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1.
An optimized stimulation intensity envelope for use in hemiplegic drop foot applications has been developed. The traditional trapezoidal stimulation intensity approach has been examined and found to be inconsistent with the muscle activity patterns observed in healthy gait and therefore unsuitable. Experimental functional electrical stimulation (FES)-elicited tibialis anterior (TA) electromyography (EMG) data was taken over the ankle range of interest (occurring during active dorsiflexion and loading response) while also taking into account the type of TA muscle contraction occurring (concentric, eccentric, and isometric) and the speed of hemiplegic ankle joint rotation. Using the processed data, a model of normalized EMG versus pulsewidth was developed. Implementation of this model showed the unsuitability of the trapezoidal approach in the reproducing of a natural EMG profile. An optimized stimulation intensity profile is proposed which is expected to accurately reproduce the natural TA EMG profile during gait.  相似文献   

2.
Augmentation of force in partially deficient muscles can be achieved by combining electrical stimulation (ES) with their volitional activation (hybrid activation). However, while the overall torque results from the combination of the volitional and the electrically-induced torque components, the exact share between these components is not known. In a previous work, we described a method to resolve the share between the torque components under isometric static contractions. In this work, we extend our analysis to the case of isometric dynamic contractions. Five healthy subjects were instructed to contract their Tibialis Anterior (TA) muscles according to a typical gait-like dynamic torque pattern, that was visually displayed to them, while monitoring their actual ankle torque and TA electromyography (EMG). These experiments were done with and without augmented activation by means of ES. A computational algorithm was developed to dissociate the volitional from the overall torque, based on EMG signal processing and on precalibration of the dynamic system of the volitional torque versus EMG. The results indicated the quantitative relations between decrease in the volitional torque and the required increase in ES enhancement. The developed method also demonstrated what ES intensity profile is necessary to produce a desired overall torque output. This provides the means for designing an adaptive rehabilitation device for the hybrid activation of deficient muscles.  相似文献   

3.
Problems with shifting attentional set and concurrent performance of tasks are key cognitive deficits in Parkinson's disease (PD). Our aim was to examine the effects of deep brain stimulation of the subthalamic nucleus on tests of set shifting and dual task performance in patients with PD. Twelve patients with PD were assessed on tests of set shifting and on dual task performance with subthalamic nucleus (STN) stimulation switched on and off in a counterbalanced order. All patients obtained a clinical benefit from deep brain stimulation (DBS) of the STN. STN stimulation significantly improved set shifting. The effect of DBS on dual task performance was not significant. Change in measures of set shifting was significantly associated with the change in the motor symptoms of PD with DBS. The improved set shifting with DBS of the STN in PD supports the critical role of the striato-frontal circuits in this cognitive function.  相似文献   

4.
Previous studies have shown that immobilization causes muscle atrophy and that the rate of atrophy depends on the length at which the muscle is immobilized. However, most studies have been carried out in neurologically intact animals that were capable of generating at least some voluntary muscle activation. In this study, terrodotoxin was applied chronically to the rat sciatic nerve to produce complete paralysis of distal muscles for seven days, and the ankle was immobilized to hold the muscles at long or short lengths. Paralysis without immobilization resulted in relative weight losses of 36% for soleus, 19% for tibialis anterior (TA), and 17% for lateral gastrocnemius (LG) muscles. Casting the ankle in plantarflexion stretched TA and reduced its weight loss to 10%. Soleus and LG were shortened by this intervention and had increased losses of 43% and 28%, respectively. Fixing the limb in dorsiflexion resulted in a posture similar to that adopted by the unrestrained rats and had no significant effect on the amount of muscle atrophy compared to that in unrestrained paralyzed animals.  相似文献   

5.
Effects of STN DBS on rigidity in Parkinson's disease.   总被引:1,自引:0,他引:1  
We quantified the effects of deep brain stimulation (DBS) of the subthalamic nucleus (STN) and medication on Parkinsonian rigidity using an objective measure of work about the elbow joint during a complete cycle of imposed 1-Hz sinusoidal oscillations. Resting and activated rigidity were analyzed in four experimental conditions: 1) off treatment; 2) on DBS; 3) on medication; and 4) on DBS plus medication. Rigidity at the elbow joint was also assessed using the Unified Parkinson's Disease Rating Scale (UPDRS). We tested ten patients who received STN DBS and ten age-matched neurologically healthy control subjects. The activated rigidity condition increased work in both Parkinson's disease (PD) patients and control subjects. In PD patients, STN DBS reduced both resting and activated rigidity as indicated by work and the UPDRS rigidity score. This is the first demonstration that STN stimulation reduces rigidity using an objective measure such as work. In contrast, the presurgery dose of antiparkinsonian medication did not significantly improve the UPDRS rigidity score and reduced work only in the activated rigidity condition. Our results suggest that STN DBS may be more effective in alleviating rigidity in the upper limb of PD patients than medications administered at presurgery dosage level.  相似文献   

