Neuroscience and Mental Health Institute (NMHI), School of Molecular & Systems Medicine, University of Alberta, Edmonton, Alberta, Canada.
Compr Physiol. 2018 Dec 13;9(1):127-148. doi: 10.1002/cphy.c180006.
Neuroprostheses (NPs) are electrical stimulators that activate nerves, either to provide sensory input to the central nervous system (sensory NPs), or to activate muscles (motor NPs: MNPs). The first MNPs were belts with inbuilt batteries and electrodes developed in the 1850s to exercise the abdominal muscles. They became enormously popular among the general public, but as a result of exaggerated therapeutic claims they were soon discredited by the medical community. In the 1950s, MNPs reemerged for the serious purpose of activating paralyzed muscles. Neuromuscular electrical stimulation (NMES), when applied in a preset sequence, is called therapeutic electrical stimulation (TES). NMES timed so that it enhances muscle contraction in intended voluntary movements is called functional electrical stimulation (FES) or functional neuromuscular stimulation (FNS). It has been 50 years since the first FES device, a foot-drop stimulator, was described and 40 years since the first implantable version was tested in humans. A commercial foot-drop stimulator became available in the 1970s, but for various reasons, it failed to achieve widespread use. With advances in technology, such devices are now more convenient and reliable. Enhancing upper limb function is a more difficult task, but grasp-release stimulators have been shown to provide significant benefits. This chapter deals with the technical aspects of NMES, the therapeutic and functional benefits of TES and FES, delayed-onset and carryover effects attributable to "neuromodulation" and the barriers and opportunities in this rapidly developing field. © 2019 American Physiological Society. Compr Physiol 9:127-148, 2019.
神经假体（NPs）是一种电刺激器，可激活神经，要么向中枢神经系统提供感觉输入（感觉神经假体，sensory NPs），要么激活肌肉（运动神经假体：MNPs）。第一批 MNPs 是 19 世纪 50 年代开发的内置电池和电极的腰带，用于锻炼腹部肌肉。它们在公众中大受欢迎，但由于夸大了治疗效果，很快就被医学界所否定。20 世纪 50 年代，MNPs 重新出现，旨在激活瘫痪的肌肉。当神经肌肉电刺激（NMES）以预设的顺序应用时，被称为治疗性电刺激（TES）。NMES 定时使肌肉收缩增强，与预期的自愿运动相匹配，被称为功能性电刺激（FES）或功能性神经肌肉刺激（FNS）。自第一台 FES 设备，即足下垂刺激器问世以来已经过去了 50 年，自第一台植入式版本在人类中进行测试以来已经过去了 40 年。一种商用的足下垂刺激器于 20 世纪 70 年代上市，但由于各种原因，未能广泛使用。随着技术的进步，这些设备现在更加方便和可靠。增强上肢功能是一项更为艰巨的任务，但抓握释放刺激器已被证明具有显著的益处。本章介绍 NMES 的技术方面、TES 和 FES 的治疗和功能益处、由于“神经调节”而产生的迟发和延续效应，以及这个快速发展领域中的障碍和机遇。© 2019 美国生理学会。综合生理学 9：127-148，2019。
