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2014 IEEE 19th International Functional Electrical Stimulation Society Annual Conference (IFESS)最新文献

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Effectiveness of lower limb controlled surface functional electrical stimulation in SCI — Review of evidence 下肢控制性表面功能电刺激治疗脊髓损伤的有效性——证据综述
Seyed Mohammad Hassan Sefidgar, Ahmad Khairi Abdul Wahab, N. A. Hamzaid
Central nervous system (CNS) is composed of the brain and the spinal cord. Any impairment in the functionality of these parts can cause serious disabilities such as movement impairment and urinary incontinence. Spinal cord injury (SCI) and stroke are two conditions affected by injury of the CNS. This article presents a systematic review of the efficiencies as well as the inefficiencies of the Surface-Functional Electrical Stimulation (S-FES) that benefits from closed loop and control strategies to be engaged in rehabilitative interventions for paraplegic SCI patients. This study resulted in nine papers for review. To evaluate the evidence, the feasibility, fatigue resistance, safety and tracking error factors of each reported study were considered. From this study, it was concluded that the integration of control system into S-FES can promote rehabilitation process while minimize or control counterproductive elements such as fatigue and spasm as well as monitoring the activity for better safety measures during the S-FES intervention.
中枢神经系统(CNS)由大脑和脊髓组成。这些部分功能的任何损害都可能导致严重的残疾,如运动障碍和尿失禁。脊髓损伤和脑卒中是由中枢神经系统损伤引起的两种疾病。本文系统回顾了表面功能电刺激(S-FES)的有效性和低效性,它受益于闭环和控制策略,用于截瘫SCI患者的康复干预。这项研究产生了九篇论文供审查。为了评估证据,考虑了每个研究报告的可行性、疲劳抗力、安全性和跟踪误差因素。本研究得出结论,将控制系统集成到S-FES中可以促进康复过程,同时减少或控制疲劳和痉挛等适得其反的因素,并在S-FES干预期间监测活动以获得更好的安全措施。
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引用次数: 0
Multi-pad stimulation device for treating foot drop: Case study 治疗足下垂的多垫刺激装置:案例研究
J. Malešević, G. Bijelic, T. Keller, N. Malešević, L. Konstantinović
Many individuals with stroke express gait abnormalities and reduction of daily living activities. One of techniques for treating lower limb disabilities for improving gait patterns is functional electrical stimulation (FES). The purpose of this case report is to describe the development of FES system based on multi-pad electrodes for foot drop correction during gait and to demonstrate its use in improving gait quality of hémiplégie patients. Stimulation optimization and triggering is based on feedback from inertial sensor positioned on the patient's paretic foot. The main features are fast and reliable optimization of stimulation patterns for achieving strong dorsiflexion and plantar flexion. One hémiplégie patient participated in the 6 months case study. The functional improvement of the patient's gait was tracked during the course of the therapy. Observed indicators of rehabilitation efficiency were gait velocity, number of steps and angular velocity of ankle joint during 10 m gait test.
许多中风患者表现为步态异常和日常生活活动减少。功能性电刺激(FES)是治疗下肢残疾以改善步态模式的技术之一。本病例报告的目的是描述基于多垫电极的FES系统的发展,用于步态时的足下垂矫正,并展示其在改善hims患者步态质量方面的应用。刺激优化和触发是基于来自惯性传感器的反馈定位在病人的麻痹足。主要特点是快速和可靠的优化刺激模式,以实现强背屈和足底屈。一名hims患者参加了为期6个月的病例研究。在治疗过程中,追踪患者步态的功能改善情况。在10 m步态试验中,观察步态速度、步数和踝关节角速度对康复效果的影响。
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引用次数: 5
Influence of volitional contraction on muscle response to functional electrical stimulation 意志收缩对功能性电刺激下肌肉反应的影响
Kai Gui, Dingguo Zhang
This paper focuses on the volitional contraction's impact on Functional Electrical Stimulation (FES). Hammerstein model, which combines static nonlinearity, isometric response curve (IRC), and dynamical linearity, is a common model to present the muscle response to electrical stimulation. We utilized the responses to a pseudo-random binary sequence (PRBS) excitation to identify the static nonlinearity. Then, ramp deconvolution method was used to obtain the dynamical linearity in different volitional contraction levels. Five able-bodied subjects' flexor carpi ulnaris in isometric contraction were tested. Finally, we find normalized dynamical linearity nearly remains unchanged as the volitional contraction changes. And the dead zone and saturation zone of IRC increases accompanying the bigger volitional contraction, while the linearity zone decreases. So, it is suitable to reduce the adjustable electrical stimulation intensity's scope.
