Canton Stephen, Momeni Kamyar, Ramanujam Arvind, Garbarini Erica, Forrest Gail F
Annu Int Conf IEEE Eng Med Biol Soc. 2016 Aug;2016:3143-3146. doi: 10.1109/EMBC.2016.7591395.
The goal of this paper is to study the effects of supine and stand retraining (SRT) interventions with and without multi muscle neuromuscular electrical stimulation (NMES) on the neuromuscular EMG responses of the leg muscles for individuals with motor complete SCI during walking on a body-weight support (BWS) treadmill. The main outcome variables were EMG amplitude, integrated EMG and co-contraction indices (co-excitation and co-activation) collected during a 10-minute walking treadmill trial. Data was analyzed for the first, fifth and tenth minute of walking. Results showed that both Supine+NMES and SRT+NMES interventions increased spatial-temporal aspects of muscle activity (mean EMG amplitude and integrated EMG) of lower limb muscles. SRT+NMES (loading) showed greater gains in the proximal anterior leg compartments. On the contrary, SRT without NMES (SRT only) exhibited deterioration of activity within the same muscle groups. Co-contraction indices increased for both post-NMES interventions suggesting that task-specificity of training is important to achieve the fundamental reciprocal firing known to able-bodied gait. These results show that combination of NMES+loading during passive rhythmic gait will induce neuroplasticity in the lower limbs that ultimately provides a potential effective means to recover gait in individuals with SCI.
本文的目的是研究在体重支持（BWS）跑步机上行走时，有或没有多肌肉神经肌肉电刺激（NMES）的仰卧位和站立再训练（SRT）干预对运动完全性脊髓损伤个体腿部肌肉神经肌肉肌电图反应的影响。主要结果变量是在10分钟的跑步机行走试验中收集的肌电图振幅、积分肌电图和共同收缩指数（共同兴奋和共同激活）。对行走的第一分钟、第五分钟和第十分钟的数据进行了分析。结果表明，仰卧位+NMES和SRT+NMES干预均增加了下肢肌肉活动的时空参数（平均肌电图振幅和积分肌电图）。SRT+NMES（负荷）在前腿部近端区域显示出更大的改善。相反，无NMES的SRT（仅SRT）在相同肌肉群中表现出活动恶化。两种NMES后干预的共同收缩指数均增加，这表明训练的任务特异性对于实现健全步态中已知的基本交互放电很重要。这些结果表明，在被动节律性步态期间NMES与负荷相结合将诱导下肢神经可塑性，这最终为脊髓损伤个体恢复步态提供了一种潜在的有效方法。
