Voluntary participation of hemiplegic patients is crucial for functional electrical stimulation therapy.A wearable functional electrical stimulation system has been proposed for real-time volitional hand motor functio...Voluntary participation of hemiplegic patients is crucial for functional electrical stimulation therapy.A wearable functional electrical stimulation system has been proposed for real-time volitional hand motor function control using the electromyography bridge method.Through a series of novel design concepts,including the integration of a detecting circuit and an analog-to-digital converter,a miniaturized functional electrical stimulation circuit technique,a low-power super-regeneration chip for wireless receiving,and two wearable armbands,a prototype system has been established with reduced size,power,and overall cost.Based on wrist joint torque reproduction and classification experiments performed on six healthy subjects,the optimized surface electromyography thresholds and trained logistic regression classifier parameters were statistically chosen to establish wrist and hand motion control with high accuracy.Test results showed that wrist flexion/extension,hand grasp,and finger extension could be reproduced with high accuracy and low latency.This system can build a bridge of information transmission between healthy limbs and paralyzed limbs,effectively improve voluntary participation of hemiplegic patients,and elevate efficiency of rehabilitation training.展开更多
Background:Post-stroke dysphagia is one of the common clinical symptoms in the rehabilitation department of primary hospitals,which seriously affects the quality of life of patients and their families.Majority of medi...Background:Post-stroke dysphagia is one of the common clinical symptoms in the rehabilitation department of primary hospitals,which seriously affects the quality of life of patients and their families.Majority of medical workers have comprehensively studied post-stroke dysphagia as it easily induces inhalation pneumonia,asphyxia,and many other complications.At present,many methods for post-stroke dysphagia have been proved to be effective.With regard to comprehensive treatment effect,patient compliance,technology promotion difficulty,grassroots hospital operability,and other factors,we found that acupoint injection combined with nerve electrical stimulation is a good method worthy of promotion.Methods:A total of 130 patients with dysphagia after stroke were randomly divided into nerve electrical stimulation group(n=41),acupoint injection group(n=40),and comprehensive treatment group(nerve electrical stimulation plus acupoint injection,n=49).The therapeutic effect in each group was evaluated before treatment and 20 days after treatment using the improved water swallow test,video fluoroscopic swallowing study,and standardized swallowing assessment.Results:After 20 days of treatment,significant differences were noted in each group.The scores of improved water swallow test decreased from 4.10±0.74 to 2.12±0.95 in the nerve electrical stimulation group,4.00±0.78 to 2.28±1.04 in the acupoint injection group,and 4.16±0.77 to 1.73±0.79 in the comprehensive treatment group;video fluoroscopic swallowing study scores increased from 3.71±2.16 to 5.05±2.111 in the nerve electrical stimulation group,3.80±1.94 to 5.20±1.942 in the acupoint injection group,and 3.73±2.22 to 6.24±2.21 in the comprehensive treatment group;and standardized swallowing assessment scores of the three groups also decreased from 35.13±3.38 to 28.17±3.42,34.66±3.46,and 34.48±3.26 to 26.39±3.86,respectively.The overall scores of each group after treatment were significantly different from those before treatment(P<0.05),indicating that both nerve electrical stimulation and acupoint injection were effective for post-stroke dysphagia;the scores of nerve electrical stimulation group and acupoint injection group were similar,but those of the comprehensive treatment group were significantly better than the single treatments(P<0.05).It shows that the two treatment methods have synergistic effect,and combined treatments have more benefits.Conclusion:Nerve electrical stimulation and acupoint injection have a synergistic therapeutic effect on post-stroke dysphagia.The combined treatment is more beneficial to patients with post-stroke dysphagia than the single treatments.展开更多