本文主要研究意志收缩对功能性电刺激(FES)的影响。Hammerstein模型是描述肌肉对电刺激反应的常用模型,它结合了静态非线性、等长响应曲线(IRC)和动态线性。我们利用伪随机二值序列(PRBS)激励下的响应来识别静态非线性。然后,采用斜坡反褶积方法,得到了不同意志收缩水平下的动态线性。对5名健全人尺腕屈肌进行等距收缩测试。最后,我们发现归一化动态线性随着意志收缩的变化几乎保持不变。随意志收缩的增大,IRC的死区和饱和区增大,线性区减小。因此,减小可调电刺激强度的范围是合适的。
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引用次数: 5
Bilateral transcutaneous posterior tibial nerve stimulation for functional anorectal pain 双侧经皮胫后神经刺激治疗功能性肛肠疼痛
S. Takano
Background: Reports indicate that percutaneous posterior tibial nerve stimulation improve pain symptoms of the patients with chronic pelvic pain. Objective: The aim of this study is to assess the efficacy of bilateral transcutaneous posterior tibial nerve stimulation (PTNS) for functional anorectal pain. Design: Prospective study. Single-group pilot study. Patients: 10 patients with functional anorectal pain were enrolled in this study. Settings/Interventions: All patients received 30 minutes of stimulation twice per week for 6 weeks. Patients were evaluated by history, physical, the visual analogue scale (VAS) for pain and frequency of pain as Rome III criteria. Main Outcome Measures: VAS for pain and frequency of pain were measured. Results: 9 patients completed the treatment. Mean VAS for pain significant decreased from 5.7 to 1.5 (P<;0.01). 77.8% of patients had a improvement of >50% in the VAS for pain. Mean days of pain per a month significant decreased from 21.2 to 8.9(p=0.03). Limitations: This study was limited by its small size and its lack of blinding and control. Conclusions: Our finding suggest that bilateral PTNS may improve pain symptoms for patients with functional anorectal pain. Long-term follow-up studies are needed to verify these preliminary results.
背景:有报道表明经皮胫后神经刺激可改善慢性盆腔疼痛患者的疼痛症状。目的:评价双侧经皮胫后神经刺激(PTNS)治疗功能性肛肠疼痛的疗效。设计:前瞻性研究。单组初步研究。患者:本研究纳入10例功能性肛肠疼痛患者。设置/干预:所有患者均接受30分钟的刺激,每周2次,持续6周。以病史、体格、视觉模拟疼痛量表(VAS)和疼痛频率作为Rome III标准对患者进行评估。主要观察指标:测量疼痛VAS评分和疼痛发生频率。结果:9例患者完成治疗。疼痛的平均VAS评分从5.7降至1.5 (P50%)。每月平均疼痛天数从21.2天显著减少到8.9天(p=0.03)。局限性:本研究规模小,缺乏盲法和对照。结论:本研究提示双侧PTNS可改善功能性肛肠疼痛患者的疼痛症状。需要长期的后续研究来验证这些初步结果。
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引用次数: 1
Effect of FES in rehabilitation of cerebral palsy children by analysis of surface EMG in tibialis anterior muscle 胫骨前肌表肌电图分析FES在脑瘫患儿康复中的作用
R. Mukhopadhyay, M. Mahadevappa, P. Lenka, A. Biswas
In this study we have evaluated the efficacy of Functional Electrical Stimulation (FES) in the rehabilitation of spastic Cerebral Palsy (CP) children, by surface electromyographic (sEMG) analysis of the Tibialis Anterior (TA) muscles. Ten children with spastic diaplegic/hemiplegic cerebral palsy within the age group of 5 to 14 years received both FES for 30 minutes and the conventional physiotherapy for 30 minutes a day, for 5 days a week, up to 12 weeks. The measurement of electromyography (EMG) of both the baseline (at the initiation) and post treatment (after intervention) were obtained. These data were analysed for both amplitude and frequency related parameters. The results report a rise in Root Mean Square (RMS), Mean Absolute Value (MAV), EMG peak amplitude and Integrated EMG (IEMG) values. Improvement was also seen in Median Frequency (MDF), Mean Frequency (MNF) and the total power of the EMG power spectrum. Hence we can conclude that FES combined with conventional physiotherapy improves the muscle strength in spastic CP children.
