肌电图（EMG）触发的经皮脊髓和髋部刺激用于慢性卒中患者的步态康复：一项随机对照试验。
Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trial.
作者信息
Tani Mami, Yamaguchi Tomofumi, Honaga Kaoru, Takahashi Yoko, Kono Hidemi, Murakami Yuhei, Isayama Reina, Haruyama Koshiro, Fujino Yuji, Matsuda Tadamitsu, Fukunaga Issei, Hori Masaaki, Tanuma Akira, Wada Futoshi, Hatori Kozo, Fujiwara Toshiyuki
机构信息
Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan.
出版信息
J Neuroeng Rehabil. 2025 Jul 7;22(1):154. doi: 10.1186/s12984-025-01690-0.
BACKGROUND
Transcutaneous spinal stimulation has been applied to gait rehabilitation for persons with neurological diseases. The authors developed electromyography-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation and called this system FAST walk. This study aimed to assess the effect of FAST walk in a randomized, controlled trial.
METHODS
All participants were randomly allocated to three groups: FAST walk combined with treadmill gait training (FAST walk); spinal stimulation combined with treadmill gait training (spinal stim); and treadmill gait training (treadmill). Participants performed two sets of 15-min treadmill gait training with 5-min intervals in the FAST walk, spinal stim, and treadmill groups. Gait training was performed twice weekly for a total of 10 sessions. The primary outcome was 10-m walking time. The secondary outcomes were the time symmetry index (TSI) with gait analysis and spinal reciprocal inhibition on the conditioned-test H reflex study.
RESULTS
Twenty persons with chronic stroke participated in this study, and 17 persons completed this study. For the primary outcome, there was no significant interaction between time and intervention in 10-m walking time on two-way analysis of covariance (ANCOVA) (P = 0.382, η = 0.064). For the FAST walk group, 10-m walking time improved significantly at post and post-4w (P = 0.024 and 0.022, respectively). In the other groups, no significant improvements in 10-m walking time were seen at post and post-4w compared with before. There was also no significant between-group difference in the 10-m walking time.
CONCLUSIONS
The newly developed electromyography-triggered transcutaneous spinal cord and hip stimulation, FAST walk, is safe and may improve the gait speed of persons with chronic stroke. We did not, however, find a significant between-group difference among the FAST walk, spinal stim, and treadmill gait groups.
TRIAL REGISTRATION
Japan Registry of Clinical Trial (JRCT registration ID: jRCTs032180289).
背景
经皮脊髓刺激已应用于神经疾病患者的步态康复。作者开发了用于步态康复的肌电图触发经皮脊髓和髋部刺激，并将该系统称为FAST walk。本研究旨在通过随机对照试验评估FAST walk的效果。
方法
所有参与者被随机分为三组：FAST walk联合跑步机步态训练（FAST walk组）；脊髓刺激联合跑步机步态训练（脊髓刺激组）；以及跑步机步态训练（跑步机组）。FAST walk组、脊髓刺激组和跑步机组的参与者进行两组15分钟的跑步机步态训练，间隔5分钟。每周进行两次步态训练，共10次。主要结局指标为10米步行时间。次要结局指标包括步态分析的时间对称性指数（TSI）和条件测试H反射研究中的脊髓交互抑制。
结果
20名慢性中风患者参与了本研究，17名患者完成了研究。对于主要结局指标，在双向协方差分析（ANCOVA）中，10米步行时间在时间和干预之间没有显著交互作用（P = 0.382，η = 0.064）。对于FAST walk组，10米步行时间在训练后和训练后4周时显著改善（分别为P = 0.024和0.022）。在其他组中，与训练前相比，训练后和训练后4周时10米步行时间没有显著改善。10米步行时间在组间也没有显著差异。
结论
新开发的肌电图触发经皮脊髓和髋部刺激FAST walk是安全的，可能会提高慢性中风患者的步态速度。然而，我们没有发现FAST walk组、脊髓刺激组和跑步机步态组之间存在显著的组间差异。
试验注册
日本临床试验注册中心（JRCT注册号：jRCTs032180289）。
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