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基于传感器的多通道 FES 系统控制膝关节并减少脑卒中后步态中的站立相不对称。

A Sensor-Based Multichannel FES System to Control Knee Joint and Reduce Stance Phase Asymmetry in Post-Stroke Gait.

机构信息

Institut Saint-Pierre, 34250 Palavas, France.

INRIA, Sophia-Antipolis, 06902 Montpellier, France.

出版信息

Sensors (Basel). 2021 Mar 18;21(6):2134. doi: 10.3390/s21062134.

Abstract

Most of the studies using functional electrical stimulation (FES) in gait rehabilitation have been focused on correcting the drop foot syndrome. Using FES to control the knee joint in individuals with central nervous system (CNS) disorders could also play a key role in gait recovery: spasticity decrease, higher range of motion, positive effect on balance, limiting hyperextension and flexion in stance phase, reducing joint overload, etc. In stance phase, an accurate timing and a fine tuning of stimulation parameters are however required to provide a proper control of the knee stimulation while ensuring a safe and efficient support. In this study, 11 participants were equipped with inertial measurements units (IMU) and foot pressure insoles after supratentorial ischemic or hemorrhagic stroke, informing on knee angle and gait events used to online adapt FES during a 10 m walking protocol. Asymmetry of stance time and weight bearing were monitored as well as gait quality and physiological cost through a series of relevant markers. Vertical trunk motion has been significantly reduced during gait with FES (-value = 0.038). Despite no significant improvement of stance phase asymmetry has been found, this preliminary work shows evidence of promising technical and rehabilitative potentials of a sensor-based multichannel FES system to control knee joint in post-stroke gait.

摘要

大多数使用功能性电刺激 (FES) 进行步态康复的研究都集中在纠正足下垂综合征上。使用 FES 来控制中枢神经系统 (CNS) 障碍患者的膝关节,也可以在步态恢复中发挥关键作用:降低痉挛、提高运动范围、对平衡产生积极影响、限制站立期的过度伸展和弯曲、减少关节过载等。然而,在站立期,需要准确的定时和精细的刺激参数调整,以提供适当的膝关节刺激控制,同时确保安全和高效的支撑。在这项研究中,11 名参与者在幕上缺血性或出血性中风后配备了惯性测量单元 (IMU) 和足底压力鞋垫,用于在 10 米步行协议期间在线适应 FES,记录膝关节角度和步态事件。还监测了站立时间和承重的不对称性,以及通过一系列相关标志物监测步态质量和生理成本。使用 FES 后,垂直躯干运动在步态中显著减少 (-值=0.038)。尽管没有发现站立期不对称性有显著改善,但这项初步研究表明,基于传感器的多通道 FES 系统具有控制中风后步态中膝关节的有前途的技术和康复潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f36/8002887/6b268344354b/sensors-21-02134-g001.jpg

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