在动态膝关节伸展过程中，使用顺序和空间分布的电极刺激瘫痪的股四头肌。
Stimulation of paralysed quadriceps muscles with sequentially and spatially distributed electrodes during dynamic knee extension.
机构信息
Department of Physical Therapy, University of Delaware, Newark, United States of America.
Institute for Rehabilitation and Performance Technology, Division of Mechanical Engineering, Department of Engineering and Information Technology, Bern University of Applied Sciences, Pestalozzistrasse 20, Burgdorf, 3400, Switzerland.
出版信息
J Neuroeng Rehabil. 2019 Jan 7;16(1):5. doi: 10.1186/s12984-018-0471-y.
BACKGROUND
During functional electrical stimulation (FES) tasks with able-bodied (AB) participants, spatially distributed sequential stimulation (SDSS) has demonstrated substantial improvements in power output and fatigue properties compared to conventional single electrode stimulation (SES). The aim of this study was to compare the properties of SDSS and SES in participants with spinal cord injury (SCI) in a dynamic isokinetic knee extension task simulating knee movement during recumbent cycling.
METHOD
Using a case-series design, m. vastus lateralis and medialis of four participants with motor and sensory complete SCI (AIS A) were stimulated for 6 min on both legs with both electrode setups. With SES, target muscles were stimulated by a pair of electrodes. In SDSS, the distal electrodes were replaced by four small electrodes giving the same overall stimulation frequency and having the same total surface area. Torque was measured during knee extension by a dynamometer at an angular velocity of 110 deg/s. Mean power of the left and right sides (P) was calculated from all stimulated extensions for initial, final and all extensions. Fatigue is presented as an index value with respect to initial power from 1 to 0, whereby 1 means no fatigue.
RESULTS
SDSS showed higher P values for all four participants for all extensions (increases of 132% in participant P1, 100% in P2, 36% in P3 and 18% in P4 compared to SES) and for the initial phase (increases of 84%, 59%, 66%, and 16%, respectively). Fatigue resistance was better with SDSS for P1, P2 and P4 but worse for P3 (0.47 vs 0.35, 0.63 vs 0.49, 0.90 vs 0.82 and 0.59 vs 0.77, respectively).
CONCLUSION
Consistently higher P was observed for all four participants for initial and overall contractions using SDSS. This supports findings from previous studies with AB participants. Fatigue properties were better in three of the four participants. The lower fatigue resistance with SDSS in one participant may be explained by a very low muscle activation level in this case. Further investigation in a larger cohort is warranted.
背景
在有能力的（AB）参与者进行功能性电刺激（FES）任务时，与传统的单电极刺激（SES）相比，空间分布顺序刺激（SDSS）在功率输出和疲劳特性方面显示出了显著的改善。本研究的目的是在模拟躺卧自行车时膝关节运动的动态等速膝关节伸展任务中，比较脊髓损伤（SCI）参与者中 SDSS 和 SES 的特性。
方法
使用病例系列设计，对 4 名运动和感觉完全性 SCI（AIS A）的参与者的股外侧肌和股内侧肌，在双腿上使用两种电极设置进行 6 分钟的刺激。在 SES 中，目标肌肉由一对电极刺激。在 SDSS 中，用四个小电极代替远端电极，以保持相同的总刺激频率和相同的总表面积。通过角速度为 110 度/秒的测力计测量膝关节伸展时的扭矩。从所有刺激伸展中计算左侧和右侧的平均功率（P），以初始、终末和所有伸展的所有伸展。疲劳表示为相对于初始功率的指数值，1 表示无疲劳。
结果
对于所有 4 名参与者的所有伸展，SDSS 均显示出更高的 P 值（参与者 P1 的所有伸展增加 132%，P2 增加 100%，P3 增加 36%，P4 增加 18%，与 SES 相比）和初始阶段（分别增加 84%、59%、66%和 16%）。对于 P1、P2 和 P4，SDSS 的抗疲劳能力更好，但对于 P3 则更差（0.47 对 0.35、0.63 对 0.49、0.90 对 0.82 和 0.59 对 0.77）。
结论
对于所有 4 名参与者的初始和整体收缩，使用 SDSS 观察到一致更高的 P。这支持了以前与 AB 参与者进行的研究结果。在 4 名参与者中的 3 名中，疲劳特性更好。在一名参与者中，SDSS 的疲劳抵抗力较低可能是由于在这种情况下肌肉激活水平非常低。需要在更大的队列中进一步研究。
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