一种用于跖屈中枢驱动临床评估的便携式、集成神经刺激的力测量平台。
A Portable, Neurostimulation-Integrated, Force Measurement Platform for the Clinical Assessment of Plantarflexor Central Drive.
作者信息
Collimore Ashley N, Alvarez Jonathan T, Sherman David A, Gerez Lucas F, Barrow Noah, Choe Dabin K, Binder-Macleod Stuart, Walsh Conor J, Awad Louis N
机构信息
Department of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA.
Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA.
出版信息
Bioengineering (Basel). 2024 Jan 30;11(2):137. doi: 10.3390/bioengineering11020137.
Plantarflexor central drive is a promising biomarker of neuromotor impairment; however, routine clinical assessment is hindered by the unavailability of force measurement systems with integrated neurostimulation capabilities. In this study, we evaluate the accuracy of a portable, neurostimulation-integrated, plantarflexor force measurement system we developed to facilitate the assessment of plantarflexor neuromotor function in clinical settings. Two experiments were conducted with the Central Drive System (CEDRS). To evaluate accuracy, experiment #1 included 16 neurotypical adults and used intra-class correlation (ICC) to test agreement of plantarflexor strength capacity measured with CEDRS versus a stationary dynamometer. To evaluate validity, experiment #2 added 26 individuals with post-stroke hemiparesis and used one-way ANOVAs to test for between-limb differences in CEDRS' measurements of plantarflexor neuromotor function, comparing neurotypical, non-paretic, and paretic limb measurements. The association between paretic plantarflexor neuromotor function and walking function outcomes derived from the six-minute walk test (6MWT) were also evaluated. CEDRS' measurements of plantarflexor neuromotor function showed high agreement with measurements made by the stationary dynamometer (ICC = 0.83, < 0.001). CEDRS' measurements also showed the expected between-limb differences ('s < 0.001) in maximum voluntary strength (Neurotypical: 76.21 ± 13.84 ft-lbs., Non-paretic: 56.93 ± 17.75 ft-lbs., and Paretic: 31.51 ± 14.08 ft-lbs.), strength capacity (Neurotypical: 76.47 ± 13.59 ft-lbs., Non-paretic: 64.08 ± 14.50 ft-lbs., and Paretic: 44.55 ± 14.23 ft-lbs.), and central drive (Neurotypical: 88.73 ± 1.71%, Non-paretic: 73.66% ± 17.74%, and Paretic: 52.04% ± 20.22%). CEDRS-measured plantarflexor central drive was moderately correlated with 6MWT total distance (r = 0.69, < 0.001) and distance-induced changes in speed (r = 0.61, = 0.002). CEDRS is a clinician-operated, portable, neurostimulation-integrated force measurement platform that produces accurate measurements of plantarflexor neuromotor function that are associated with post-stroke walking ability.
跖屈中枢驱动是神经运动功能障碍的一个有前景的生物标志物；然而，由于缺乏具有集成神经刺激功能的测力系统，常规临床评估受到阻碍。在本研究中，我们评估了我们开发的一种便携式、集成神经刺激的跖屈力测量系统的准确性，以促进临床环境中跖屈神经运动功能的评估。使用中枢驱动系统（CEDRS）进行了两项实验。为了评估准确性，实验1纳入了16名神经功能正常的成年人，并使用组内相关系数（ICC）来测试CEDRS测量的跖屈力量与固定测力计测量结果的一致性。为了评估有效性，实验2增加了26名中风后偏瘫患者，并使用单因素方差分析来测试CEDRS测量的跖屈神经运动功能在肢体间的差异，比较神经功能正常、非患侧和患侧肢体的测量结果。还评估了患侧跖屈神经运动功能与六分钟步行试验（6MWT）得出的步行功能结果之间的关联。CEDRS测量的跖屈神经运动功能与固定测力计的测量结果高度一致（ICC = 0.83，< 0.001）。CEDRS的测量结果还显示了最大自主力量（神经功能正常：76.21±13.84英尺磅，非患侧：56.93±17.75英尺磅，患侧：31.51±14.08英尺磅）、力量（神经功能正常：76.47±13.59英尺磅，非患侧：64.08±14.50英尺磅，患侧：44.55±14.23英尺磅）和中枢驱动（神经功能正常：88.73±1.71%，非患侧：73.66%±17.74%，患侧：52.04%±20.22%）方面预期的肢体间差异（P < 0.001）。CEDRS测量的跖屈中枢驱动与6MWT总距离（r = 0.69，P < 0.001）和距离引起的速度变化（r = 0.61，P = 0.002）中度相关。CEDRS是一个由临床医生操作的、便携式、集成神经刺激的测力平台，可准确测量与中风后步行能力相关的跖屈神经运动功能。
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