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优化多域功能性电刺激参数,实现“开灯”任务,并提高脑卒中后患者上肢运动学的可重复性。

Optimal Multifield Functional Electrical Stimulation Parameters for the "Turn on the Light" Task and Related Upper Limb Kinematics Repeatability in Poststroke Subjects.

机构信息

Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Porto, Portugal.

Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Functional Sciences, School of Health, Polytechnic of Porto, Porto, Portugal.

出版信息

Arch Phys Med Rehabil. 2021 Jun;102(6):1180-1190. doi: 10.1016/j.apmr.2020.10.135. Epub 2020 Nov 27.

Abstract

OBJECTIVE

To characterize the optimal functional electrical stimulation (FES) parameters that assist the turn on the light task (TOTL) on poststroke participants and to analyze the related upper limb (UL) kinematics repeatability.

DESIGN

Cross-sectional study.

SETTING

Human movement research center.

PARTICIPANTS

Poststroke individuals (N=11) with history of a single unilateral stroke that resulted in a motor control dysfunction of the contralesional UL.

INTERVENTIONS

FES based on surface multifield technology applied to the contralesional wrist and finger extensors during the TOTL.

MAIN OUTCOME MEASURES

FES outcome metrics (virtual electrodes, stimulation duration, intensity) and kinematic metrics (end-point kinematics [absolute and relative duration, mean and peak velocities, relative instant of peak velocity, index of curvature, number of movement units] and joint kinematics [shoulder, elbow, wrist end position and range of movement]). Outcome measures were assessed 2 times with a 72-hour maximum time interval.

CONCLUSION

It was possible to establish reliable FES parameters that assisted the TOTL on poststroke participants. These stimulation parameters led to high to very high repeatability in terms of UL kinematics for most of the cases.

摘要

目的

确定最佳功能性电刺激(FES)参数,以辅助脑卒中患者完成开灯任务(TOTL),并分析相关上肢(UL)运动学的可重复性。

设计

横断面研究。

地点

人体运动研究中心。

参与者

脑卒中患者(N=11),单侧脑卒中病史,导致对侧 UL 运动功能障碍。

干预

在 TOTL 期间,应用表面多场技术对患侧腕部和手指伸肌进行 FES。

主要观察指标

FES 结果指标(虚拟电极、刺激持续时间、强度)和运动学指标(末端运动学[绝对和相对持续时间、平均和峰值速度、相对峰值速度时刻、曲率指数、运动单位数量]和关节运动学[肩部、肘部、腕部末端位置和运动范围])。在 72 小时的最大时间间隔内,对结果指标进行了 2 次评估。

结论

能够为脑卒中患者确定可靠的 FES 参数,辅助 TOTL。对于大多数病例,这些刺激参数可使 UL 运动学具有高到非常高的可重复性。

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