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联合运动训练和经皮脊髓刺激后亚急性脊髓损伤患者跨任务背屈能力评估

Assessment of Dorsiflexion Ability across Tasks in Persons with Subacute SCI after Combined Locomotor Training and Transcutaneous Spinal Stimulation.

作者信息

Hope Jasmine M, Field-Fote Edelle C

机构信息

Hulse Spinal Cord Injury Research Laboratory, Crawford Research Institute, Shepherd Center, Atlanta, GA 30309, USA.

Neuroscience Graduate Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA 30322, USA.

出版信息

Bioengineering (Basel). 2023 Apr 26;10(5):528. doi: 10.3390/bioengineering10050528.

Abstract

In people with spinal cord injury (SCI), transcutaneous spinal stimulation (TSS) has an immediate effect on the ability to dorsiflex the ankle, but persistent effects are not known. Furthermore, TSS has been associated with improved walking, increased volitional muscle activation, and decreased spasticity when combined with locomotor training (LT). In this study, the persistent impact of combined LT and TSS on dorsiflexion during the swing phase of walking and a volitional task in participants with SCI is determined. Ten participants with subacute motor-incomplete SCI received 2 weeks of LT alone (wash-in phase), followed by 2 weeks of either LT + TSS (TSS at 50 Hz) or LT + TSS (intervention phase). There was no persistent effect of TSS on dorsiflexion during walking and inconsistent effects on the volitional task. There was a strong positive correlation between the dorsiflexor ability for both tasks. There was a moderate effect of 4 weeks of LT on increased dorsiflexion during the task (d = 0.33) and walking (d = 0.34) and a small effect on spasticity (d = -0.2). Combined LT + TSS did not show persistent effects on dorsiflexion ability in people with SCI. Four weeks of locomotor training was associated with increased dorsiflexion across tasks. Improvements in walking observed with TSS may be due to factors other than improved ankle dorsiflexion.

摘要

在脊髓损伤(SCI)患者中,经皮脊髓刺激(TSS)对踝关节背屈能力有即时影响,但持续效果尚不清楚。此外,当与运动训练(LT)相结合时,TSS与步行改善、自主肌肉激活增加以及痉挛减轻有关。在本研究中,确定了联合LT和TSS对SCI参与者步行摆动期背屈和一项自主任务的持续影响。十名亚急性运动不完全性SCI参与者先单独接受2周的LT(导入期),然后接受2周的LT + TSS(50Hz的TSS)或LT + TSS(干预期)。TSS对步行期间的背屈没有持续影响,对自主任务的影响也不一致。两项任务的背屈能力之间存在很强的正相关。4周的LT对任务期间(d = 0.33)和步行期间(d = 0.34)背屈增加有中等程度的影响,对痉挛有较小影响(d = -0.2)。联合LT + TSS对SCI患者的背屈能力未显示出持续影响。四周的运动训练与各任务中背屈增加有关。TSS观察到的步行改善可能归因于踝关节背屈改善以外的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07c8/10215738/e2fea9d13f7b/bioengineering-10-00528-g001.jpg

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