在这项研究中,我们通过对胫骨前肌(TA)的表面肌电图(sEMG)分析,评估了功能性电刺激(FES)在痉挛型脑瘫(CP)儿童康复中的疗效。10例5 ~ 14岁的痉挛性瘫痪/偏瘫性脑瘫患儿,每天接受30分钟的FES治疗和30分钟的常规物理治疗,每周5天,持续12周。测量基线(开始时)和治疗后(干预后)的肌电图(EMG)。对这些数据进行幅度和频率相关参数的分析。结果显示,平均均方根(RMS)、平均绝对值(MAV)、肌电信号峰值幅度和综合肌电信号(IEMG)值均有所上升。中位频率(MDF)、平均频率(MNF)和肌电功率谱的总功率也有改善。因此,我们可以得出结论,FES联合常规物理治疗可提高痉挛性脑瘫儿童的肌肉力量。
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引用次数: 2
A review of different parameters of functional electric stimulation leg ergometry training in spinal cord injured individuals to formulate careful systematic comparisons between studies 回顾不同参数的功能性电刺激腿部几何训练在脊髓损伤的个体制定仔细的系统比较研究之间
Nur-E-Habiba, N. A. Hamzaid
The purpose of this paper is to understand the importance of considering the same or similar parameters in terms of functional electric stimulation-leg ergometry (FES-LE) study designing to formulate careful systematic comparisons between studies to provide spinal cord injury (SCI) patients with the best beneficial usages of FES-LE by developing injury-level specific standardized training protocols. This literature review is online based systematic research and most articles were obtained from online databases. Analyzing the studies included in these articles revealed that each study is different in numerous ways such as study designs, statistical methods, populations' demography, sample size, health measurements, clinical or laboratory techniques and data analysis methods. Dissimilarities in these parameters, along with their own individual limitations, and inconsistencies in the studies caused difficulties in making systematic comparisons and drawing reliable conclusions regarding the most significant effects and the best way of FES-LE usages in individuals with SCL Therefore, it is crucially important to develop a consensual standardized FES-LE training protocol for each heterogeneous group (e.g. acute vs. chronic; complete vs. incomplete; tetra vs. paraplegic) with its own homogeneous subjects (patients with similar demography). Quantifying the precise dose of stress, or determining the duration of FES intervention for each group of individuals with the same or similar level of injury and demography should also be documented in the standardized FES training protocol. Among different health assessments, measuring the muscle morphological changes (e.g. CSAf, fiber size, MHC) is very effective, as they directly refer to muscle strength improvements. Therefore, muscle morphological changes would be worth measuring in the standardized FES training studies. Hence, designing worldwide consensual injury-level specific standardized FES-LE training protocols would help the future studies to be constructed maintaining the same parameters and following consistencies; and thus, results from these studies could be used to formulate true systematic comparisons between them to determine the most effective usages of FES-LE in SCI individuals.
本文的目的是了解在功能性电刺激-腿部几何学(FES-LE)研究中考虑相同或相似参数的重要性,旨在通过制定损伤级别特定的标准化训练方案,为脊髓损伤(SCI)患者提供FES-LE的最佳有益使用。本文献综述是基于网络的系统研究,大部分文章来源于网络数据库。分析这些文章中的研究表明,每项研究在许多方面都是不同的,例如研究设计、统计方法、人口统计学、样本量、健康测量、临床或实验室技术以及数据分析方法。这些参数的差异,加上它们自身的个体局限性,以及研究中的不一致性,导致很难进行系统比较,并得出关于SCL患者使用FES-LE的最显著效果和最佳方法的可靠结论。因此,为每个异质组(例如急性组与慢性组;Complete和incomplete;利乐与截瘫患者的对比),其研究对象均为同类(具有相似人口统计学特征的患者)。在标准化的FES训练方案中,也应量化具有相同或相似损伤水平和人口统计学的每组个体的精确应激剂量,或确定FES干预的持续时间。在不同的健康评估中,测量肌肉形态变化(如CSAf、纤维大小、MHC)是非常有效的,因为它们直接涉及肌肉力量的改善。因此,在标准化的FES训练研究中,肌肉形态的变化是值得测量的。因此,设计世界范围内一致同意的伤害级别特定的标准化FES-LE训练方案将有助于构建保持相同参数和以下一致性的未来研究;因此,这些研究的结果可以用来在它们之间形成真正的系统比较,以确定FES-LE在脊髓损伤患者中的最有效使用。
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引用次数: 0
A pilot study of the stability of the ankle joint moment and M-wave evoked by intermittent stimulation 间歇性刺激引起的踝关节力矩和m波稳定性的初步研究
Naosuke Yamamoto, M. Nitta, Y. Tagawa, H. Kuno
We examined the stability of the ankle joint moment (AM) and M-wave amplitude evoked by electrical stimulation of the gastrocnemius and soleus muscle. The use of functional electrical stimulation (FES) is associated with some problems, including the fact that the muscle activity evoked by electrical stimulation decreases with muscle fatigue. Also, when electrical stimulation is delivered via surface electrodes, the stimulation reaching the muscle can vary according to the impedance between the electrode and the skin. In this paper, we performed experiments to (1) examine the relation between AM and stimulation intensity and between M-wave amplitude and stimulation intensity; (2) determine the change in this relation over a long duration; and (3) identify a strategy to allow the muscle to recover from fatigue. In the first experiment, M-wave amplitude and AM changed similarly with respect to the stimulation voltage. In the second experiment, the pattern of the M-wave and AM both showed downward. The pattern, however, was not similar at the soleus. In the third experiment, M-wave and AM remained almost constant compared with fatigued response in the second experiment. We showed that it is possible to generate a stable AM using electrical stimulation of the muscle. To ensure the stability of AM, it is necessary to consider the characteristics of the muscle (e.g., the proportion of fast and slow twitch fibers), the stimulation area, and the state of the muscles (e.g., fatigue).
