Abstract:
OBJECTIVES:To explore and quantify the physical and functional effects of stabilizing the torso with electrical stimulation of the paralyzed hip and trunk musculature after motor complete tetraplegia. DESIGN:Single-subject case study with repeated measures and concurrent controls. SETTING:Academic outpatient rehabilitation center. PARTICIPANTS:Forty-four-year-old man with C4 American Spinal Injury Association grade A tetraplegia 20 years postspinal cord injury. INTERVENTION:A surgically implanted multichannel pulse generator and intramuscular stimulating electrodes to activate lumbar erector spinae, quadratus lumborum, and gluteus maximus muscles bilaterally. MAIN OUTCOME MEASURES:Outcomes assessed with and without stimulation included (1) spinal alignment and pelvic orientation, (2) pulmonary function and ventilatory volumes, (3) forward bimanual reaching distance, (4) seated stability and resistance to externally applied disturbances, (5) maximal force and speed of rowing-like movements, and the ability to (6) independently return to an erect seated position from full forward or lateral flexion and (7) roll in bed without assistance. RESULTS:Stimulation improved spinal convexity and kyphosis by 26 degrees and 21 degrees , reduced posterior pelvic tilt by 11 degrees , increased forced expiratory volume and vital capacity by 10% and 22%, and improved forward reach by more than 7cm. Average resistance to sagittal disturbances increased by more than 40% (P<.002), and mean force exerted during underhanded pulling more than doubled (P=.014) with stimulation. Restoration of upright sitting in both sagittal and coronal planes and bed turning was made possible through appropriately timed activation of the hip and trunk muscles. CONCLUSIONS:A neuroprosthesis for controlling the paralyzed torso can positively impact spinal alignment, seated posture, pulmonary function, trunk stability, and reach. Stimulation of hip and trunk muscles can improve performance of activities of daily living as well as enable independent wheelchair and bed mobility.
journal_name
Arch Phys Med Rehabiljournal_title
Archives of physical medicine and rehabilitationauthors
Triolo RJ,Boggs L,Miller ME,Nemunaitis G,Nagy J,Bailey SNdoi
10.1016/j.apmr.2008.07.029subject
Has Abstractpub_date
2009-02-01 00:00:00pages
340-7issue
2eissn
0003-9993issn
1532-821Xpii
S0003-9993(08)01627-4journal_volume
90pub_type
杂志文章abstract:UNLABELLED:This self-directed learning module highlights prosthetic treatment considerations and challenges in children and young adults. It is part of the chapter on acquired limb deficiencies in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,评审
doi:
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of low-intensity laser therapy in the treatment of musculoskeletal low back pain. DESIGN:A double-masked, placebo-controlled, randomized clinical trial. SETTING:A physical medicine and rehabilitation clinic. PARTICIPANTS:Sixty-three ambulatory men and women between the ages of 1...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0003-9993(99)90167-3
更新日期:1999-06-01 00:00:00
abstract::Twelve patients with spinal cord injuries were studied to determine whether the anal sphincter could be used as an index of urethral sphincter activity and to determine the bladder and striated sphincter response to anal and rectal stimulation. Electromyogram (emg) needle electrodes were placed in the external urethra...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1979-06-01 00:00:00
abstract::The purpose of this investigation was to assess the adaptations of middle-aged women and men to a ten-week physical training program. Before and after training on a treadmill maximal oxygen uptake (VO2 max), heart rates and blood lactate were measured. Also, heart rates during submaximal exercise were observed. Additi...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1975-06-01 00:00:00
abstract::The purpose of the study was to evaluate the differences in the amplitudes of the compound muscle action potentials of the hypothenar muscles and the differences in conduction times. Differences in shoot segment responses were determined by stimulating the ulnar nerve at 2-cm intervals across the elbow in 20 normal ad...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1988-11-01 00:00:00
abstract::Three patients with severe traumatic brain injury demonstrated significant improvement in arousal and initiation after administration of tricyclic antidepressants. The first patient showed improved motor and speech initiation in response to amitriptyline following several months of functional plateau. The second patie...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/s0003-9993(96)90225-7