6.
A real-time functional electrical stimulation (FES) state controller was designed that utilized sensory nerve cuff signals from the cat forelimb to control the timing of stimulation of the Palmaris Longus (PalL) muscle during walking on the treadmill. Sensory nerve signals from the median and superficial radial nerves provided accurate, reliable feedback related to foot contact and lift-off which, when analyzed with single threshold Schmitt triggers, produced valuable state information about the step cycle. The study involved three experiments: prediction of the timing of muscle activity in an open-loop configuration with no stimulation, prediction of the timing of muscle activity in a closed-loop configuration that included stimulation of the muscle over natural PaIL electromyogram (EMG), and temporary paralysis of selected forelimb muscles coupled with the use of the state controller to stimulate the PalL in order to return partial support function to the anesthetized limb. The FES state controller was tested in a variety of walking conditions, including different treadmill speeds and slopes. The results obtained in these experiments demonstrate that nerve cuff signals can provide a useful source of feedback to FES systems for control of limb function.  相似文献   

7.
The ability to produce various force patterns at the ankle by microstimulation of the gray matter of the spinal cord was investigated in spinalized frogs. We evaluated the recruitment properties of individual spinal sites and found that forces increase linearly with activation level in the low-force range studied, while the structure of the force pattern remains invariant. We also measured the responses produced by coactivation of two spinal sites activated at two pairs of stimulation levels. Responses were measured at the mechanical level by recording forces at the ankle; and, at the muscular level by recording the electromyographic (EMG) activity of 11 hindlimb muscles. We found that for both pairs of activation, the forces under coactivation were the scaled vectorial summation of the individual responses. At the muscular level, rectified and integrated EMGs also summated during coactivation. Numerous force patterns could, thus, be created by the activation of a few individual sites. These results suggest that microstimulation of the circuitry of the spinal cord (higher order neurons than the motoneurons) holds promise as a new functional neuromuscular stimulation technique for the restoration of multi-joint movements  相似文献   

8.
Epidural spinal cord stimulation (ESCS) combined with partial weight bearing therapy (PWBT) has been reported to facilitate recovery of functional walking for individuals after chronic incomplete spinal cord injury (ISCI). Muscle activities were analyzed in this report to examine the modulation effect of ESCS on muscle recruitment during gait training. Two ISCI individuals participated in the study and both are classified as ASIA C with low motor scores in the lower limbs. Stimulating electrodes were placed at the epidural space over T10-L2 spinal segments, along the midline in participant 1 (S1), and off-midline in participant 2 (S2). Surface electromyograms (EMGs) from leg muscles under both ESCS ON and OFF conditions recorded during treadmill gait were analyzed in time-frequency domains. ESCS application produced acute modulations in muscle activities in both participants, but the observed pattern, magnitude, and spectral content of the EMGs differed. In S1, ESCS induced a significant shift in the temporal pattern of muscle activity toward normal comparing with that when ESCS was OFF, though without eliciting noticeable change in frequency distribution between ESCS ON and OFF conditions. When ESCS was applied in S2, a modulation of EMG magnitude was observed and, consequently, improved joint kinematics during walking. In this case, a stimulation entrainment appeared in time-frequency analysis. The results suggest that ESCS activates neural structures in the dorsal aspect of the spinal cord and facilitates gait-related muscle recruitment. The exact effects of ESCS depend on the electrode placement and possibly injury history and residual functions, but in general ESCS produces a positive effect on improved walking speed, endurance, and reduced sense of effort in both ISCI subjects.  相似文献   

