Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, People's Republic of China.
J Neural Eng. 2009 Dec;6(6):066007. doi: 10.1088/1741-2560/6/6/066007. Epub 2009 Nov 17.
The gait outcome measures used in clinical trials of paraplegic locomotor training determine the effectiveness of improved walking function assisted by the functional electrical stimulation (FES) system. Focused on kinematic, kinetic or physiological changes of paraplegic patients, traditional methods cannot quantify the walking stability or identify the unstable factors of gait in real time. Up until now, the published studies on dynamic gait stability for the effective use of FES have been limited. In this paper, the walker tipping index (WTI) was used to analyze and process gait stability in FES-assisted paraplegic walking. The main instrument was a specialized walker dynamometer system based on a multi-channel strain-gauge bridge network fixed on the frame of the walker. This system collected force information for the handle reaction vector between the patient's upper extremities and the walker during the walking process; the information was then converted into walker tipping index data, which is an evaluation indicator of the patient's walking stability. To demonstrate the potential usefulness of WTI in gait analysis, a preliminary clinical trial was conducted with seven paraplegic patients who were undergoing FES-assisted walking training and seven normal control subjects. The gait stability levels were quantified for these patients under different stimulation patterns and controls under normal walking with knee-immobilization through WTI analysis. The results showed that the walking stability in the FES-assisted paraplegic group was worse than that in the control subject group, with the primary concern being in the anterior-posterior plane. This new technique is practical for distinguishing useful gait information from the viewpoint of stability, and may be further applied in FES-assisted paraplegic walking rehabilitation.
用于截瘫运动训练临床研究的步态结果测量指标确定了功能性电刺激 (FES) 系统辅助改善行走功能的有效性。传统方法侧重于截瘫患者的运动学、动力学或生理学变化，无法实时量化行走稳定性或识别步态的不稳定因素。到目前为止，关于 FES 有效使用的动态步态稳定性的已发表研究有限。在本文中，使用步行者倾斜指数 (WTI) 来分析和处理 FES 辅助截瘫行走中的步态稳定性。主要仪器是一种基于固定在步行器框架上的多通道应变计桥网络的专用步行者测力计系统。该系统在行走过程中收集患者上肢与步行器之间的手柄反作用力矢量的力信息；然后将信息转换为步行者倾斜指数数据，这是患者行走稳定性的评估指标。为了展示 WTI 在步态分析中的潜在有用性，对 7 名正在接受 FES 辅助行走训练的截瘫患者和 7 名正常对照者进行了初步临床试验。通过 WTI 分析，对这些患者在不同刺激模式下和正常行走时膝关节固定的对照者下的步态稳定性水平进行了量化。结果表明，FES 辅助截瘫组的行走稳定性比对照组差，主要关注的是前后平面。这项新技术从稳定性的角度实用地区分了有用的步态信息，并且可能进一步应用于 FES 辅助截瘫行走康复中。
