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   Brain-controlled functional electrical stimulation therapy for gait rehabilitation after stroke: A safety study  
   
نویسنده mccrimmon c.m. ,king c.e. ,wang p.t. ,cramer s.c. ,nenadic z. ,do a.h.
منبع journal of neuroengineering and rehabilitation - 2015 - دوره : 12 - شماره : 1
چکیده    Background: many stroke survivors have significant long-term gait impairment,often involving foot drop. current physiotherapies provide limited recovery. orthoses substitute for ankle strength,but they provide no lasting therapeutic effect. brain-computer interface (bci)-controlled functional electrical stimulation (fes) is a novel rehabilitative approach that may generate permanent neurological improvements. this study explores the safety and feasibility of a foot-drop-targeted bci-fes physiotherapy in chronic stroke survivors. methods: subjects (n=9) operated an electroencephalogram-based bci-fes system for foot dorsiflexion in 12 one-hour sessions over four weeks. gait speed,dorsiflexion active range of motion (arom),six-minute walk distance (6mwd),and fugl-meyer leg motor (fm-lm) scores were assessed before,during,and after therapy. the primary safety outcome measure was the proportion of subjects that deteriorated in gait speed by ≥0.16 m/s at one week or four weeks post-therapy. the secondary outcome measures were the proportion of subjects that experienced a clinically relevant decrease in dorsiflexion arom (≥2.5˚),6mwd (≥20 %),and fm-lm score (≥10 %) at either post-therapy assessment. results: no subjects (0/9) experienced a clinically significant deterioration in gait speed,dorsiflexion arom,6mwt distance,or fm-lm score at either post-therapy assessment. five subjects demonstrated a detectable increase (≥0.06 m/s) in gait speed,three subjects demonstrated a detectable increase (≥2.5) in dorsiflexion arom,five subjects demonstrated a detectable increase (≥10 %) in 6mwd,and three subjects demonstrated a detectable increase (≥10 %) in fm-lm. five of the six subjects that exhibited a detectable increase in either post-therapy gait speed or 6mwd also exhibited significant (p<0.01 using a mann-whitney u test) increases in electroencephalogram event-related synchronization/desynchronization. additionally,two subjects experienced a clinically important increase (≥0.16 m/s) in gait speed,and four subjects experienced a clinically important increase (≥20 %) in 6mwd. linear mixed models of gait speed,dorsiflexion arom,6mwd,and fm-lm scores suggest that bci-fes therapy is associated with an increase in lower motor performance at a statistically,yet not clinically,significant level. conclusion: bci-fes therapy is safe. if it is shown to improve post-stroke gait function in future studies,it could provide a new gait rehabilitation option for severely impaired patients. formal clinical trials are warranted. © 2015 mccrimmon et al.
کلیدواژه Brain computer interface; Dorsiflexion; EEG; Electrical stimulation; Gait therapy; Stroke recovery
آدرس department of biomedical engineering,university of california,irvine,ca 92697, United States, department of biomedical engineering,university of california,irvine,ca 92697, United States, department of biomedical engineering,university of california,irvine,ca 92697, United States, department of neurology,university of california,irvine,orange,ca 92868,united states,department of anatomy and neurology,university of california,irvine,ca 92697,united states,department of physical medicine and rehabilitation,university of california,irvine,orange,ca 92868, United States, department of biomedical engineering,university of california,irvine,ca 92697,united states,department of electrical engineering and computer science,university of california,irvine,ca 92697, United States, department of neurology,university of california,irvine,orange,ca 92868, United States
 
     
   
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