9.
The research into a correlation between joint biomechanics and the action of muscles that act on the limb segment involved during movement has become very important in recent years. However, while the techniques for elaborating the EMG signal and its relationship with the dynamics of movement are described in detail in the literature, from a clinical point of view publications on how these techniques are used for clinical gait analysis applications are scarce. The purpose of dynamic EMG in clinical gait analysis is essentially to define the muscular activity that controls joint movement during gait, as shown by studies carried out on children with cerebral palsy, in which the abnormal pattern of muscle activation is used, for example, as an indication for surgical tendon transfer or lengthening  相似文献   

10.
How does the activation of several muscles combine to produce reliable multijoint movements? To study this question, we stimulated up to six sites in muscles, nerves, and the spinal cord. Flexion and extension of the hip, knee, and ankle were elicited in anesthetized and decerebrate cats. The movements occurred largely in the sagittal plane against a constant spring load and covered most of the passive range of motion of the cat's limb. The movements of the end-point (foot) were compared with predictions based on vectorial summation of end-point movements elicited by stimulating single electrodes. The lengths of the movements produced by stimulating more than one site exceeded what was expected from linear summation for small movements (<3 cm) and showed a less than linear summation for large movements (>11 cm). The data were compared with muscle and limb models. Since the deviations from linearity were predictable as a function of distance, adjustments might easily be learned by trial and error. The summation was less complete for spinal stimulation, compared to nerve and muscle stimulation, so spinal circuits do not appear to compensate for the nonlinearities. Movements were elicited from positions of the limb not only in a neutral position, but also in front and behind the neutral position. A degree of convergence was seen, even with stimulation of some individual muscles, but the convergence increased as more muscles were stimulated and more joints were actively involved. This suggests that convergence to an equilibrium-point arises at least partly from muscle properties. In conclusion, there are deviations from linear vectorial summation, and these deviations increase when more muscles are stimulated. The convergence to an equilibrium-point may simplify the computations needed to produce movements involving many muscles.  相似文献   

11.
This paper proposes and tests on able-bodied subjects a control strategy that can be practically applied in unilateral transradial amputees for simultaneous and proportional control of multiple degrees-of-freedom (DOFs). We used artificial neural networks to estimate kinematics of the complex wrist/hand from high-density surface electromyography (EMG) signals of the contralateral limb during mirrored bilateral movements in free space. The movements tested involved the concurrent activation of wrist flexion/extension, radial/ulnar deviation, forearm pronation/supination, and hand closing. The accuracy in estimation was in the range 79%-88% (r(2) index) for the four DOFs in six able-bodied subjects. Moreover, the estimation of the pronation/supination angle (wrist rotation) was influenced by the reduction in the number of EMG channels used for the estimation to a greater extent than the other DOFs. In conclusion, the proposed method and set-up provide a viable means for proportional and simultaneous control of multiple DOFs for hand prostheses.  相似文献   

12.
In the present study, muscle activity was measured after transcranial magnetic stimulation (TMS) was applied over the primary motor cortex during finger tapping. The duration of finger tapping was increased by the application of TMS. A remarkable change in electromyogram (EMG) of hand muscles was also observed during and after finger tapping. The silent period, in which voluntary EMG during the finger tapping was suppressed by TMS, was observed. Integral EMG revealed that TMS increased muscle activity at the completion of the finger tap after silent period. Copyright © 2009 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.  相似文献   

13.
This study examined the control of elbow force in nine patients with Parkinson's disease when visual feedback was available and when visual feedback was removed to determine how medication (Meds) and unilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) affect memory guided force control. Patients were examined in each of four treatment conditions: 1) off treatment; 2) Meds; 3) STN DBS; and 4) Meds plus STN DBS. With visual feedback available, there was no difference in force output across treatment conditions. When visual feedback was removed force output drifted under the target in both the off-treatment and the Meds conditions. However, when on STN DBS or Meds plus STN DBS force output drifted above the target. As such, only STN DBS had a significant effect on force output in the vision removed condition. Increased force output when on STN DBS may have occurred due to disruptions in the basal ganglia-thalamo-cortical circuitry. We suggest that modulation of output of the internal segment of the globus pallidus by STN DBS may drive the effect of STN DBS on memory guided force control.  相似文献   

