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用于偏瘫步态训练的闭环功能性电刺激(FES)膝关节固定器的研发。

The development of a knee locker with closed-loop functional electrical stimulation (FES) for hemiplegia in gait training.

作者信息

Chen Yu-Luen, Chang Walter-H, Chen Shih-Ching, Sheu Peng-Fei, Chen Weoi-Luen

机构信息

Department of Electronic Engineering, Hwa-Hsia College of Technology & Commerce, Taipei, Taiwan, ROC.

出版信息

Disabil Rehabil. 2003 Aug 19;25(16):916-21. doi: 10.1080/0963828031000122230.

Abstract

PURPOSE

A knee locker with closed-loop functional electrical stimulation (FES) system has been developed to prevent the quadriceps weakness and the drop-foot of the hemiplegia during gait training.

METHOD

The FES system is triggered by a footswitch on the heel of the disabled foot to stimulate the tibialis anterior muscle for dorsi-flexion and to turn-off the knee locker in the swing phase through the main controller. Besides, the footswitch on the heel of the affected-side can be used to stimulate the quadriceps and to turn-on the knee locker for quadriceps weakness in the stance phase.

RESULTS

It is revealed that the mean velocity, cadence, stride length, active ankle motion range, and functional ambulation category (FAC) have improved significantly from 0.15 +/- 0.04 m sec( - 1), 43.3 +/- 15.4 steps min( - 1), 0.36 +/- 0.11 m, 15 degrees, level 2 to 0.43 +/- 0.21 m sec( - 1), 69.4 +/- 19.1 steps min( - 1), 0.73 +/- 0.17 m, 40 degrees, level 4 respectively for the patient. A paired t-test indicated that differences in the electromyography (EMG) of the tibialis anterior and the quadriceps muscles between patient's disabled (affected-side) foot and normal (unaffected-side) foot are not significant (p > 0.05) after 16 weeks of training.

CONCLUSIONS

It is concluded that this new knee locker with closed-loop FES system is capable of providing the hemiplegia with restoration to regular walking after appropriate gait training.

摘要

目的

已开发出一种带有闭环功能性电刺激(FES)系统的膝关节锁定器,以预防步态训练期间偏瘫患者的股四头肌无力和足下垂。

方法

FES系统由残疾侧足跟处的脚踏开关触发,以刺激胫前肌进行背屈,并在摆动期通过主控制器关闭膝关节锁定器。此外,患侧足跟处的脚踏开关可用于刺激股四头肌,并在站立期开启膝关节锁定器以应对股四头肌无力的情况。

结果

结果显示,患者的平均速度、步频、步长、主动踝关节活动范围和功能性步行分类(FAC)从0.15±0.04米/秒、43.3±15.4步/分钟、0.36±0.11米、15度、2级分别显著提高到0.43±0.21米/秒、69.4±19.1步/分钟、0.73±0.17米、40度、4级。配对t检验表明,经过16周训练后,患者残疾(患侧)足与正常(未患侧)足的胫前肌和股四头肌肌电图(EMG)差异不显著(p>0.05)。

结论

得出结论,这种带有闭环FES系统的新型膝关节锁定器能够在适当的步态训练后使偏瘫患者恢复正常行走。

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