我们研究了电刺激腓肠肌和比目鱼肌引起的踝关节力矩(AM)和m波振幅的稳定性。功能性电刺激(FES)的使用与一些问题有关,包括电刺激引起的肌肉活动随着肌肉疲劳而减少。此外,当电刺激通过表面电极传递时,到达肌肉的刺激可以根据电极和皮肤之间的阻抗而变化。本文通过实验验证了:(1)调幅与刺激强度、m波振幅与刺激强度的关系;(2)确定这种关系在很长一段时间内的变化;(3)确定一种策略,让肌肉从疲劳中恢复。在第一个实验中,m波振幅和AM随刺激电压的变化相似。在第二个实验中,m波和AM波的模式都是向下的。然而,比目鱼的情况却不一样。在第三个实验中,与第二个实验的疲劳响应相比,m波和AM几乎保持不变。我们证明了通过电刺激肌肉来产生稳定的AM是可能的。为了保证AM的稳定性,需要考虑肌肉的特性(例如,快、慢肌纤维的比例)、刺激区域和肌肉的状态(例如,疲劳)。
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引用次数: 1
Mechanomyography sensors for detection of muscle activities and fatigue during Fes-evoked contraction 在fes诱发的收缩过程中,用于检测肌肉活动和疲劳的肌力描记传感器
M. Ng, Maryam Pourmajidian, N. A. Hamzaid
The experiment is to investigate the reliability of two different mechanomyogram (MMG) sensors recording during functional electrical stimulation (FES)-evoked contraction. The MMG based sensors used in this study are vibromyography (VMG) and muscle contraction (MC) sensor. One spinal cord injured (SCI) patient was requested to perform knee extension movements during two sessions of isotonic exercise for strength and fatigue tests. Data from each sensor was collected, processed and analysed in personal computer. Processed data of sensors were correlated with the measured output torque to identify the linearity of sensors signal with output. Analyzed data from both MMG based sensors are tabulated and compared. The sensor with coefficient of correlation nearest to 1 is considered more reliable in muscle activity and fatigue detection. From the findings, it can be concluded that MC sensor is better in detecting and measuring muscle activities for SCI subjects. While for detecting and measuring muscle fatigue VMG performs better for SCI subjects.
