Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, ON, M5S 3G9, Canada; KITE-Toronto Rehabilitation Institute, University Health Network, 520 Sutherland Dr., Toronto, ON, M4G 3V9, Canada.
KITE-Toronto Rehabilitation Institute, University Health Network, 520 Sutherland Dr., Toronto, ON, M4G 3V9, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada.
Med Eng Phys. 2024 Oct;132:104238. doi: 10.1016/j.medengphy.2024.104238. Epub 2024 Sep 16.
Individuals with incomplete spinal cord injury (iSCI) demonstrate impaired upright balance, resulting in increased fall risk. Task-specific visual feedback balance training (VFBT) has previously been shown to improve upright balance. In addition, therapies using functional electrical stimulation (FES) have been shown to improve various motor functions. Combining VFBT with FES therapy (FES+VFBT) may synergistically improve balance control for those with iSCI. Here we developed the FES+VFBT system that delivered physiologically relevant electrical stimulations to soleus (SOL) and tibialis anterior (TA) muscles during VFBT. Ten young able-bodied individuals participated. Kinematic, kinetic, SOL and TA electromyography (EMG) data during quiet standing and limits-of-stability test were used to design the controller for the FES+VFBT system. To evaluate the performance of the designed controller, the controller outputs, which represented stimulation intensities, were compared with the recorded SOL and TA EMG during the four tasks associated with VFBT (i.e., bullseye, hunting, colour-matching, and ellipse tasks). Except for the bullseye task, the designed controller outputs were highly correlated with the recorded EMG, suggesting that the controller could generate electrical stimulations in a physiological manner. We expect that the addition of FES therapy to VFBT could contribute to improving standing balance for individuals with iSCI.
不完全性脊髓损伤（iSCI）个体表现出直立平衡受损，导致跌倒风险增加。特定任务的视觉反馈平衡训练（VFBT）已被证明可以改善直立平衡。此外，使用功能性电刺激（FES）的疗法已被证明可以改善各种运动功能。将 VFBT 与 FES 治疗（FES+VFBT）相结合，可能会协同改善 iSCI 患者的平衡控制。在这里，我们开发了一种 FES+VFBT 系统，该系统在 VFBT 期间向比目鱼肌（SOL）和胫骨前肌（TA）传递生理相关的电刺激。十名年轻的健康个体参与了实验。在静息站立和稳定性极限测试期间的运动学、动力学、SOL 和 TA 肌电图（EMG）数据被用于设计 FES+VFBT 系统的控制器。为了评估设计的控制器的性能，将控制器输出（代表刺激强度）与与 VFBT 相关的四个任务（即靶心、狩猎、颜色匹配和椭圆任务）期间记录的 SOL 和 TA EMG 进行了比较。除了靶心任务外，设计的控制器输出与记录的 EMG 高度相关，这表明该控制器可以以生理方式产生电刺激。我们期望将 FES 治疗添加到 VFBT 中可以有助于改善 iSCI 患者的站立平衡。