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of isokinetic exercise versus a program of patient education on pain and function in older persons with knee osteoarthritis. DESIGN:A randomized, comparative clinical trial, with interventions lasting 8 weeks and evaluations of 12 weeks. SETTING:An outpatient Veterans Affairs Medical...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0003-9993(99)90032-1
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVES:To review the various causes of urinary incontinence (UI) in elderly patients and to outline a therapeutic approach to the clinical management of UI. DATA SOURCES:Online search of MEDLINE and additional references selected from the articles found during the search. STUDY SELECTION:All peer-reviewed article...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,评审
doi:10.1053/apmr.2001.9392
更新日期:2001-01-01 00:00:00
abstract:UNLABELLED:This self-directed learning module highlights common comorbidities found in people with amputations and their impact on functional outcome. It is part of the study guide on limb deficiency and vascular rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,评审
doi:10.1016/j.apmr.2005.11.025
更新日期:2006-03-01 00:00:00
abstract::For this study of intractable pain after spinal cord injury (SCI), a questionnaire was developed, pilot-tested and mailed to 356 previously hospitalized SCI patients, 200 (56%) of whom returned the completed questionnaire. Of the respondents, 160 (80%) reported abnormal sensation and 96 (48%) called the discomfort pai...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1979-12-01 00:00:00
abstract:OBJECTIVE:To describe in-line skating interests and practices, protective gear usage, and injury patterns in a population-based group of in-line skaters. DESIGN:A two-page questionnaire with multiple choice questions and one write-in response question. PARTICIPANTS:The survey was sent to 1,000 members of an in-line s...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/s0003-9993(97)90309-9
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVES:To model 12-month rehospitalization risk among Medicare beneficiaries receiving inpatient rehabilitation for spinal cord injury (SCI) or traumatic brain injury (TBI) and to create 2 (SCI- and TBI-specific) interactive tools enabling users to generate monthly projected probabilities of rehospitalization on th...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2016.12.012
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To test the effectiveness of the GivMohr sling in reducing subluxation while providing joint compression through a flaccid limb, using the criterion standard of radiography for measuring subluxation. DESIGN:Anteroposterior 0 degree radiographs were taken of each subject: 1 of the unaffected shoulder and 3 of...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.apmr.2005.07.291
更新日期:2005-12-01 00:00:00
abstract::A computer-based version of the rod-and-frame test for verticality perception has been developed. The task tested verticality perception of subjects by using the computer mouse to rotate a bright rod to a vertical orientation within a square frame that was tilted through a range of angles from 30 degrees counterclockw...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2004.05.022
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:To use low- and high-dose adrenocorticotropin (ACTH) tests to assess adrenal reserve in men with spinal cord injury (SCI). DESIGN:After an overnight fast, 1 microg and 200 microg ACTH were injected intravenously at time 0 and 60 minutes between 8 AM and 9 AM. Blood was withdrawn at 30-minute intervals from t...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/s0003-9993(99)90075-8
更新日期:1999-08-01 00:00:00
abstract::To determine effects of severe muscular dystrophy on the performance of dynamic exercise, cardiorespiratory responses to incremental work on a bicycle ergometer and isokinetic limb strength measurements were compared for 13 dystrophic boys and 13 normal, untrained boys. The dystrophic boys (D) were matched to the norm...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1977-05-01 00:00:00
abstract::Two advanced magnetic resonance neuroimaging techniques, functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), have recently made their way into clinically oriented research and hold great promise to study the brain's adaptive changes of function and structure after aphasic stroke, respectiv...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,评审
doi:10.1016/j.apmr.2011.02.023
更新日期:2012-01-01 00:00:00
