Development of a Functional Electrical Stimulation System for Bone Health Maintenance in Spinal Cord Injury Patients

根据Every Eight Hours和Spinal Research等慈善机构的统计，英国估计有40，000名脊髓受伤者，每八小时就有一个新的人受伤。许多死亡的主要原因现在不再是脊髓损伤的直接结果，而是与年龄和不活动有关的条件。这意味着对医疗支持的长期需求;特别是，脊髓损伤患者治疗骨质疏松性骨折往往导致长期住院。因此，重要的是尽量减少脊髓损伤后骨质疏松症的影响;这突出了针对骨骼健康的运动计划的必要性。这项研究旨在开发有效的功能性电刺激（FES）诱导的负重运动，以改善和维持脊髓损伤患者下肢的骨骼健康。建议的运动类型将使用一种新型的智能站立框架和FES系统来完成，以周期性地激活不同的肌肉，同时保持站立和蹲姿。假设这些运动将产生足够的关节接触力，有利于踝关节、膝关节和髋关节的骨骼健康。使用生物力学建模软件，将寻求这些练习的最佳组合，以设计针对骨骼健康的康复计划。为了有益于骨骼健康，这些练习需要每周重复几次，每天做同样的事情很有可能会让患者感到无聊或沮丧。为了解决这个问题，将开发康复辅助设备，以保持患者的积极性。这些辅助设备将使用视频游戏技术（基于Xbox Kinect），使患者的会话更具吸引力，以鼓励依从性并给予成就感。这也将允许患者和临床医生监测康复计划的进展，并在必要时对其进行修改。

According to statistics from charities such as Every Eight Hours and Spinal Research, there are an estimated 40,000 spinal cord injured people in the UK and a new person is injured every eight hours. Many primary causes of death are now no longer direct results of spinal cord injury but are conditions linked to age and inactivity. This means that there are long-term demands on medical support; in particular, treatment of osteoporotic bone fractures often results in lengthy spells in hospital for individuals with spinal cord injury. It is therefore important to minimize the effect of osteoporosis after spinal cord injury; this highlights the need for exercise programmes to target bone health. The proposed research aims to develop effective Functional Electrical Stimulation (FES) induced weight bearing exercises to improve and maintain bone health in the lower extremities of spinal cord injury patients. The type of exercises proposed will be completed using a novel smart standing frame and FES system to cyclically activate different sets of muscles whilst maintaining standing and crouch poses. The hypothesis is that these exercises will induce sufficient joint contact forces to be beneficial for bone health in the ankle, knee and hip joints. Using biomechanical modelling software an optimal combination of these exercises will be sought in order to design a rehabilitation programme to target bone health. To be beneficial to bone health, these exercises need to be repeated several times a week and there is a good chance patients will get bored or frustrated doing the same thing every day. To solve this problem, rehabilitation aids will be developed to keep patients motivated. These aids will use video game technology (based on the Xbox Kinect), to make the sessions more engaging for the patient to encourage compliance and give a sense of achievement. This will also allow the patient and clinician to monitor the progress of a rehabilitation programme and modify it as necessary.