IEEE Rev Biomed Eng. 2019;12:154-167. doi: 10.1109/RBME.2018.2874132. Epub 2018 Oct 11.
The past decades have witnessed remarkable progress in neural technologies such as functional electrical stimulation (FES) and their applications in neurorehabilitation and neuromodulation. These advances are powered by new neuroscientific understandings of the organization and compositionality of neuromuscular control illuminating how muscle groups may be activated together as discrete units known as muscle synergies. These parallel developments have promoted novel approaches to clinical rehabilitation for neurological disorders that are insurmountable to current treatments. One such breakthrough is the evolution of FES as a therapeutic tool in poststroke rehabilitation with an interventional strategy particularly inspired by the concept that muscles in humans may be purposefully coordinated through neuromotor modules represented as muscle synergies. This paper will review recent advances in multichannel FES technology, its potential applications in poststroke rehabilitation, new findings that support the neurological basis of the muscle synergies for generating natural motor tasks, and the application of the muscle-synergy concept in poststroke assessment and rehabilitation of motor impairment. Finally, we will recommend future directions of development in relation to assistive FES and synergy-driven adaptive training for poststroke rehabilitation.
在过去的几十年中，神经技术（如功能性电刺激 (FES)）取得了显著的进展，其在神经康复和神经调节中的应用也得到了扩展。这些进步的取得是基于对神经肌肉控制的组织和组合性的新的神经科学理解，这些理解揭示了肌肉群如何作为离散的单位（称为肌肉协同）一起被激活。这些平行的发展促进了针对神经障碍的临床康复的新方法，这些方法是当前治疗方法无法克服的。其中一个突破是 FES 作为一种治疗工具在中风后康复中的发展，其干预策略特别受到这样一种概念的启发，即人类的肌肉可以通过作为肌肉协同的神经运动模块来有目的地协调。本文将综述多通道 FES 技术的最新进展、其在中风后康复中的潜在应用、支持肌肉协同产生自然运动任务的神经基础的新发现，以及肌肉协同概念在中风后运动障碍评估和康复中的应用。最后，我们将针对中风后康复的辅助 FES 和协同驱动自适应训练，提出未来的发展方向。
