单腿主动踏板可增强运动皮质的兴奋性，而不是对脊髓运动神经元的抑制。偏瘫患者骑自行车轮椅时腿部肌肉活动的变化：我们测量了非卧床重度偏瘫患者骑自行车轮椅时双腿肌肉的肌电活动。瘫痪的LOWE…的肌肉与等长随意收缩相比，右肢体在踏板时有更多的活动。这一结果表明，即使在重度偏瘫患者中，驾驶自行车轮椅也能诱导瘫痪腿部肌肉的一些活动。虚拟现实(VR)训练机的研制：研制了虚拟现实驾驶训练设备和可测量每条腿旋转扭矩的卧式测力仪。我们将其用于偏瘫中风患者的功能训练。为定量测量自行车轮椅的驾驶技能提供了一些有用的参数。自行车轮椅的运动实用性：对部分单位使用自行车轮椅后的身心活动变化进行了测量。驾驶自行车轮椅不会影响心肺功能。从这个角度来看，自行车轮椅和标准型轮椅一样安全。在使用机构的老年残疾人中，驾驶自行车轮椅与标准型轮椅相比，增加了体力和脑力活动，一天的运动距离显著延长。通过本研究，在一定程度上揭示了自行车轮椅的临床应用价值和安全性，以及脚踏车运动临床效应的背景机制。今后自行车轮椅的临床推广应用不仅适用于偏瘫患者，也适用于众多残疾人。较少