Neuroprosthesis for restoring quiet stance and balance during quit stances in individuals with spinal cord injury

在加拿大，大约有36,000人患有脊髓损伤（SCI）。脊髓损伤的发生率估计为每百万人中有35人，这意味着每年大约有1000例新的损伤。每一次伤害在第一年平均给个人和医疗保健系统造成198,335美元的损失，随后每年额外增加24,154美元。这些费用的很大一部分与许多脊髓损伤患者需要照顾者的服务来帮助他们完成各种日常任务有关，比如做饭、吃饭、接送和如厕。本研究计划的目的是开发一种神经假体，用于站立和平衡脊髓损伤继发神经损伤的个体。具体来说，拟议的神经假体将应用功能性电刺激（FES）来人工产生所需的肌肉收缩，使瘫痪患者能够站起来，进行稳定的无支撑站立和坐下。该系统的开发将使SCI消费者在烹饪时能够站立，能够够到架子上的食材，能够在从轮椅上移动到床上、汽车上等活动中拥有更多的控制权。目前，还没有一种神经假体可以促进长时间和无支撑的站立。该设备的开发将彻底改变脊髓损伤患者的康复治疗和辅助技术。脊髓损伤患者可以在日常生活活动中拥有更大的独立性，而不必大幅改变物理环境，购买昂贵的设备或聘请护理人员。一种有效的用于无支撑站立的神经假体将大大提高SCI患者的生活质量，同时降低SCI消费者和社会的损害成本。除了明显的功能优势外，神经假体还可以通过使用户长时间负重骨骼和关节来防止骨脱矿。这将减少这些患者通常经历的低能量骨折的发生率。神经假体还会增加患者腿部和下背部的肌肉体积，从而减少压疮的发生频率。

In Canada, approximately 36,000 people live with spinal cord injury (SCI). The incidence of SCI is estimated at 35 per million population, which translates roughly into 1,000 new injuries every year. Each injury costs the individual and the health care system an average of $198,335 in the first year, and an additional $24,154 each subsequent year. A significant part of these expenses are associated with the fact that many individuals with SCI require the services of a caregiver to assist them with various daily tasks such as cooking, eating, transfers and toileting. The purpose of this research program is to develop a neuroprosthesis for standing and balancing for individuals with neurologic impairments secondary to SCI. Specifically, the proposed neuroprosthesis will apply functional electrical stimulation (FES) to artificially generate muscle contractions required to allow paralyzed individuals to stand up, perform stable unsupported standing, and to sit down. The development of this system will enable SCI consumers to perform activities such as being able to stand while cooking, reach for ingredients on shelves, and have more control when transferring from their wheelchairs to their beds, cars, etc. Currently, a neuroprosthesis that can facilitate prolonged and unsupported standing does not exist. Development of this device will revolutionize both the rehabilitation treatment and assistive technologies for individuals with SCI. Rather than having to significantly modify the physical environment, buy expensive equipment or hire caregivers, a person with SCI may be able to have greater independence in their activities of daily living. An effective neuroprosthesis for unsupported standing will considerably improve the quality of life for individuals with SCI, while reducing the cost of the impairment to both SCI consumers and society. Aside from the obvious functional benefits, the neuroprosthesis will prevent bone demineralization by allowing its users to load their bones and joints for prolonged periods of time. This will result in the reduction of incidence of low energy fractures commonly experienced by these patients. The neuroprosthesis will also increase the muscle volume in patients' legs and lower backs, resulting in the reduction in frequency of pressure sores.