کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3448627 1595706 2005 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Effects of Intramuscular Trunk Stimulation on Manual Wheelchair Propulsion Mechanics in 6 Subjects With Spinal Cord Injury
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی و دندانپزشکی (عمومی)
پیش نمایش صفحه اول مقاله
Effects of Intramuscular Trunk Stimulation on Manual Wheelchair Propulsion Mechanics in 6 Subjects With Spinal Cord Injury
چکیده انگلیسی

ObjectiveTo quantify the effects of stabilizing the paralyzed trunk and pelvis with electrical stimulation on manual wheelchair propulsion.DesignSingle-subject design case series with subjects acting as their own concurrent controls.SettingHospital-based clinical biomechanics laboratory.ParticipantsIndividuals (N=6; 4 men, 2 women; mean age ± SD, 46±10.8y) who were long-time users (6.1±3.9y) of implanted neuroprostheses for lower extremity function and had chronic (8.6±2.8y) midcervical- or thoracic-level injuries (C6-T10).InterventionsContinuous low-level stimulation to the hip (gluteus maximus, posterior adductor, or hamstrings) and trunk extensor (lumbar erector spinae and/or quadratus lumborum) muscles with implanted intramuscular electrodes.Main Outcome MeasuresPushrim kinetics (peak resultant force, fraction effective force), kinematics (cadence, stroke length, maximum forward lean), and peak shoulder moment at preferred speed over 10-m level surface; speed, pushrim kinetics, and subjective ratings of effort for level 100-m sprints and up a 30.5-m ramp of approximately 5% grade.ResultsThree of 5 subjects demonstrated reduced peak resultant pushrim forces (P≤.014) and improved efficiency (P≤.048) with stimulation during self-paced level propulsion. Peak sagittal shoulder moment remained unchanged in 3 subjects and increased in 2 others (P<.001). Maximal forward trunk lean also increased by 19% to 26% (P<.001) with stimulation in these 3 subjects. Stroke lengths were unchanged by stimulation in all subjects, and 2 showed extremely small (5%) but statistically significant increases in cadence (P≤.021). Performance measures for sprints and inclines were generally unchanged with stimulation; however, subjects consistently rated propulsion with stimulation to be easier for both surfaces.ConclusionsStabilizing the pelvis and trunk with low levels of continuous electrical stimulation to the lumbar trunk and hip extensors can positively impact the mechanics of manual wheelchair propulsion and reduce both perceived and physical measures of effort.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Archives of Physical Medicine and Rehabilitation - Volume 94, Issue 10, October 2013, Pages 1997–2005
نویسندگان
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