14.
Clonus is defined as an involuntary rhythmic muscle contraction that generally occurs in people who have sustained lesions involving descending motor pathways in the neuraxis, and is usually accompanied by other signs of reflex hyperexcitability such as spasticity. This paper hypothesizes that clonus arises when two conditions occur simultaneously: 1) the reflex pathway contains long delay times (implying innervation of distal limb muscles, exacerbated when these muscles display slow twitch properties) and 2) the excitability of the motoneurons is enhanced. This paper tested this dual hypothesis by developing a computer model representing the ankle reflex pathway. This model included the ankle muscles, afferent and efferent pathways, and a monosynaptic spinal link between spindle afferents and motoneurons. Simulations show that as the motoneuron current threshold was reduced (reflecting increased excitability of spinal motoneurons), normal reflex responses became unstable and oscillations developed similar to those observed in spastic patients. In parallel, when we choose reflex delay times typical for distal leg muscles in man, system stability is poor, and oscillations occur readily with increasing motoneuron excitability. As simulated pathway delays are reduced, oscillatory behavior is also reduced, and usually damps out. Conversely, as simulated reflex delays are increased, oscillations increase in amplitude and do not decay. Finally, these two phenomena interact, so that increasing motoneuron excitability will induce reflex oscillations for intermediate loop delays. These findings support the hypothesis that unstable oscillatory behavior, such as the oscillations observed in clonus, will occur when the motoneuron excitability increases in a reflex pathway containing long delays. This change in excitability is mediated by a reduction in motoneuron firing threshold, rather than by an increase in feedback gain. Furthermore, we demonstrate that sustained oscillations occur readily through self reexcitation, which reduces the need to propose that a "central oscillator" must be involved in generating clonus.  相似文献   

15.
The K+ channel blocker 3,4-diaminopyrindine (DAP) increases diaphragm force, use of which could potentially improve muscle performance during functional neuromuscular stimulation. To determine the extent of hindlimb muscle force augmentation, and delineate whether DAP effects vary in muscles comprised of mainly slow versus fast fibers, rat soleus, extensor digitorum longus (EDL) and diaphragm muscle samples were studied in vitro. DAP increased force of all three muscles, but at high concentrations the force increases were transient and were followed by declines in force below baseline. The maximum DAP-induced twitch force increase was smaller for soleus (38 +/-7%) than both EDL (94+/-12%) (P < 0.05) and diaphragm (93+/-13%) (P < 0.01). During fatigue-inducing 20 Hz stimulation (tested at an intermediate DAP concentration), force of soleus muscle remained significantly elevated by DAP for the entire testing period, force of DAP-treated EDL muscle rapidly declined to values in untreated muscle, and force of DAP-treated diaphragm had an intermediate force-time profile. Muscles varied in extent to which isometric contractile kinetics were altered by DAP. Thus, the K+ channel blocker DAP improves contractile performance of limb muscles, but the profile of improvement is distinct between the soleus and EDL muscles.  相似文献   

16.
Activity from muscle afferents regarding ankle kinesthesia was recorded using cuff electrodes in a rabbit preparation in which tactile input from the foot was eliminated. The purpose was to determine if such activity can provide information useful in controlling functional electrical stimulation (FES) systems that restore mobility in spinal injured man. The rabbit's ankle was passively flexed and extended while the activity of the tibial and peroneal nerves was recorded. Responses to trapezoidal stimulus profiles were investigated for excursions from 10 degrees to 60 degrees using velocities from 5 degrees/s to 30 degrees/s and different initial ankle positions. The recorded signals mainly reflect activity from primary and secondary muscle afferents. Dorsiflexion stretched the ankle extensors and produced velocity dependent activity in the tibial nerve, and this diminished to a tonic level during the stimulus plateau. The peroneal nerve was silent during dorsiflexion, but was activated by stretch of the peroneal muscles during ankle extension. The responses of the two nerves behaved in a reciprocal manner, but exhibited considerable hysteresis, since motion that relaxed the stretch to the driving muscle produced an immediate cessation of the prior stretch induced activity. A noted difference between the tibial and peroneal nerve responses is that the range of joint position change that activated the flexor afferents was greater then for the extensor afferents. Ankle rotation at higher velocities increased the dynamic stretch evoked responses during the stimulus ramp but showed no effect on the tonic activity during the stimulus plateau. Prestretching the muscles by altering the initial position increased the response to the ramp movement, however, for the peroneal nerve, when the prestretch brought the flexor muscles near to their maximal lengths, the response to additional stretch provided by the ramp movement was diminished. The results indicate that the whole nerve recorded muscle afferent activity may be useful for control of FES assisted standing, because it can indicate the direction of rotation of the passively moved ankle joint, along with coarse information regarding the rate of movement and static joint position.  相似文献   

