Kinugawa Kaoru, Mano Tomoo, Wada Hiroki, Ozaki Maki, Shirai Daisuke, Imura Tadashi, Kido Akira
Department of Neurology, Nara Medical University: 840 Shijo-cho, Kashihara, Nara 634-8521, Japan.
Department of Rehabilitation Medicine, Nara Medical University, Japan.
J Phys Ther Sci. 2022 Jun;34(6):473-477. doi: 10.1589/jpts.34.473. Epub 2022 Jun 6.
[Purpose] This study aimed to evaluate the improvement in lower extremity hemiplegia following brain tumor operation with an integrated volitional control electrical stimulator (IVES). [Participant and Methods] A 40 year-old male with anaplasic oligodendroglioma in the right frontal lobe underwent IVES in the rectus femoris and tibialis anterior muscles using the power-assist and sensor-trigger modes. Lower extremity motor function was assessed before and after the therapy sessions. An assessment was conducted using various techniques, including static posturography and surface electromyography. [Results] Static posturography showed an improvement in the center of pressure and sway area after IVES gait training. Based on a time-series statistical parametric mapping analysis, the activation pattern of each muscle after the treatment was different. Muscle synergy analysis revealed decreased total variance accounted for by a single synergy in the affected and normal sides after the treatment. [Conclusion] Patients with chronic hemiplegic lower extremity impairment responded well to IVES gait training. Electromyography-triggered functional electrical stimulation may enhance sensory-motor integration. Proprioceptive feedback plays a crucial role in improving motor control.
[目的] 本研究旨在评估使用集成式自主控制电刺激器(IVES)进行脑肿瘤手术后下肢偏瘫的改善情况。[参与者与方法] 一名40岁男性,右侧额叶患有间变性少突胶质细胞瘤,在股直肌和胫骨前肌使用助力和传感器触发模式进行IVES治疗。在治疗前后评估下肢运动功能。采用多种技术进行评估,包括静态姿势描记法和表面肌电图。[结果] 静态姿势描记法显示,IVES步态训练后压力中心和摆动面积有所改善。基于时间序列统计参数映射分析,治疗后各肌肉的激活模式不同。肌肉协同分析显示,治疗后患侧和正常侧由单一协同作用解释的总方差均降低。[结论] 慢性下肢偏瘫患者对IVES步态训练反应良好。肌电图触发的功能性电刺激可能增强感觉运动整合。本体感觉反馈在改善运动控制中起关键作用。