Impact of an implanted neuroprosthesis on community ambulation in incomplete SCI
| Autor: | Gilles Pinault, Lisa M. Lombardo, Rudolf Kobetic, Ronald J. Triolo, Kevin M. Foglyano, Stephanie Nogan Bailey, Stephen M. Selkirk |
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| Rok vydání: | 2017 |
| Předmět: |
030506 rehabilitation
medicine.medical_specialty Knee Joint Neuroprosthetics medicine.medical_treatment 0206 medical engineering Electric Stimulation Therapy Stimulation Walking 02 engineering and technology 03 medical and health sciences Physical medicine and rehabilitation Gait training medicine Humans Range of Motion Articular Gait Spinal cord injury Spinal Cord Injuries Research Articles Rehabilitation business.industry Biomechanics Prostheses and Implants Middle Aged medicine.disease 020601 biomedical engineering Preferred walking speed Physical therapy Female Hip Joint Neurology (clinical) 0305 other medical science business human activities |
| Zdroj: | The Journal of Spinal Cord Medicine. 41:165-173 |
| ISSN: | 2045-7723 1079-0268 |
| Popis: | OBJECTIVE: Test the effect of a multi-joint control with implanted electrical stimulation on walking after spinal cord injury (SCI). DESIGN: Single subject research design with repeated measures. SETTING: Hospital-based biomechanics laboratory and user assessment of community use. PARTICIPANTS: Female with C6 AIS C SCI 30 years post injury. INTERVENTIONS: Lower extremity muscle activation with an implanted pulse generator and gait training. OUTCOME MEASURES: Walking speed, maximum distance, oxygen consumption, upper extremity (UE) forces, kinematics and self-assessment of technology. RESULTS: Short distance walking speed at one-year follow up with or without stimulation was not significantly different from baseline. However, average walking speed was significantly faster (0.22 m/s) with stimulation over longer distances than volitional walking (0.12 m/s). In addition, there was a 413% increase in walking distance from 95 m volitionally to 488 m with stimulation while oxygen consumption and maximum upper extremity forces decreased by 22 and 16%, respectively. Stimulation also produced significant (P ≤ 0.001) improvements in peak hip and knee flexion, ankle angle at foot off and at mid-swing. CONCLUSION: An implanted neuroprosthesis enabled a subject with incomplete SCI to walk longer distances with improved hip and knee flexion and ankle dorsiflexion resulting in decreased oxygen consumption and UE support. Further research is required to determine the robustness, generalizability and functional implications of implanted neuroprostheses for community ambulation after incomplete SCI. |
| Databáze: | OpenAIRE |
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