17.
Muscle forces move our limbs. These forces must be estimated with indirect techniques, as direct measurements are neither generally possible nor practical. An electromyography (EMG)-to-force processing technique was developed. Ankle joint moments and, by extension, ankle muscle forces were calculated. The ankle moment obtained by inverse dynamics was calculated for ten normal adults during free speed gait. There was close correlation between inverse dynamics ankle moments and moments determined by the EMG-to-force processing approach. Muscle forces were determined. The gait peak Achilles tendon force occurred in late single limb support. Peak force observed (2.9 kN) closely matched values obtained where force transducers were used to obtain in vivo muscle forces (2.6 kN). The EMG-to-force processing model presented here appears to be a practical means to determine in vivo muscle forces.  相似文献   

18.
An understanding of the muscle power contributions to the crank and limb segments in recumbent pedaling would be useful in the development of rehabilitative pedaling exercises. The objectives of this work were to 1) quantify the power contributions of the muscles to driving the crank and limb segments using a forward dynamic simulation of low-power pedaling in the recumbent position, and 2) determine whether there were differences in the muscle power contributions at three different pedaling rates. A forward dynamic model was used to determine the individual muscle excitation amplitude and timing to drive simulations that best replicated experimental kinematics and kinetics of recumbent pedaling. The segment kinematics, pedal reaction forces, and electromyograms (EMG) of 10 muscles of the right leg were recorded from 16 subjects as they pedaled a recumbent ergometer at 40, 50, and 60 rpm and a constant 50 W workrate. Intersegmental joint moments were computed using inverse dynamics and the muscle excitation onset and offset timing were determined from the EMG data. All quantities were averaged across ten cycles for each subject and averaged across subjects. The model-generated kinematic and kinetic quantities tracked almost always within 1 standard deviation (SD) of the experimental data for all three pedaling rates. The uniarticular hip and knee extensors generated 65% of the total mechanical work in recumbent pedaling. The triceps surae muscles transferred power from the limb segments to the crank and the bi-articular muscles that crossed the hip and knee delivered power to the crank during the leg transitions between flexion and extension. The functions of the individual muscles did not change with pedaling rate, but the mechanical energy generated by the knee extensors and hip flexors decreased as pedaling rate increased. By varying the pedaling rate, it is possible to manipulate the individual muscle power contributions to the crank and limb segments in recumbent pedaling and thereby design rehabilitative pedaling exercises to meet specific objectives.  相似文献   

19.
Leg amputations are common in accidents and diseases. The present active bionic legs use Electromyography (EMG) signals in lower limbs (just before the location of the amputation) to generate active control signals. The active con-trol with EMGs greatly limits the potential of using these bionic legs because most accidents and diseases cause se-vere damages to tissues/muscles which originates EMG signals. As an alternative, the present research attempted to use an upper limb swing pattern to control an active bionic leg. A deep neural network (DNN) model is implemented to recognize the patterns in upper limb swing, and it is used to translate these signals into active control input of a bionic leg. The proposed approach can generate a full gait cycle within 1082 milliseconds, and it is comparable to the normal (a person without any disability) 1070 milliseconds gait cycle.  相似文献   

20.
Individuals with a C5/C6 spinal-cord injury (SCI) have paralyzed elbow extensors, yet retain weak to strong voluntary control of elbow flexion and some shoulder movements. They lack elbow extension, which is critical during activities of daily living. This research focuses on the functional evaluation of a developed synergistic controller employing remaining voluntary elbow flexor and shoulder electromyography (EMG) to control elbow extension with functional electrical stimulation (FES). Remaining voluntarily controlled upper extremity muscles were used to train an artificial neural network (ANN) to control stimulation of the paralyzed triceps. Surface EMG was collected from SCI subjects while they produced isometric endpoint force vectors of varying magnitude and direction using triceps stimulation levels predicted by a biomechanical model. ANNs were trained with the collected EMG and stimulation levels. We hypothesized that once trained and implemented in real-time, the synergistic controller would provide several functional benefits. We anticipated the synergistic controller would provide a larger range of endpoint force vectors, the ability to grade and maintain forces, the ability to complete a functional overhead reach task, and use less overall stimulation than a constant stimulation scheme.  相似文献   

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