EMG analysis of the shoulder muscles for creating stimulation data for FES and clinical trial to reconstruct the shoulder function.

我们一直在研究使用功能性电刺激(FES)来恢复运动功能，FES由经皮肌内金属丝电极和便携式多通道刺激器组成。肩关节运动的重建是女性肩部运动的难点之一。本研究的第一阶段旨在阐明健康受试者肩部运动过程中的肌肉活动情况。第二阶段是利用由肌电分析结果产生的刺激数据，通过功能电刺激控制偏瘫患者的肩部运动。我们用线电极同时调查了24块肌肉，其中12块肌肉表现出较高的活性。这些肌肉的活动模式可分为三组，组1、组2和组3分别在早期、整个阶段和后半段活跃。此外，第2组根据增长模式的不同分为两种类型。我们还研究了肩部肌肉在不同负荷和运动速度下的活动变化。肩部肌肉的典型肌电模式在小范围、轻负荷和慢角速度下没有变化。同时，为了对肌电进行定性的分析，研究了动态收缩过程中功率频率分析的最佳记录方式，并利用肌电分析结果产生的刺激数据，应用FES对一名偏瘫患者进行了肩部运动控制。在屈曲90度范围内重建肩关节屈曲运动。要使FES恢复功能更实用，还需进一步研究。此外，我们还应用电刺激改善偏瘫患者肩关节半脱位，取得了多项效果。

We have been studying to restore motor function using the functional electrical stimulation (FES) which consist of percutaneous intramuscular wire electrodes and portable multichannel stimulator. The reconstruction of the shoulder motion is one of the difficult issue for the FES.The first stage of the purpose of this study was to clarify the muscle activity during the shoulder movement in the healthy subjects. The second stage was to control the shoulder movement in a hemiplegic patient by means of FES using the stimulation data which is created from the result of EMG analysis.We have investigated 24 muscles simultaneously using wire electrodes and 12 muscles out of them showed higher activities. The activity patterns of these muscles could be divided into three groups, group 1,2 and 3 were active in the early stage, throughout the whole stage and in the latter half, respectively. Furthermore, group 2 was divided into 2 types with difference of the increasing pattern. We have also studied activity changes of the shoulder muscles in various loads and motion speed. The typical EMG pattern of the shoulder muscles showed no change at the narrow range with light load and slow angle velocity. Simultaneously, for the qualitative EMG analysis, optimum recording way to analyze power frequency during dynamic contraction was studied.A hemiplegic patient has been applied FES to control shoulder motion using the stimulation data which is created from the result of EMG analysis. The shoulder flexion motion was reconstructed within 90 degrees of flexion. Further investigation that to make FES more practical method to restore shouledr function is required. In addition, we have applied electrical stimulation to improve subluxation of the shoulder joint in hemiplegic patients and got several outcome.