Contralaterally Controlled FES Combined with Brain Stimulation for Severe Upper limb Hemiplegia
对侧控制FES联合脑刺激治疗重度上肢偏瘫
基本信息
- 批准号:10642652
- 负责人:
- 金额:$ 66.18万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-05-01 至 2025-04-30
- 项目状态:未结题
- 来源:
- 关键词:Activities of Daily LivingAffectAreaArticular Range of MotionBrachial ParesisBrainChronicClinicalContralateralDevelopmentEquilibriumExtensorFPS-FES OncogeneFingersGoalsHandHemiplegiaImpairmentInterventionLeftLimb structureMeasuresMotionMotorMotor CortexMovementNeuronal PlasticityOutcomeOutputParalysedParesisParticipantPathway interactionsPatientsRandomizedRecovery SupportRehabilitation therapyResidual stateResourcesSelf CareShapesShoulderTechniquesTestingThumb structureTranscranial magnetic stimulationUnderserved PopulationUnited StatesUpper ExtremityWristchronic strokeclinically relevantconventional therapyeffective therapyexperiencefunctional electrical stimulationfunctional gainfunctional independencefunctional restorationhand dysfunctionimprovedlimb movementmotor controlmotor impairmentmultimodalityneuralneuromuscular stimulationneurophysiologynew therapeutic targetnoninvasive brain stimulationnovel therapeuticspost strokerepetitive transcranial magnetic stimulationsensorstroke patientstroke survivorstroke therapytheories
项目摘要
PROJECT SUMMARY/ABSTRACT
Development of rehabilitation interventions that are both effective and appropriate for patients with severe
upper limb paresis remains a major unmet clinical need. These patients have little to no volitional movement
and therefore are left with a non-functional upper limb. Many rehabilitation therapies are inappropriate for this
sub-population because they require significant residual movement. We have developed and tested a new
therapy that can be delivered in patients with little to no residual hand/finger motion. Known as contralaterally
controlled functional electrical stimulation (CCFES), the technique applies neuromuscular electrical stimulation
(NMES) to paretic wrist, finger, and thumb extensors to produce hand opening. The patient controls the
intensity of stimulation by wearing a glove with sensors on their unaffected contralateral hand. When the
patient opens their unaffected hand, a proportional intensity of stimulation opens their paretic hand. Therefore,
no residual movement of the paretic hand is necessary, which allows even patients with severe paresis to
engage in functional task practice using the affected upper limb. We have shown in a recent RCT that CCFES
is more effective than conventional NMES at reducing upper limb motor impairment in severe patients. But
patients continue to experience limitation in functional abilities. The goal of this study is to build upon the gains
achieved with CCFES in severe patients by augmenting its effects with another technique we have shown to
facilitate improvements in this sub-population. Non-invasive brain stimulation delivered to facilitate the intact
contralesional higher-motor cortices (cHMC) can have positive effects on upper limb motor control in severe
patients. When extensive damage to ipsilesional corticospinal pathways renders the damaged ipsilesional
primary motor cortex (iM1) ineffective at controlling paretic limb movement, intact, contralesional motor cortices
especially the cHMC can contribute by changing the balance of interhemispheric inhibition between motor
cortices and by increasing the excitability of uncrossed projections from the contralesional cortex to the paretic
upper limb. Therefore, here, we will test the scientific premise that CCFES augmented with facilitation of cHMC
will lead to greater upper limb motor improvement in severe patients than CCFES augmented with
conventional facilitation of iM1 or than CCFES alone. Seventy-two patients with severe hand impairment will
receive 12 weeks of CCFES + cHMC facilitation, CCFES + iM1 facilitation, or CCFES + sham brain
stimulation. Assessments of upper limb motor function and neurophysiology will be completed at baseline, 6,
12, 24, and 36 weeks. This study will 1) determine whether cHMC facilitation augments the effects of CCFES
to produce greater improvements in upper limb function in severe patients, 2) investigate the underlying
neurophysiologic mechanisms contributing to restored paretic limb motor control, and 3) evaluate and identify
patient factors that affect efficacy of CCFES + cHMC facilitation.
!
项目总结/文摘
项目成果
期刊论文数量(5)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Contralaterally Controlled Functional Electrical Stimulation Combined With Brain Stimulation for Severe Upper Limb Hemiplegia-Study Protocol for a Randomized Controlled Trial.
