Perkins T A, Brindley G S, Donaldson N D, Polkey C E, Rushton D N
MRC Neurological Prostheses Unit, London, UK.
Med Biol Eng Comput. 1994 Jul;32(4):367-72. doi: 10.1007/BF02524686.
An 11-channel multiplexed stimulator of nerves and muscles in the left forearm was implanted for hand control in January 1986 in a 21 year old woman who, after sustaining a C6 spinal lesion 7 years earlier, had voluntary shoulder and elbow movement but paralysed hands, trunk and legs. The patient controls the stimulation via a microcomputer control box and an RF transdermal link. We have investigated the control of her stimulated hand with a joystick under her contralateral hand which she moves from the shoulder and elbow. Since 1986, we have tried a variety of joystick control schemes involving power and key grips. Currently, for grip adjustment, forward and backward joystick movements correspond to thumb extension and abduction, respectively giving in addition both finger and wrist extension, whereas right and left joystick movements yield fist closure and thumb opposition/adduction and flexion, respectively. Useful grasps are available by moving the joystick forward and then left (key grip), by moving the joystick backward and left (pinch grip), or by moving the joystick back and right (power grip). Thus, three distinct grips may be selected using these three quadrants of joystick movement. An additional control mode was found to be desirable to augment the patient's limited voluntary wrist positioning and provide wrist stability while adjusting finger grip.
1986年1月，为了实现手部控制，在一名21岁女性的左前臂植入了一台11通道的神经和肌肉多路复用刺激器。该女性7年前发生C6脊髓损伤，肩部和肘部有自主运动，但手部、躯干和腿部瘫痪。患者通过一个微型计算机控制盒和一个射频经皮链路来控制刺激。我们用一个操纵杆对她受刺激的手进行了控制研究，该操纵杆由她对侧的手从肩部和肘部移动来操作。自1986年以来，我们尝试了各种涉及力量和关键抓握的操纵杆控制方案。目前，对于抓握调整，操纵杆向前和向后移动分别对应拇指伸展和外展，此外还会产生手指和手腕伸展，而操纵杆向右和向左移动分别产生握拳以及拇指对掌/内收和屈曲。通过向前然后向左移动操纵杆（关键抓握）、向后然后向左移动操纵杆（捏握）或向后然后向右移动操纵杆（力量抓握）可实现有用的抓握。因此，利用操纵杆运动的这三个象限可以选择三种不同的抓握方式。人们发现需要一种额外的控制模式来增强患者有限的自主手腕定位能力，并在调整手指抓握时提供手腕稳定性。