Objective To seek a better therapy for treating post-stroke dysphagia. Methods Patients with stroke and swallowing disorders were randomly divided into ordinary acupuncture group （group A, 58 cases） and swallowing n...Objective To seek a better therapy for treating post-stroke dysphagia. Methods Patients with stroke and swallowing disorders were randomly divided into ordinary acupuncture group （group A, 58 cases） and swallowing neuromuscular electrical stimulation combined with acupuncture group （group B, 62 cases）. Two-group patients were given the same basic internal medical treatment. In addition, group A was given normal acupuncture treatment with the choice of local points： Junjin （金津 EX-HN 12）, Yuye（玉液 EX-HN 23）, Fengchi （风池 GB 20）, Yifeng （翳风 TE 17）, Lianquan （廉泉 CV 23）, Wangu （完骨 GB 12）. Group B was given swallowing neuromuscular electrical stimulation combined with acupuncture： GB 20, Fengfu （风夜 GV 16）, TE 17, Yiming （翳明 EX-HN 14）, Yamen （哑门 GV 15）, Tianrong（天容 SI 17）, Tianchuang （天窗 SI 16）, CV 23, the uniform reinforcing-reducing manipulation was used; EX- HN 12, EX-HN 13, the piercing and blood-letting method （1-2 mL blood） was used; at the same time, the swallowing neuromuscular electrical stimulation therapy device was used to electrically stimulate the nerves and muscles in the throat and neck at specific output pulse current （50-100 Hz）. Treatment was made twice a day, 30 minutes each time. Two weeks after the treatment, the patients were assessed in symptoms improvement and clinical efficacy. Results The total effective rate in group B was 91.4% and 75.8% in group A; in the total efficiency comparison in both groups, χ^2=5.232, P〈0.05. The difference in improvement of symptoms with post-stroke dysphagia treated with above mentioned combination treatment was statistically significant between both groups （P〈0.05）. Conclusion The above mentioned swallowing neuromuscular electrical stimulation combined with acupuncture treatment has a better clinical effect when compared with ordinary acupuncture.展开更多
目的探讨下颏抗阻力训练(chin tuck against resistance,CTAR)联合吞咽低频电刺激治疗脑卒中(cerebral stroke,CS)后吞咽障碍(dysphagia after actue stroke,DAS)患者的疗效。方法采用配对病例对照研究法选取虞城县人民医院康复科2021年...目的探讨下颏抗阻力训练(chin tuck against resistance,CTAR)联合吞咽低频电刺激治疗脑卒中(cerebral stroke,CS)后吞咽障碍(dysphagia after actue stroke,DAS)患者的疗效。方法采用配对病例对照研究法选取虞城县人民医院康复科2021年1月至2023年9月收治的84例CS后DAS患者进行回顾性研究,按治疗方案不同分为参照组(n=42)、研究组(n=42)。其中采用吞咽低频电刺激治疗的患者设为参照组,采用CTAR联合吞咽低频电刺激治疗的患者设为研究组。比较两组治疗前、治疗4周后吞咽功能障碍分级情况、标准吞咽功能评定量表(SSA)评分、功能性经口舌摄食量表(FOIS)评分、舌骨喉活动度、表面肌电图、吞咽障碍特异性生命质量量表(SWAL-QOL)评分。结果研究组治疗4周后吞咽功能障碍改善情况优于参照组(P<0.05);研究组治疗4周后SSA评分为(24.18±2.12)分,低于参照组(28.79±3.77)分,FOIS评分为(5.68±0.45)分,高于参照组(4.63±0.51)分(P<0.05);研究组治疗4周后舌骨前移、上移活动度分别为(11.47±2.55)mm、(17.38±4.59)mm,高于参照组(8.25±1.06)mm、(14.03±4.56)mm(P<0.05);研究组治疗4周后最大波幅为(725.38±55.02)V,高于参照组(605.98±49.65)V,吞咽时程为(1.11±0.15)s,短于参照组(1.33±0.21)s(P<0.05);研究组治疗4周后SWAL-QOL评分为(125.32±15.32)分,高于参照组(102.54±14.25)分(P<0.05)。结论CTAR联合吞咽低频电刺激治疗CS后DAS患者可有效提高舌骨喉活动度,改善吞咽、摄食功能,促进生活质量提升。展开更多
基金supported by the National Natural Science Foundation of China,No.90307013,90707005,61534003the Science&Technology Pillar Program of Jiangsu Province in China,No.BE2013706
文摘Voluntary participation of hemiplegic patients is crucial for functional electrical stimulation therapy.A wearable functional electrical stimulation system has been proposed for real-time volitional hand motor function control using the electromyography bridge method.Through a series of novel design concepts,including the integration of a detecting circuit and an analog-to-digital converter,a miniaturized functional electrical stimulation circuit technique,a low-power super-regeneration chip for wireless receiving,and two wearable armbands,a prototype system has been established with reduced size,power,and overall cost.Based on wrist joint torque reproduction and classification experiments performed on six healthy subjects,the optimized surface electromyography thresholds and trained logistic regression classifier parameters were statistically chosen to establish wrist and hand motion control with high accuracy.Test results showed that wrist flexion/extension,hand grasp,and finger extension could be reproduced with high accuracy and low latency.This system can build a bridge of information transmission between healthy limbs and paralyzed limbs,effectively improve voluntary participation of hemiplegic patients,and elevate efficiency of rehabilitation training.
基金This work was supported by the Jiangsu Provincial Administration of Traditional Chinese Medicine(No.YB201840).