本实验旨在探讨两种不同的机械肌图(MMG)传感器在功能性电刺激(FES)诱发收缩时记录的可靠性。在本研究中使用的基于MMG的传感器是振动肌图(VMG)和肌肉收缩(MC)传感器。一位脊髓损伤(SCI)患者被要求在两次等张运动中进行膝关节伸展运动,以进行强度和疲劳测试。每个传感器的数据在个人计算机上收集、处理和分析。将传感器处理后的数据与实测输出转矩进行关联,识别传感器信号与输出的线性度。对两种基于MMG的传感器的分析数据进行了制表和比较。相关系数接近1的传感器被认为在肌肉活动和疲劳检测中更可靠。由此可见,MC传感器在检测和测量脊髓损伤受试者肌肉活动方面具有较好的效果。而VMG对脊髓损伤受试者的肌肉疲劳检测和测量效果较好。
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引用次数: 6
Evaluation of isokinetic muscle performance using a novel mechanomyogram sensor 用一种新型的肌力图传感器评估等速肌肉性能
Maryam Pourmajidian, Yasotha Padmanatha, Hasliza Yusoff, A. Wahab, N. Hasnan, N. A. Hamzaid, G. Davis
A pilot investigation was conducted on the measurement of muscle performance during voluntary exercise using a novel mechanomyogram muscle contraction sensor quantifying muscle tension - the MC-Sensor (TMG-BMC Ltd. Ljubljana, Slovenia). Surface electromyography (sEMG) and the torque output from an isokinetic dynamometer were used as reference for comparative assessment of the MC-sensor data. Five able-bodied subjects performed isokinetic knee extension at 90 deg· s-1 and 120 deg· s-1. Correlation coefficients (r) between the muscle tension data from MC-sensor, sEMG and Biodex were calculated using Microsoft Excel and a high correlation was observed with an average rvalue of 0.82 to 0.91 at 90 deg· s1, and 0.77 to 0.90 at 120 deg· s-1, respectively. A stronger association was observed between MC-sensor and Biodex, compared to MC-EMG and Biodex-EMG. This might be due to reported complications in achieving an accurate force-EMG ratio. However, further research is necessary to establish the reliability of the mechanomyogram sensors before muscle tension can be utilized as a proxy for muscle force during functional electrical stimulation(FES)-evoked exercise and/or functional movements.
我们使用一种新型的肌肌力图肌肉收缩传感器MC-Sensor (TMG-BMC Ltd.)来测量自愿运动期间的肌肉表现。卢布尔雅那(斯洛文尼亚)。表面肌电图(sEMG)和等速测功机的扭矩输出作为参考,对mc传感器数据进行比较评估。5名身体健全的受试者进行90°·s-1和120°·s-1等速膝关节伸展。使用Microsoft Excel计算MC-sensor、sEMG和Biodex的肌肉张力数据之间的相关系数(r),在90°·s-1时,平均r值为0.82 ~ 0.91,在120°·s-1时,平均r值为0.77 ~ 0.90。与MC-EMG和Biodex- emg相比,MC-sensor和Biodex- emg之间存在更强的相关性。这可能是由于在获得准确的力-肌电比时报道的并发症。然而,在肌肉张力可以作为功能性电刺激(FES)诱发的运动和/或功能性运动中肌肉力的代表之前,需要进一步的研究来建立机械肌图传感器的可靠性。
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引用次数: 0
Fabrication of flat electrodes utilizing picosecond laser manufacturing technology: Preliminary study for fabrication of a novel transverse intrafascicular multichannel electrode 利用皮秒激光制造技术制造平面电极:一种新型横向束内多通道电极制造的初步研究
Matthias Mueller, F. Kohler, J. Ordonez, T. Stieglitz, M. Schuettler
Over the last decade we developed methods for the fabrication of laser-structured electrode arrays for neural engineering. For these electrode arrays a metal foil was structured with a 1064 nm Nd:YAG laser in the nanosecond pulse regime and placed within a silicone rubber substrate. Due to process restrictions the individual electrode sites are not in plane with the upper layer of the silicone rubber. Here, a new laser in the picosecond regime (355 nm Nd:YVO4) was used for laser-structuring. This allowed the fabrication of a novel electrode array out of a 25 μm thick sheet of MP35N metal with thinned-down and buried tracks as well as fixations for the electrode sites and contact pads. For the opening of the single electrodes two different processes, hatching and cutting, have been tested. Due to the interaction of the laser with the metal hatched electrodes had an increased surface area which was investigated with electrochemical measurements. The individual thicknesses of the layers were measured with a novel way of directly laser cutting the electrodes and measuring under a light microscope.
在过去的十年中,我们开发了用于神经工程的激光结构电极阵列的制造方法。对于这些电极阵列,金属箔在纳秒脉冲范围内用1064 nm Nd:YAG激光器结构,并放置在硅橡胶衬底内。由于工艺限制,单个电极位点不与硅橡胶的上层在平面上。本文采用皮秒级激光(355nm Nd:YVO4)进行激光结构。这样就可以用25 μm厚的MP35N金属薄片制造出一种新型电极阵列,该电极阵列具有薄化和埋入的轨道,以及电极位置和接触垫的固定装置。对于单电极的开口,已经测试了两种不同的工艺,孵化和切割。由于激光与金属的相互作用,孵出的电极表面积增加,用电化学测量研究了这一现象。采用激光直接切割电极并在光学显微镜下测量各层厚度的新方法。
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引用次数: 4
期刊
2014 IEEE 19th International Functional Electrical Stimulation Society Annual Conference (IFESS)
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