ELECTROSTIMULATION FOR STROKE REHABILITATION

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。先前的研究表明，通过肌电控制的神经肌肉刺激促进的重复性运动可以增强中风幸存者的运动恢复。然而，这些研究没有得到很好的控制，作用机制也没有得到解决。本项目的目的是：1)评估肌电控制的神经肌肉刺激在促进慢性中风幸存者上肢运动恢复方面的效果；2)确定肌电控制的神经肌肉刺激是否通过运动损伤的中枢测量介导其对运动恢复的影响。该方案的重点将包括一项单盲、随机临床试验，以评估肌电控制的神经肌肉刺激对运动损伤和中枢运动功能的客观测量的影响。34名慢性中风幸存者将被随机分配到肌电图控制的神经肌肉促进组或对照组。三极经皮电极可以检测微弱的肌电图信号并提供神经肌肉刺激，将被植入所有受试者体内。治疗将持续四周，结果将在治疗结束和治疗后12周进行评估。本研究将证明肌电控制的神经肌肉刺激促进慢性中风幸存者的运动恢复，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.