[Rehabilitation treatment of patients with children cerebral palsy using functional muscle electrostimulation during gait].

A technique for investigation of biomechanical and electromyographic parameters of gait in patients with diplegic form of children cerebral palsy (CCP) was described. Peculiarities of biomechanical and innervation structure of locomotor act in such patients were found. Recommendations for muscle electrostimulation during gait were specified. The best therapeutic effect was achieved in the combined four-channel electrostimulation of gluteus maximus muscles in the first half of support phase and of anterior tibial muscles in the end of the support phase and during the transfer phase. The muscle electrostimulation during gait demonstrated a positive effect of the treatment on the process of movement rehabilitation of CCP patients with diplegic form.

Functional electrostimulation of muscles as a method for restoring motor functions.

The main functions of a method of functional electrical stimulation of muscles (FES) are described: diagnostic, prognostic, and therapeutic. The main indication for using the FES method is a deficiency of muscle function, which may be organic (due to lesions to neuromuscular structures) or functional (associated with relaxation of the muscular apparatus). The five most significant functions of the FES method were established: 1) identification of correctable movements and stimulable muscles; 2) identification of the amplitude and time program for stimulation; 3) stimulation regimes for pathological gaits; 4) stimulation parameters; 5) positioning of skin electrodes on the human body. Using the example of two severe central nervous system pathologies (spinal cord lesions in the lumbosacral area and hemiparesis of cerebral origin), the positive effects of FES on the process of motor rehabilitation of this category of patients were demonstrated.

[Functional myoelectrostimulation as a method for motor functions rehabilitation]. / Funktsiona'naia élektrostimuliatsiia myshts kak metod vosstanovleniia dvigatel'nykh funktsii.

The main features, namely diagnostic, prognostic, therapeutic, of functional myoelectrostimulation (FMES) method are described. FMES is primarily indicated in muscle function deficit, which can be organic (neuromuscle disorders) and functional (muscle relaxation). Five most essential FMES operations include: (1) choice of correctable movements and stimulated muscles; determination of (2) amplitude and temporal stimulation programs; (3) stimulation regimes in pathological gait; (4) stimulation parameters; (5) localization of the skin electrodes on the body. A positive influence of FMES on the process of movement rehabilitation was demonstrated in 2 cases of severe central nervous system pathologies--the consequences of the spinal cord lesion in sacral-lumbar area and hemiparesis of cerebral genesis.

[Physiological reasoning and results of using the functional electrostimulation of muscles in pathological walking]. / Fiziologicheskie obosnovaniia i rezul'taty primeneniia funktsional'noi élektrostimuliatsii pri patologicheskoi khod'be.

The ideology of a method of muscle electrostimulation (MES) in walking up and down the stairs is under discussion in the paper. It is pointed out that the above locomotor acts, which are based on the central innervation program, are principally similar; periods and zones of muscle excitation and inhibition during the locomotor cycle are specified; MES is shown to be a variety of phase muscle electrostimulation. A hypothesis is put forward on the MES significance in normalizing the locomotor skills. The main MES function are described, i.e. therapy, diagnostics and prognostication. The key indication for MES administration in pathological walking is defined, i.e. a deficit of the muscle function (DMF). A new method is suggested for DMF determination through examining the muscle-force moments estimated by mathematic modeling. The MES technique is shown to comprise 5 main stages: choice of corrected movements and muscle stimulation as well as setting-up of the amplitude and temporal MES parameters, of electrode parameters and of a stimulation regime in walking. Medical contraindications to MES stages of patients' rehabilitation are defined. The results of a successful treatment of above 6000 patients with different pathological conditions of the support-motor apparatus are summarized.

[Biomechanical and physiological substantiation for application of functional muscle electrostimulation in performing rhythmic movements on bicycle ergometer]. / Biomekhanicheskoe i fiziologicheskoe obosnovanie primeneniia funktsional'noi élektrostimuliatzii myshts pri vypolnenii ritmicheskikh dvizhenii na veloérgometre.

Kinematic and electromyographic parameters in conduction of rhythmic movements on the bicycle ergometer were studied in a group of healthy subjects. It is shown that these movements are characterized by a stable biomechanical and innervation stereotype consisting of two interacting synergies: flexor and extensor. Force extensor synergy plays the key role which provides both triggering and maintenance of certain rhythm of rotation. Flexor synergy is primarily corrective. Basing on the data obtained, stimulated muscles are selected in basic phases of the cycle, algorithms of time and amplitude programs of muscle electrostimulation in conduction of bicycle ergometry are proposed.

[Method and construction of programmed electric muscle stimulation in gait disorders]. / Metod i ustroistva programmiruemoi élektrostimuliatsii myshts pri patologicheskoi khod'be.

The Research Institute of Prosthesis and Prosthesis Making, Moscow, has developed a method for artificial movement correction (AMC) and designed a programmable muscle electrostimulation device (PMED) for its application. The essence of the AMC method is that to use a multichannel PMED in a good agreement with the natural programme of muscle excitation and contraction in the locomotor cycle. Due to this, many days' training enhances the viability of muscles, corrects movements, and gives rise to near-normal gait. The AMC method was used to design stationary and portable electro-stimulators synchronized with step phases wherein muscles function. Among other things, an 8-channel movement correcting apparatus controlled from a personal computer, which is adjustable to the walking rate has been designed. The AMC method has shown a high therapeutical effect in over 4500 neurological and orthopedic patients.

[Device for correcting elements of human walking by electric stimulation of muscles of the lower extremities]. / Ustroistvo korrektsii élementov khod'by cheloveka posredstvom élektrostimuliatsii myshts nizhnikh konechnostei.

In recent years electric stimulation of the lower limbs muscles in man while walking, particularly for cases of infantile cerebral paralysis, has found wide application. The device implementing correction of the pace components in walking must be carried directly by man. Therefore, it should be of a minature size, light weight, cheap and contain an autonomic power source. The skeleton diagram and basic technical characteristics of the device's set-up are presented.