Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’bala...Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’balance function and gait.Methods:Fifty-two cases of hemiplegic stroke patients were randomly divided into two groups,26 in the control group and 26 in the observation group,using computer-generated random grouping.All participants underwent conventional treatment and rehabilitation training.In addition to these,the control group received repetitive transcranial magnetic pseudo-stimulation therapy+motor control training,while the observation group received repetitive transcranial magnetic stimulation therapy+motor control training.The balance function and gait parameters of both groups were compared before and after the interventions and assessed the satisfaction of the interventions in both groups.Results:Before the invention,there were no significant differences in balance function scores and each gait parameter between the two groups(P>0.05).However,after the intervention,the observation group showed higher balance function scores compared to the control group(P<0.05).The observation group also exhibited higher step speed and step frequency,longer step length,and a higher overall satisfaction level with the intervention compared to the control group(P<0.05).Conclusion:The combination of repetitive transcranial magnetic stimulation and motor control training in the treatment of stroke-induced hemiplegia has demonstrated positive effects.It not only improves the patient’s balance function and gait but also contributes to overall physical rehabilitation.展开更多
Gait recognition is the key question of functional electrical stimulation (FES) system control for paraplegic walking. A new risk-tendency-graph (RTG) method was proposed to recognize the stability information in FES-...Gait recognition is the key question of functional electrical stimulation (FES) system control for paraplegic walking. A new risk-tendency-graph (RTG) method was proposed to recognize the stability information in FES-assisted walking gait. The main instrument was a specialized walker dynamometer system based on a multi-channel strain-gauge bridge network fixed on the walker frame. During walking process, this system collected the reaction forces between patient's upper extremities and walker and converted them into RTG morphologic curves of dynamic gait stability in temporal and spatial domains. To demonstrate the potential usefulness of RTG, preliminary clinical trials were done with paraplegic patients. The gait stability levels of two walking cases with 4- and 12-week FES training from one subject were quantified (0.43 and 0.19) from the results of temporal and spatial RTG. Relevant instable phases in gait cycle and dangerous inclinations of patient's body during walking process were also brought forward. In conclusion, the new RTG method is practical for distinguishing more useful gait stability information for FES system control.展开更多
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
目的分析高频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合任务导向性训练在脑卒中后偏瘫患者中的效果。方法选取佛山市第五人民医院2020年7月—2022年1月的52例脑卒中后偏瘫患者为研究对象,根据随机数字表...目的分析高频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合任务导向性训练在脑卒中后偏瘫患者中的效果。方法选取佛山市第五人民医院2020年7月—2022年1月的52例脑卒中后偏瘫患者为研究对象,根据随机数字表法分为2组,各26例。导向训练组采用务导向性训练,联合组在导向训练组基础上联合高频rTMS治疗。比较2组患者治疗前后上肢运动功能、偏瘫侧肌力以及神经功能情况。结果治疗前,2组患者上肢Fugl-Meyer评估法(Fugl-Meyer assessment,FMA)评分比较,差异无统计意义(P>0.05)。治疗后1、2、4、8、12个月,联合组的FMA评分分别为(43.86±7.13)分、(48.45±8.38)分、(52.45±7.89)分、(54.48±9.22)分、(58.42±10.43)分,高于导向训练组的(38.13±6.87)分、(41.38±7.94)分、(43.25±8.63)分、(46.12±8.21)分、(50.25±9.12)分,组间差异有统计学意义(P<0.05)。治疗前,2组患者医学研究委员会量表(Medical Research Council,MRC)评分比较,差异无统计学意义(P>0.05);治疗后1、2、4、8、12个月,联合组的MRC评分分别为(2.39±0.40)分、(2.76±0.51)分、(3.06±0.52)分、(3.47±0.47)分、(3.94±0.79)分,均高于导向训练组的(2.08±0.34)分、(2.39±0.46)分、(2.67±0.53)分、(3.10±0.49)分、(3.40±0.85)分,组间差异有统计学意义(P<0.05)。治疗前,2组患者美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评分比较,差异无统计意义(P>0.05);治疗后1、2、4、8、12个月,联合组的NIHSS评分分别为(21.06±3.73)分、(19.08±2.41)分、(16.47±2.03)分、(14.24±2.46)分、(13.10±2.34)分,低于导向训练组的(23.45±3.15)分、(21.09±3.56)分、(18.34±2.12)分、(16.84±2.65)分、(15.36±2.05)分,组间差异有统计学意义(P<0.05)。结论高频rTMS联合任务导向性训练应用于脑卒中后偏瘫患者中能有效改善患者偏瘫侧上肢肌力及功能,促进患者神经功能恢复,可为后期高频rTMS联合任务导向性训练在脑卒中后偏瘫患者中的应用提供理论基础。展开更多
文摘Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’balance function and gait.Methods:Fifty-two cases of hemiplegic stroke patients were randomly divided into two groups,26 in the control group and 26 in the observation group,using computer-generated random grouping.All participants underwent conventional treatment and rehabilitation training.In addition to these,the control group received repetitive transcranial magnetic pseudo-stimulation therapy+motor control training,while the observation group received repetitive transcranial magnetic stimulation therapy+motor control training.The balance function and gait parameters of both groups were compared before and after the interventions and assessed the satisfaction of the interventions in both groups.Results:Before the invention,there were no significant differences in balance function scores and each gait parameter between the two groups(P>0.05).However,after the intervention,the observation group showed higher balance function scores compared to the control group(P<0.05).The observation group also exhibited higher step speed and step frequency,longer step length,and a higher overall satisfaction level with the intervention compared to the control group(P<0.05).Conclusion:The combination of repetitive transcranial magnetic stimulation and motor control training in the treatment of stroke-induced hemiplegia has demonstrated positive effects.It not only improves the patient’s balance function and gait but also contributes to overall physical rehabilitation.
