RESUMO
Functional electrical stimulation (FES) has been described as electrical stimulation of muscle deprived of nervous control with a view to providing muscular contraction and producing a functionally useful movement. It is used in the rehabilitation of neurological and locomotor disorders. Its effects can be explained in a number of ways: (a) as a functional reorganization of the interneuron system, (b) the formation of alternative pathways, and (c) changes in the morphology of cells of the central nervous system. The results of research and development are presented.
Assuntos
Terapia por Estimulação Elétrica/instrumentação , Paralisia/reabilitação , Feminino , Hemiplegia/reabilitação , Humanos , Locomoção , Masculino , Atividade Motora/fisiologia , Movimento , Contração Muscular , IugosláviaRESUMO
In patient with damaged upper motor neurones we show the therapeutic effect of electrical stimulation (called FES) of peripheral mixed nerves on the restoration of motor activity and movements. The results of neurophysiological, kinesiological and clinical observations are presented. We discuss the possible mechanisms, especially the spinal ones, which are fundamental for such a rhythmic activity as gait. We discuss them also from the point of view of activation of proprioceptive feedback mechanisms and of achieved sensory reinforcement influencing the spinal reflex mechanisms as well as the preserved supraspinal integrated activity which contributes to the long-term FES effect. The stimulation modes, the control of stimuli in relation to the needs of individual patients (hemiplegia in adults, paraparesis, cerebral palsy in children and multiple sclerosis) as well as the motor deficit are discussed. We conclude that the electronic system used for this purpose represents a functionally active orthotic aid with therapeutic effects.
Assuntos
Terapia por Estimulação Elétrica , Hemiplegia/terapia , Movimento , Contração Muscular , Adolescente , Adulto , Vias Aferentes/fisiopatologia , Idoso , Braço/fisiopatologia , Criança , Pré-Escolar , Vias Eferentes/fisiopatologia , Feminino , Marcha , Humanos , Lactente , Perna (Membro)/fisiopatologia , Masculino , Pessoa de Meia-Idade , Espasticidade Muscular , Nervo Fibular/fisiopatologia , Transmissão SinápticaRESUMO
Functional electrical stimulation (FES) is used in control of motor activity and movements in patients suffering movement handicaps due to central nervous system damage. The method is analyzed from the viewpoint of physical medicine, biocybernetics and technological development. Systems developed to date are presented and a critical survey of the method in light of indications is provided. Special attention is devoted to the present applicability of the systems of FES and to their potential use.
Assuntos
Terapia por Estimulação Elétrica , Transtornos dos Movimentos/reabilitação , Paralisia/reabilitação , Adulto , Paralisia Cerebral/reabilitação , Pré-Escolar , Terapia por Estimulação Elétrica/instrumentação , Terapia por Estimulação Elétrica/métodos , Hemiplegia/reabilitação , HumanosRESUMO
The degree of pain reported by ten volunteers upon electrical stimulation of their peroneal nerves was measured while stimulus parameters were varied. The responses were compared for stimulations, all of which produced the same amount of ankle torque. The stimulation parameters examined were pulse duration, 0.3 and 1.0 msec; repetition frequence, 20, 50 and 100 hertz; pulse shape, square wave and exponential wave; impedance of stimulator output, constant voltage and constant current; direct current bias, positive or negative to the stimulus; and wave phase, uniphasic and biphasic. Pulse duration of 0.3 msec and constant voltage output were the only two parameters significantly associated with minimum pain response. Analysis of voltage and current wave forms for the different stimulus parameters indicated that the sensation of pain was dependent upon the total amount of electrical charge delivered to the tissue with the pulse.