文摘Background:Post-stroke dysphagia is one of the common clinical symptoms in the rehabilitation department of primary hospitals,which seriously affects the quality of life of patients and their families.Majority of medical workers have comprehensively studied post-stroke dysphagia as it easily induces inhalation pneumonia,asphyxia,and many other complications.At present,many methods for post-stroke dysphagia have been proved to be effective.With regard to comprehensive treatment effect,patient compliance,technology promotion difficulty,grassroots hospital operability,and other factors,we found that acupoint injection combined with nerve electrical stimulation is a good method worthy of promotion.Methods:A total of 130 patients with dysphagia after stroke were randomly divided into nerve electrical stimulation group(n=41),acupoint injection group(n=40),and comprehensive treatment group(nerve electrical stimulation plus acupoint injection,n=49).The therapeutic effect in each group was evaluated before treatment and 20 days after treatment using the improved water swallow test,video fluoroscopic swallowing study,and standardized swallowing assessment.Results:After 20 days of treatment,significant differences were noted in each group.The scores of improved water swallow test decreased from 4.10±0.74 to 2.12±0.95 in the nerve electrical stimulation group,4.00±0.78 to 2.28±1.04 in the acupoint injection group,and 4.16±0.77 to 1.73±0.79 in the comprehensive treatment group;video fluoroscopic swallowing study scores increased from 3.71±2.16 to 5.05±2.111 in the nerve electrical stimulation group,3.80±1.94 to 5.20±1.942 in the acupoint injection group,and 3.73±2.22 to 6.24±2.21 in the comprehensive treatment group;and standardized swallowing assessment scores of the three groups also decreased from 35.13±3.38 to 28.17±3.42,34.66±3.46,and 34.48±3.26 to 26.39±3.86,respectively.The overall scores of each group after treatment were significantly different from those before treatment(P<0.05),indicating that both nerve electrical stimulation and acupoint injection were effective for post-stroke dysphagia;the scores of nerve electrical stimulation group and acupoint injection group were similar,but those of the comprehensive treatment group were significantly better than the single treatments(P<0.05).It shows that the two treatment methods have synergistic effect,and combined treatments have more benefits.Conclusion:Nerve electrical stimulation and acupoint injection have a synergistic therapeutic effect on post-stroke dysphagia.The combined treatment is more beneficial to patients with post-stroke dysphagia than the single treatments.
文摘Objective To seek a better therapy for treating post-stroke dysphagia. Methods Patients with stroke and swallowing disorders were randomly divided into ordinary acupuncture group （group A, 58 cases） and swallowing neuromuscular electrical stimulation combined with acupuncture group （group B, 62 cases）. Two-group patients were given the same basic internal medical treatment. In addition, group A was given normal acupuncture treatment with the choice of local points： Junjin （金津 EX-HN 12）, Yuye（玉液 EX-HN 23）, Fengchi （风池 GB 20）, Yifeng （翳风 TE 17）, Lianquan （廉泉 CV 23）, Wangu （完骨 GB 12）. Group B was given swallowing neuromuscular electrical stimulation combined with acupuncture： GB 20, Fengfu （风夜 GV 16）, TE 17, Yiming （翳明 EX-HN 14）, Yamen （哑门 GV 15）, Tianrong（天容 SI 17）, Tianchuang （天窗 SI 16）, CV 23, the uniform reinforcing-reducing manipulation was used; EX- HN 12, EX-HN 13, the piercing and blood-letting method （1-2 mL blood） was used; at the same time, the swallowing neuromuscular electrical stimulation therapy device was used to electrically stimulate the nerves and muscles in the throat and neck at specific output pulse current （50-100 Hz）. Treatment was made twice a day, 30 minutes each time. Two weeks after the treatment, the patients were assessed in symptoms improvement and clinical efficacy. Results The total effective rate in group B was 91.4% and 75.8% in group A; in the total efficiency comparison in both groups, χ^2=5.232, P〈0.05. The difference in improvement of symptoms with post-stroke dysphagia treated with above mentioned combination treatment was statistically significant between both groups （P〈0.05）. Conclusion The above mentioned swallowing neuromuscular electrical stimulation combined with acupuncture treatment has a better clinical effect when compared with ordinary acupuncture.
文摘目的探讨下颏抗阻力训练(chin tuck against resistance,CTAR)联合吞咽低频电刺激治疗脑卒中(cerebral stroke,CS)后吞咽障碍(dysphagia after actue stroke,DAS)患者的疗效。方法采用配对病例对照研究法选取虞城县人民医院康复科2021年1月至2023年9月收治的84例CS后DAS患者进行回顾性研究,按治疗方案不同分为参照组(n=42)、研究组(n=42)。其中采用吞咽低频电刺激治疗的患者设为参照组,采用CTAR联合吞咽低频电刺激治疗的患者设为研究组。比较两组治疗前、治疗4周后吞咽功能障碍分级情况、标准吞咽功能评定量表(SSA)评分、功能性经口舌摄食量表(FOIS)评分、舌骨喉活动度、表面肌电图、吞咽障碍特异性生命质量量表(SWAL-QOL)评分。结果研究组治疗4周后吞咽功能障碍改善情况优于参照组(P<0.05);研究组治疗4周后SSA评分为(24.18±2.12)分,低于参照组(28.79±3.77)分,FOIS评分为(5.68±0.45)分,高于参照组(4.63±0.51)分(P<0.05);研究组治疗4周后舌骨前移、上移活动度分别为(11.47±2.55)mm、(17.38±4.59)mm,高于参照组(8.25±1.06)mm、(14.03±4.56)mm(P<0.05);研究组治疗4周后最大波幅为(725.38±55.02)V,高于参照组(605.98±49.65)V,吞咽时程为(1.11±0.15)s,短于参照组(1.33±0.21)s(P<0.05);研究组治疗4周后SWAL-QOL评分为(125.32±15.32)分,高于参照组(102.54±14.25)分(P<0.05)。结论CTAR联合吞咽低频电刺激治疗CS后DAS患者可有效提高舌骨喉活动度,改善吞咽、摄食功能,促进生活质量提升。
