Nathan R H
Mechanical Engineering Department, Ben Gurion University of the Negev, Beer Sheva, Israel.
Crit Rev Biomed Eng. 1993;21(6):485-568.
The condition of the paralyzed patient is described, regarding both the primary paralysis and the secondary physiological changes in the upper limb resulting in abilities and disabilities in upper limb function. Although the review relates mainly to spinal cord injuries at the C4, C5, and C6 levels, other conditions are noted such as hemiplegia. Activation of muscle by functional neuromuscular stimulation (FNS) is discussed. The biomechanics of the FNS-activated paralyzed upper limb is analyzed for activation by both implanted and by surface electrodes, and a review is presented of open-loop strategies for systems in clinical use. Closed-loop strategies applied to the upper extremity are reviewed for analog and digital systems, and regimes developed for specific functional activities are outlined. Finally, adaptive control strategies are surveyed.
本文描述了瘫痪患者的状况，涉及原发性瘫痪以及上肢的继发性生理变化，这些变化导致了上肢功能方面的能力与残疾情况。尽管该综述主要涉及颈4、颈5和颈6水平的脊髓损伤，但也提到了其他情况，如偏瘫。文中讨论了通过功能性神经肌肉刺激（FNS）激活肌肉的方法。分析了通过植入式电极和表面电极激活FNS的瘫痪上肢的生物力学，并对临床使用系统的开环策略进行了综述。对应用于上肢的模拟和数字系统的闭环策略进行了综述，并概述了针对特定功能活动制定的方案。最后，对自适应控制策略进行了调查。
