Hara Yukihiro
Chiba Hokusoh Hospital, Nippon Medical School.
Rinsho Shinkeigaku. 2011 Nov;51(11):1063-5. doi: 10.5692/clinicalneurol.51.1063.
Our understanding of motor learning, neuro-plasticity and functional recovery after the occurrence of brain lesion has grown significantly. New findings in basic neuroscience provided stimuli for research in motor rehabilitation. Electrical stimulation can be applied in a variety of ways to the neurological impairment. Especially, electromyography (EMG) initiated electrical muscle stimulation improves motor dysfunction of the hemiparetic arm and hand. Triggered electrical stimulation is reported to be more effective than non-triggered electrical stimulation in facilitating upper extremity motor recovery. Power-assisted FES induces greater muscle contraction by electrical stimulation in proportion to the voluntary integrated EMG signal picked up. Daily power-assisted FES home program therapy with the novel equipment has been able to improve wrist, finger extension and shoulder flexion effectively. Combined modulation of voluntary movement, proprioceptional sensory feedback and electrical stimulation might play an important role to facilitate impaired sensory-motor integration in power-assisted FES therapy. It is recognized that increased cerebral blood flow in the sensory-motor cortex area on the injured side during power-assisted FES session compared to simple active movement or simple electrical stimulation in a multi-channels Near-infrared spectroscopy (NIRS) study to non-invasively and dynamically measure hemoglobin levels in the brain during functional activity.
我们对脑损伤后运动学习、神经可塑性和功能恢复的理解有了显著增长。基础神经科学的新发现为运动康复研究提供了动力。电刺激可以通过多种方式应用于神经损伤。特别是,肌电图(EMG)引发的肌肉电刺激可改善偏瘫手臂和手部的运动功能障碍。据报道,触发式电刺激在促进上肢运动恢复方面比非触发式电刺激更有效。功率辅助功能性电刺激(FES)根据采集到的自愿整合肌电信号,通过电刺激诱导更大的肌肉收缩。使用新型设备进行每日功率辅助FES家庭程序治疗能够有效改善手腕、手指伸展和肩部屈曲。在功率辅助FES治疗中,自愿运动、本体感觉反馈和电刺激的联合调制可能在促进受损的感觉运动整合方面发挥重要作用。在一项多通道近红外光谱(NIRS)研究中,与简单的主动运动或简单的电刺激相比,功率辅助FES治疗期间患侧感觉运动皮层区域的脑血流量增加,该研究用于在功能活动期间非侵入性地动态测量大脑中的血红蛋白水平。