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Fahrradfahren Querschnittgelähmter mittels funktioneller Elektrostimulation

Eine experimentelle und modellbasierte Untersuchung der Leistungsabgabe

Paraplegic cycling using functional electrical stimulation

Experimental and model-based study of power output

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Zusammenfassung

Das durch funktionelle Elektrostimulation (FES) realisierte Fahrradfahren Querschnittgelähmter bietet die Möglichkeit des Muskel- und kardiovaskulären Trainings in Kombination mit einer erhöhten Mobilität im täglichen Leben. Zur Untersuchung der Frage, ob diese Methode einer größeren Gruppe von querschnittgelähmten Patienten zur Verfügung gestellt werden kann, wurde Anfang 2003 an der Neurologischen Klinik der Universität München die erste deutsche Machbarkeitsstudie für Fahrradfahren durch FES mit bisher 7 Patienten gestartet. Diese konnten bereits zu Beginn ohne Training Strecken zwischen 0,5–1,6 km zurücklegen. Um beim FES-Ergometertraining kardiovaskuläre Adaptationsprozesse in Gang zu setzen oder beim FES-Radfahren alltagstaugliche Fahrstrecken bewältigen zu können, muss ein Mindestmaß an Leistung abgegeben werden, eine derzeit im Regelfall noch nicht erfüllbare Forderung. In der vorgelegten Arbeit wurden zwei der Ursachen, die die Leistungsabgabe beeinträchtigen—anhaltender Höchstleistungsbetrieb und viskose Gelenkreibung—, genauer analysiert und mögliche Ansatzpunkte zur Erhöhung der Ausgangsleistung und der Ausdauerzeit diskutiert.

Abstract

Cycling using functional electrical stimulation offers paraplegics the possibility of muscle and cardiovascular training as well as the chance for independent locomotion. To investigate whether this method might be suitable for a large group of paraplegics, the first German feasibility study of functional electrical stimulation (FES) cycling with seven paraplegic patients was started at the beginning of 2003. Even at the beginning of the study, and without training, these patients were able to drive distances of 0.5–1.6 km. To stimulate cardiovascular adaptation processes in the case of FES ergometer training or to cover useful distances in the case of FES cycling, a minimum amount of generated mechanical output power is required, which as a rule cannot be achieved yet. In this study, we point out two particular aspects of FES cycling, which impair power output: prolonged fatigue mode and viscous joint friction of the paraplegic FES cyclist. We discuss current possibilities for increasing output power and endurance.

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Danksagung

Wir danken der Deutschen Forschungsgemeinschaft (SFB 462) für die Unterstützung des Projektes „Vom Laborsystem zur klinisch angewandten, geregelten Neuroprothese: Sensorik, Mensch-Maschine-Schnittstelle; Anwendungsstudie“, in dessen Rahmen Teile der vorliegenden Studie durchgeführt werden konnten.

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Authors and Affiliations

  1. Neurologische Klinik der Universität München, Standort Großhadern

    J. Szecsi, S. Krafczyk, J. Quintern, M. Fiegel, A. Straube & T. Brandt

  2. Neurologische Klinik, Klinikum Großhadern, Marchioninistraße 23, 81377, München, Deutschland

    J. Szecsi

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  1. J. Szecsi
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  2. S. Krafczyk
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  3. J. Quintern
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  4. M. Fiegel
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  5. A. Straube
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  6. T. Brandt
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Correspondence to J. Szecsi.

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Szecsi, J., Krafczyk, S., Quintern, J. et al. Fahrradfahren Querschnittgelähmter mittels funktioneller Elektrostimulation . Nervenarzt 75, 1209–1216 (2004). https://doi.org/10.1007/s00115-004-1802-8

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  • DOI: https://doi.org/10.1007/s00115-004-1802-8

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