ELECTROSTIMULATION FOR STROKE REHABILITATION

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。先前的研究表明，由肌电图（EMG）控制的神经肌肉刺激促进的重复练习可增强中风幸存者的运动恢复。然而，这些研究控制不佳，作用机制也没有得到解决。本项目的目的是：1）评估EMG控制的神经肌肉刺激在促进慢性卒中幸存者上肢运动恢复方面的疗效; 2）确定EMG控制的神经肌肉刺激是否通过运动损伤的中枢指标介导其对运动恢复的影响。 本方案的重点将包括一项单盲、随机临床试验，以评估EMG控制的神经肌肉刺激对运动障碍客观指标和中枢运动功能指标的影响。34名慢性卒中幸存者将被随机分配到EMG控制的神经肌肉促进组或对照组。将在所有受试者中植入能够检测弱EMG信号并提供神经肌肉刺激的三极经皮电极。治疗将持续四周，并在治疗结束时和治疗后12周评估结果。 本研究将证明，肌电图控制的神经肌肉刺激促进慢性卒中幸存者的运动恢复，并且运动恢复是由中枢机制介导的。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Previous studies have suggested that repetitive exercises facilitated by electromyograph (EMG)-controlled neuromuscular stimulation enhance the motor recovery of stroke survivors. However, those studies were poorly controlled, and mechanisms of action were not addressed. The aims of this project are to 1)assess the efficacy of EMG-controlled neuromuscular stimulation in enhancing the upper-extremity motor recovery of chronic stroke survivors, and 2) determine whether EMG-controlled neuromuscular stimulation mediates its effect on motor recovery via central measures of motor impairment. The focus of this protocol will consist of a single-blinded, randomized clinical trial to assess the effects of EMG-controlled neuromuscular stimulation on objective measures of motor impairment and measures of central motor function. Thirty-four chronic stroke survivors will be randomly assigned to either the EMG-controlled neuromuscular facilitation or control groups. Tripolar percutaneous electrodes that can detect weak EMG signals and deliver neuromuscular stimulation will be implanted in all subjects. The treatment will last four weeks and outcomes will be assessed at the end of treatment and at 12 weeks after treatment. This study will demonstrate that EMG-controlled neuromuscular stimulation enhances the motor recovery of chronic stroke survivors, and that the motor recovery is mediated by central mechanisms.