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截瘫患者的步态恢复:使用多通道表面电极功能性电刺激的可行性论证

Gait restoration in paraplegic patients: a feasibility demonstration using multichannel surface electrode FES.

作者信息

Kralj A, Bajd T, Turk R, Krajnik J, Benko H

出版信息

J Rehabil R D. 1983 Jul;20(1):3-20.

PMID:6887064
Abstract

Recent advances in science have aided research toward the restoration of biped gait in paraplegic patients by means of functional electrical stimulation (FES). In this paper it is shown how FES-restrengthened muscles of paraplegic patients have been used for simple FES-assisted standing. Those experiments subsequently led to biped gait-initializing experiments and to simple forms of biped gait synthesis. The purpose of this paper is to show the feasibility of using FES for standing and for restoring biped gait in many paraplegic patients--to present the past achievements, focus on problems, and highlight directions for future research. The results of gait obtained in three complete spinal cord injured patients (out of a series of 17) are shown, using four to six channels of FES. It is also shown how preserved reflex mechanisms of the transected spinal cord can be incorporated and employed for obtaining improved function while at the same time simplifying the FES hardware. Of the three patients reported on in detail here, two patients have managed to walk in parallel bars while the third patient has mastered independent unassisted walking over shorter distances with the aid of a roller walker. The biomechanical and control problems of this last patient's gait are presented in detail.

摘要

科学上的最新进展有助于通过功能性电刺激(FES)来恢复截瘫患者的双足步态的研究。本文展示了如何将截瘫患者经FES强化的肌肉用于简单的FES辅助站立。这些实验随后引发了双足步态初始化实验以及简单形式的双足步态合成。本文的目的是展示在许多截瘫患者中使用FES进行站立和恢复双足步态的可行性——呈现过去的成果,关注问题,并突出未来研究的方向。展示了在17例患者中的3例完全脊髓损伤患者使用四到六个FES通道获得的步态结果。还展示了如何整合并利用横断脊髓保留的反射机制来获得改善的功能,同时简化FES硬件。在这里详细报告的3例患者中,2例患者已能在双杠内行走,而第3例患者借助滚轮助行器掌握了短距离独立无辅助行走。详细介绍了最后这名患者步态的生物力学和控制问题。

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