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通过应用集成意志控制电刺激器改善一名脑肿瘤术后患者的下肢偏瘫情况。

Improvement in lower extremity hemiplegia in a post-operative brain tumor patient by applying an integrated volitional control electrical stimulator.

作者信息

Kinugawa Kaoru, Mano Tomoo, Wada Hiroki, Ozaki Maki, Shirai Daisuke, Imura Tadashi, Kido Akira

机构信息

Department of Neurology, Nara Medical University: 840 Shijo-cho, Kashihara, Nara 634-8521, Japan.

Department of Rehabilitation Medicine, Nara Medical University, Japan.

出版信息

J Phys Ther Sci. 2022 Jun;34(6):473-477. doi: 10.1589/jpts.34.473. Epub 2022 Jun 6.

Abstract

[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.

摘要

[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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a9a/9170483/ad09b2308e2a/jpts-34-473-g001.jpg

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