Živčno-mišična elektrostimulacija kot orodje v nevroprotetiki in rehabilitaciji giba

Stonič, Erazem (author), Belušič, Gregor (mentor)

Funkcionalna električna stimulacija (FES) je gibalno-terapevtska metoda, ki temelji na umetno izzvani aktivaciji motoričnih enot. Z ustreznim režimom draženja lahko obnovimo ali predrugačimo nativno funkcionalnost mišice v procesu, imenovanem reedukacija. Poleg prehodnih modifikacij lahko dosežemo tudi trajnejše fiziološke spremembe, tako v mišičnih vlaknih, kot tudi v nevronih, do stopnje, ki redefinira tipsko sliko vlaken. Klasična transkutana stimulacija mišice povzroči naključen režim rekrutacije vlaken, rezultat česar je hitrejše utrujanje. S posredno aktivacijo prek živca, bodisi transkutano, bodisi z bolj invazivnimi metodami, kot so denimo predaktivacijsko pulziranje, uporaba elektrodnega niza in prostorsko razpršene intramuskularne elektrode, pa že lahko dosežemo tudi postopno rekrutacijo vlaken. Poleg signaliziranja po ventralni veji živca izkoriščamo tudi aferentno signalizacijo, s čimer v stimulacijski sistem vključimo centralni živčni sistem, ki tako postane predmet nevromodulacijskih sprememb. Korenitost posega v delovanje lokomotornega aparata, dosegljiva s FES, odpira vrsto priložnosti v športu. Z ustrezno intervencijo se poveča učinkovitost vadbe, modifikacija tipske strukture vlaken pa maksimira potencial gibalnega aparata za dotično obremenitev. V fizioterapiji električna stimulacija z novimi tarčnimi pristopi omogoča izolirano rehabilitacijo mišičnih skupin, ki zaradi tesne sklopitve v mišično verigo otežujejo reedukacijo s klasičnimi terapevtskimi metodami.

• Language: Slovenian
• Keywords: funkcionalna električna stimulacija, motorična enota, živčno-mišična fiziologija, nevromodulacija
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: BF - Biotechnical Faculty
• Year: 2023
• PID: 20.500.12556/RUL-149770
• COBISS.SI-ID: 164390147
• Publication date in RUL: 10.09.2023

Secondary language

• Language: English
• Title: Neuromuscular electrostimulation as a tool in neuroprosthetics and movement rehabilitation

Abstract

Functional Electrical Stimulation (FES) is a movement therapy method based on artificially induced activation of motor units. With an appropriate pulsation regimen we can restore as well as modify the native functionality of muscles via the reeducation process. In addition to transient modifications more lasting physiological changes are also achievable in both muscle fibers and neurons up to a degree that redefines the fiber type profile. Classical transcutaneous muscle stimulation results in a random regimen of fiber activation leading to a quicker fatigue. Through indirect activation via nerves either transcutaneously or through more invasive methods such as pre-activation pulsation, the use of electrode arrays as well as spatially dispersed intramuscular electrodes a gradual recruitation of fibers becomes feasible. In addition to signaling via the ventral branch, it is possible to exploit afferent signaling as well, thereby incorporating the central nervous system into the stimulation system and thus making it the subject of neuromodulatory changes. The significance of intervention in the function of the locomotor apparatus achievable through FES opens up a range of opportunities in sports. Proper intervention enhances training efficiency, while modification of the fiber type structure maximizes the potential of the musculoskeletal system for the given load. In the field of physiotherapy electrical stimulation with its novel targeting approaches allows for isolated rehabilitation of muscle groups that due to their tight integration in the muscle chain make reeducation especially challenging with classical therapeutic methods.

• Keywords: functional electrical stimulation, motor unit, neuromuscular physiology, neuromodulation