Shalaby Raafat, Schauer Thomas, Liedecke Wolfgang, Raisch Jörg
Control Systems Group, Technische Universität Berlin, Germany.
Biomed Tech (Berl). 2011 Feb;56(1):23-33. doi: 10.1515/BMT.2010.055. Epub 2010 Dec 17.
Functional electrical stimulation leg cycle ergometry (FES-LCE), which is often used as exercise for people with spinal cord injury (SCI), has recently been applied in the motor rehabilitation of stroke patients. Recently completed studies show controversial results, but with a tendency to positive training effects. Current technology is identical to that used in FES-LCE for SCI, whereas the pathology of stroke differs strongly. Most stroke patients with hemiparesis are able to drive an ergometer independently. Depending on the degree of spasticity, the paretic leg will partially support or hinder movements. Electrical stimulation increases muscle force and endurance and both are prerequisites for restoring gait. However, the effect of FES-LCE on improving impaired motor coordination is unclear. To measure motor coordination during FES-LCE, an EMG-amplifier design has been investigated which suppresses stimulation artifacts and allows detection of volitional or reflex induced muscle activity. Direct measurement of EMG from stimulation electrodes between stimulation pulses is an important asset of this amplifier. Photo-MOS switches in front of the preamplifier are utilized to achieve this. The technology presented here can be used to monitor the effects of FES-LCE to adapt the stimulation strategy or to realize EMG-biofeedback training.
功能性电刺激腿部循环测力计（FES-LCE）常用于脊髓损伤（SCI）患者的锻炼，最近已应用于中风患者的运动康复。最近完成的研究结果存在争议，但有显示出积极训练效果的趋势。当前技术与用于SCI的FES-LCE相同，而中风的病理情况差异很大。大多数偏瘫的中风患者能够独立驱动测力计。根据痉挛程度，患侧腿会部分支持或阻碍运动。电刺激可增加肌肉力量和耐力，这两者都是恢复步态的先决条件。然而，FES-LCE对改善受损运动协调性的效果尚不清楚。为了测量FES-LCE期间的运动协调性，研究了一种肌电图放大器设计，该设计可抑制刺激伪迹并允许检测自主或反射诱发的肌肉活动。在刺激脉冲之间直接从刺激电极测量肌电图是该放大器的一项重要特性。前置放大器前的光控MOS开关用于实现这一点。这里介绍的技术可用于监测FES-LCE的效果，以调整刺激策略或实现肌电图生物反馈训练。