- DOI:10.3389/fneur.2022.869733
- 发表时间:2022
- 期刊:
- 影响因子:3.4
- 作者:
- 通讯作者:
Proprioceptive Augmentation With Illusory Kinaesthetic Sensation in Stroke Patients Improves Movement Quality in an Active Upper Limb Reach-and-Point Task.
- DOI:10.3389/fnbot.2021.610673
- 发表时间:2021
- 期刊:
- 影响因子:3.1
- 作者:Ferrari F;Shell CE;Thumser ZC;Clemente F;Plow EB;Cipriani C;Marasco PD
- 通讯作者:Marasco PD
Repetitive Transcranial Magnetic Stimulation of the Contralesional Dorsal Premotor Cortex for Upper Extremity Motor Improvement in Severe Stroke: Study Protocol for a Pilot Randomized Clinical Trial.
- DOI:10.1159/000521514
- 发表时间:2022
- 期刊:
- 影响因子:0
- 作者:
- 通讯作者:
Paired DBS and TMS Reveals Dentato-Cortical Facilitation Underlying Upper Extremity Movement in Chronic Stroke Survivors.
DBS 和 TMS 配对揭示了慢性中风幸存者上肢运动的齿状皮质促进作用。
- DOI:10.1177/15459683231219265
- 发表时间:2024
- 期刊:
- 影响因子:4.2
- 作者:Li,Xin;Baker,KennethB;O'Laughlin,Kyle;Chen,Jacqueline;Hogue,Olivia;Machado,AndreG;Plow,ElaB
- 通讯作者:Plow,ElaB
Cortico-Cerebellar Connectivity Underlying Motor Control in Chronic Poststroke Individuals.
慢性中风后个体运动控制下的皮质小脑连接。
- DOI:10.1523/jneurosci.2443-21.2022
- 发表时间:2022
- 期刊:
- 影响因子:0
- 作者:Gopalakrishnan,Raghavan;Cunningham,DavidA;Hogue,Olivia;Schroedel,Madeleine;Campbell,BrettA;Plow,ElaB;Baker,KennethB;Machado,AndreG
- 通讯作者:Machado,AndreG
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Ela B Plow其他文献
Rehabilitation drives post-stroke motor recovery
康复推动脑卒中后运动恢复
- DOI:
10.1016/s1474-4422(25)00100-0 - 发表时间:
2025-05-01 - 期刊:
- 影响因子:45.500
- 作者:
Teresa J Kimberley;Ela B Plow - 通讯作者:
Ela B Plow
Ela B Plow的其他文献
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{{ truncateString('Ela B Plow', 18)}}的其他基金
Contralaterally Controlled FES Combined with Brain Stimulation for Severe Upper limb Hemiplegia
对侧控制FES联合脑刺激治疗重度上肢偏瘫
- 批准号:
9922955 - 财政年份:2019
- 资助金额:
$ 66.18万 - 项目类别:
Brain Stimulation- aided Stroke Rehabilitation: Neural Mechanisms of Recovery
脑刺激辅助中风康复:恢复的神经机制
- 批准号:
8327576 - 财政年份:2011
- 资助金额:
$ 66.18万 - 项目类别:
Brain Stimulation- aided Stroke Rehabilitation: Neural Mechanisms of Recovery
脑刺激辅助中风康复:恢复的神经机制
- 批准号:
8474809 - 财政年份:2011
- 资助金额:
$ 66.18万 - 项目类别:
Brain Stimulation- aided Stroke Rehabilitation: Neural Mechanisms of Recovery
脑刺激辅助中风康复:恢复的神经机制
- 批准号:
8165770 - 财政年份:2011
- 资助金额:
$ 66.18万 - 项目类别:
Brain Stimulation- aided Stroke Rehabilitation: Neural Mechanisms of Recovery
脑刺激辅助中风康复:恢复的神经机制
- 批准号:
8878831 - 财政年份:2011
- 资助金额:
$ 66.18万 - 项目类别:
Brain Stimulation- aided Stroke Rehabilitation: Neural Mechanisms of Recovery
脑刺激辅助中风康复:恢复的神经机制
- 批准号:
8686015 - 财政年份:2011
- 资助金额:
$ 66.18万 - 项目类别:
Effects of Mental Training on Voluntary Muscle Strength in Aging
心理训练对衰老过程中随意肌力量的影响
- 批准号:
8015321 - 财政年份:1997
- 资助金额:
$ 66.18万 - 项目类别:
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