abstract::Twenty-nine subjects who had been fitted with mobile arm supports 6 months to 11 years prior to the initiation of this study were evaluated to determine criteria for successful use of such supports. All subjects were diagnosed as having Duchenne muscular dystrophy or spinal muscular atrophy. Three methods were used to...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract::Supine and sitting lower extremity cortical somatosensory evoked potential (CSEP) examinations were performed in 30 healthy volunteers to establish normal values and to determine variations in SEP parameters caused by positional changes, side of stimulation, and the influence of height. CSEPs were recorded at Cz'-Fz (...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVE:To determine the impact of aerobic exercise on maximal and submaximal cardiopulmonary responses and predictors of change in individuals with Parkinson's disease (PD). DESIGN:Single-center, parallel-group, rater-blind study. SETTING:Research laboratory PARTICIPANTS: Individual's with mild to moderate PD (N=1...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2020.12.011
更新日期:2021-01-13 00:00:00
abstract::This report presents the first description of direct peripheral nerve compression as a complication of brachial artery-basilic vein vascular access in patients with uremia who are receiving long-term hemodialysis. Three patients are presented. An expanding basilic vein hematoma compressed the radial nerve in one patie...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract:OBJECTIVE:To investigate the effects of a late-phase exercise program for patients who underwent total hip arthroplasty (THA) 4 to 12 months earlier. DESIGN:A single-blind, randomized controlled trial. SETTING:Exercises were performed in subjects' homes. Exercise instruction and measurements taken before and after th...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.apmr.2003.11.022
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:To examine differences in gait and postural stability of obese and nonobese prepubertal boys. DESIGN:Percentage of gait cycle in double support was examined to determine significant differences. Postural stability was compared using temporal and frequency measures of the center of pressure in static stance. ...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1053/mr.2000.3782
更新日期:2000-04-01 00:00:00
abstract:UNLABELLED:This self-directed learning module highlights recent developments in the acute care of stroke patients, prediction of outcome after stroke, evaluation of risk factors, secondary prevention of stroke, and the evaluation of the young adult with stroke. It is part of the study guide on stroke and neurodegenerat...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,评审
doi:10.1053/j.apmr.2003.11.013
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:To examine the validity and clinical utility of functional assessments (1-minute walk test, 10-meter walk test, Timed Up & Go [TUG] test, Timed Up and Down Stairs [TUDS] test, sit-to-stand [STS] test, and lateral step-up [LSU] test). DESIGN:Cross-sectional study. SETTING:Four special schools for adolescents...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,多中心研究
doi:10.1016/j.apmr.2013.10.025
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To validate a novel assessment of inpatient physical activity. DESIGN:Prospective cohort study for the evaluation of a novel questionnaire for physical activity in geriatric inpatients. SETTING:German geriatric inpatient rehabilitation unit. PARTICIPANTS:Patients (N=96; 67 [72%] women; median age, 81y) wit...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2011.06.032
更新日期:2011-12-01 00:00:00
abstract::The purpose of this study was to determine, in ten healthy subjects, the extent of soleus motoneuronal excitability during conditions of increased (transcutaneous electrical nerve stimulation [TENS]), decreased (Xylocaine [lidocaine]a anaesthesia) and normal (placebo anaesthesia) cutaneous inputs. Increased cutaneous ...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 临床试验,杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To examine the physiologic and functional recovery of standing balance and health-related quality of life (HRQOL) in people after mild and moderate stroke. DESIGN:Inception cohort study with evaluations at 1 month and 3 months poststroke. SETTING:Laboratory. PARTICIPANTS:Twenty-nine volunteers who had sust...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2006.11.023
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To determine and describe the demographics and functional outcomes of persons who require inpatient rehabilitation for severe penetrating head injury resulting from a gunshot wound to the head. DESIGN:Data were collected prospectively from the time of admission to acute care through discharge from inpatient ...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1053/apmr.2001.18226
更新日期:2001-03-01 00:00:00
abstract::To evaluate the efficacy and function of EMG feedback (FB) in muscle reeducation, voluntary muscle contractions with and without EMG FB were compared under controlled experimental conditions in normal human subjects (n=10). Each subject was instructed to produce 12 sustained, 30-second contractions of the left abducto...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1982-06-01 00:00:00