Non-invasive, Brain-controlled Functional Electrical Stimulation for Locomotion Rehabilitation in Individuals with Paraplegia
| Autor: | Debora S. F. Campos, Mohamed Bouri, Solaiman Shokur, Ana R. C. Donati, Miguel A. L. Nicolelis, Aurelie Selfslagh, Daniel Boari Coelho, Seidi Y. Yamauti, Sabrina Esteves de Matos Almeida |
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| Předmět: |
Adult
0301 basic medicine medicine.medical_specialty restoration lcsh:Medicine Electric Stimulation Therapy computer interface gait Article 03 medical and health sciences walking recovery Sensorimotor processing 0302 clinical medicine Motor imagery Gait (human) Physical medicine and rehabilitation Gait training chronic stroke Motor control Humans Medicine Functional electrical stimulation skeletal-muscle Author Correction lcsh:Science Spinal cord injury Spinal Cord Injuries Neurorehabilitation Balance (ability) Paraplegia Multidisciplinary business.industry lcsh:R Neurological Rehabilitation Brain medicine.disease Exercise Therapy 030104 developmental biology classification machine interfaces spinal-cord-injury lcsh:Q business Locomotion 030217 neurology & neurosurgery |
| Zdroj: | Scientific Reports Scientific Reports, Vol 9, Iss 1, Pp 1-17 (2019) |
| Popis: | Spinal cord injury (SCI) impairs the flow of sensory and motor signals between the brain and the areas of the body located below the lesion level. Here, we describe a neurorehabilitation setup combining several approaches that were shown to have a positive effect in patients with SCI: gait training by means of non-invasive, surface functional electrical stimulation (sFES) of the lower-limbs, proprioceptive and tactile feedback, balance control through overground walking and cue-based decoding of cortical motor commands using a brain-machine interface (BMI). The central component of this new approach was the development of a novel muscle stimulation paradigm for step generation using 16 sFES channels taking all sub-phases of physiological gait into account. We also developed a new BMI protocol to identify left and right leg motor imagery that was used to trigger an sFES-generated step movement. Our system was tested and validated with two patients with chronic paraplegia. These patients were able to walk safely with 65–70% body weight support, accumulating a total of 4,580 steps with this setup. We observed cardiovascular improvements and less dependency on walking assistance, but also partial neurological recovery in both patients, with substantial rates of motor improvement for one of them. |
| Databáze: | OpenAIRE |
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