RESUMO
We report three cases of survivors of chronic stroke treated with active repetitive movement training of the paretic ankle dorsiflexors mediated by intramuscular electromyographically controlled neuromuscular electrical stimulation (NMES). These case reports demonstrate the feasibility of using intramuscular electromyographically controlled NMES for facilitating ankle dorsiflexion recovery among survivors chronic stroke with moderate hemiplegia. Relevant issues for clinical implementation and future investigations are reviewed.
Assuntos
Terapia por Estimulação Elétrica/métodos , Eletromiografia , Hemiplegia/reabilitação , Acidente Vascular Cerebral/complicações , Tornozelo , Hemiplegia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
We report three cases of survivors of chronic stroke who were treated with active repetitive movement training of the paretic finger extensors mediated by intramuscular electromyographically controlled neuromuscular electrical stimulation for the purpose of motor relearning. These case reports demonstrate the feasibility of using intramuscular electromyographically controlled neuromuscular electrical stimulation for facilitating the upper limb motor recovery of chronic stroke survivors with mild to moderate hemiplegia.
Assuntos
Terapia por Estimulação Elétrica , Destreza Motora , Reabilitação do Acidente Vascular Cerebral , Adulto , Idoso , Eletromiografia , Estudos de Viabilidade , Feminino , Humanos , Pessoa de Meia-Idade , GravidezRESUMO
A custom designed chip has been developed for the control of paralyzed muscles. The system is capable of fulfilling the stimulus and telemetry needs of advanced functional neuromuscular stimulation (FNS) applications requiring multiple channels of stimulation and multiple channels for sensor or biopotential sensing. An inductive radiofrequency link provides power to the implant device as well as 2 way transcutaneous communication. An application specific integrated circuit (ASIC) decodes the commands and provides functional control within the implant, and modular circuitry provides specific implant functions. The ASIC chip provides up to 32 independent channels of stimulation with independent control of stimulus pulse duration, pulse amplitude, interphase delay, recharge phase duration, and pulse interval. It can also control up to 8 independent back telemetry analog channels with independent control of sampling rate and pulse powering parameters (amplitude and duration). The mixed analog digital chip has been fabricated in 1.2 microm n-well CMOS technology.
Assuntos
Terapia por Estimulação Elétrica/instrumentação , Paralisia/terapia , Próteses e Implantes , Telemetria/instrumentação , Conversão Análogo-Digital , Eletrônica Médica/instrumentação , Eletrofisiologia/instrumentação , Desenho de Equipamento , Humanos , Junção Neuromuscular/fisiologiaRESUMO
An implantable integrated stimulator and telemetry system has been developed. The system is capable of fulfilling the stimulus and telemetry needs of advanced functional neuromuscular stimulation (FNS) applications requiring multiple channels of stimulation and multiple channels of sensor or biopotential sensing. This system provides a command control structure, an inductive radio frequency link providing power to the implant device as well as two-way transcutaneous communication, an ASIC for decoding the command and for providing functional control within the implant, and modular circuitry providing the application specific implant functions. Biocompatible hermetic packaging, lead systems, and in-line connectors suitable for long-term implantation, provide encapsulation for the circuitry and access to the electrodes and sensors used in the application. The first implant configuration realized from this modular system is targeted for clinical implementation in persons with tetraplegia at the C6 level for restoration of hand function, using wrist position as the command control source. The implant device realized has ten channels of stimulation and telemetry used to control and sense a joint angle transducer implanted in the radio-carpal joint of the wrist. A prototype device has been fabricated and is undergoing testing in an animal.
Assuntos
Estimulação Elétrica/instrumentação , Paralisia/reabilitação , Próteses e Implantes , Telemetria , Terapia Assistida por Computador , Algoritmos , Animais , Ossos do Carpo/cirurgia , Cães , Desenho de Equipamento , Processamento de Sinais Assistido por Computador , TransdutoresRESUMO
In the present paper we describe a personal computer interface of a multichannel implantable urinary prosthesis. This system is composed of two main parts: the first one is internal and consists of an implant using a 4-microns CMOS gate array chip controlling a wide variety of waveforms via eight monopolar channels. The second, an external controller featuring a versatile software, a PCB card plugged in a portable microcomputer, and a radiofrequency-coupled technique. This device is used to transmit the power, the data and the synchronization clock to the implant by a simple binary signal modulating a 20 MHz carrier. We also report the features of implant encapsulation and electrode design and fabrication. In the experimental phase, we studied the effect of early electric stimulation of the bladder during the spinal shock phase in the dog. We present the operative techniques that enabled us to perform chronic electrostimulation of the sacral roots and discuss the results.