基金Supported by National Natural Science Foundation of China (No.60501005)Key Programof Tianjin Science Technology Support Plan(No.2007-68)
文摘Gait recognition is the key question of functional electrical stimulation (FES) system control for paraplegic walking. A new risk-tendency-graph (RTG) method was proposed to recognize the stability information in FES-assisted walking gait. The main instrument was a specialized walker dynamometer system based on a multi-channel strain-gauge bridge network fixed on the walker frame. During walking process, this system collected the reaction forces between patient's upper extremities and walker and converted them into RTG morphologic curves of dynamic gait stability in temporal and spatial domains. To demonstrate the potential usefulness of RTG, preliminary clinical trials were done with paraplegic patients. The gait stability levels of two walking cases with 4- and 12-week FES training from one subject were quantified (0.43 and 0.19) from the results of temporal and spatial RTG. Relevant instable phases in gait cycle and dangerous inclinations of patient's body during walking process were also brought forward. In conclusion, the new RTG method is practical for distinguishing more useful gait stability information for FES system control.
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.
文摘目的分析高频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合任务导向性训练在脑卒中后偏瘫患者中的效果。方法选取佛山市第五人民医院2020年7月—2022年1月的52例脑卒中后偏瘫患者为研究对象,根据随机数字表法分为2组,各26例。导向训练组采用务导向性训练,联合组在导向训练组基础上联合高频rTMS治疗。比较2组患者治疗前后上肢运动功能、偏瘫侧肌力以及神经功能情况。结果治疗前,2组患者上肢Fugl-Meyer评估法(Fugl-Meyer assessment,FMA)评分比较,差异无统计意义(P>0.05)。治疗后1、2、4、8、12个月,联合组的FMA评分分别为(43.86±7.13)分、(48.45±8.38)分、(52.45±7.89)分、(54.48±9.22)分、(58.42±10.43)分,高于导向训练组的(38.13±6.87)分、(41.38±7.94)分、(43.25±8.63)分、(46.12±8.21)分、(50.25±9.12)分,组间差异有统计学意义(P<0.05)。治疗前,2组患者医学研究委员会量表(Medical Research Council,MRC)评分比较,差异无统计学意义(P>0.05);治疗后1、2、4、8、12个月,联合组的MRC评分分别为(2.39±0.40)分、(2.76±0.51)分、(3.06±0.52)分、(3.47±0.47)分、(3.94±0.79)分,均高于导向训练组的(2.08±0.34)分、(2.39±0.46)分、(2.67±0.53)分、(3.10±0.49)分、(3.40±0.85)分,组间差异有统计学意义(P<0.05)。治疗前,2组患者美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评分比较,差异无统计意义(P>0.05);治疗后1、2、4、8、12个月,联合组的NIHSS评分分别为(21.06±3.73)分、(19.08±2.41)分、(16.47±2.03)分、(14.24±2.46)分、(13.10±2.34)分,低于导向训练组的(23.45±3.15)分、(21.09±3.56)分、(18.34±2.12)分、(16.84±2.65)分、(15.36±2.05)分,组间差异有统计学意义(P<0.05)。结论高频rTMS联合任务导向性训练应用于脑卒中后偏瘫患者中能有效改善患者偏瘫侧上肢肌力及功能,促进患者神经功能恢复,可为后期高频rTMS联合任务导向性训练在脑卒中后偏瘫患者中的应用提供理论基础。