Hart R L, Kilgore K L, Peckham P H
Case Western Reserve University, Cleveland VA Medical Center, MetroHealth Medical Center, OH 44109, USA.
IEEE Trans Rehabil Eng. 1998 Jun;6(2):208-18. doi: 10.1109/86.681187.
Implanted neuroprostheses employing functional electrical stimulation (FES) provide grasp and release to individuals with tetraplegia. This paper describes and compares three methods of controlling the stimulated hand movement: shoulder position, wrist position and myoelectric activity from the wrist extensors. Three experienced neuroprosthesis users were evaluated with each of the control methods by performing a grasp release test (GRT). A significant improvement was found between each functional electrical stimulation (FES) method and tenodesis without FES. No significant difference in overall performance was found between the three FES methods of control. Each method of control demonstrated advantages and disadvantages which depend upon characteristics of the individual patient. Factors which must be considered are injury level, voluntary wrist strength, proximal upper limb strength, the level of cognition of the patient, hand-grasp characteristics, cosmeses, importance of using both arms, and personal preference. Due to the unique characteristics of each controller type, it is advantageous to have each type available for the FES patients to adapt the system to the needs and desires of the individual patient.
采用功能性电刺激（FES）的植入式神经假体为四肢瘫痪患者提供抓握和松开功能。本文描述并比较了三种控制受刺激手部运动的方法：肩部位置、腕部位置以及来自腕伸肌的肌电活动。通过进行抓握-松开测试（GRT），对三名经验丰富的神经假体使用者采用每种控制方法进行了评估。发现每种功能性电刺激（FES）方法与无FES的肌腱固定术之间均有显著改善。三种FES控制方法在总体性能上未发现显著差异。每种控制方法都有其优缺点，这取决于个体患者的特征。必须考虑的因素包括损伤水平、自愿腕部力量、上肢近端力量、患者的认知水平、手部抓握特征、美观性、使用双臂的重要性以及个人偏好。由于每种控制器类型都有其独特的特性，为FES患者提供每种类型以便使系统适应个体患者的需求和愿望是有利的。
