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Il lavoro di tesi si è focalizzato sullo studio dell’arousal come indice psicofisiologico di attivazione e sull’applicazione della metodica di stimolazione elettrica transcranica (tES) non invasiva con lo scopo di modulare tale indice. L’obiettivo è stato quello di indagare se, applicando la tES, fosse possibile migliorare la performance di soggetti giovani sani in compiti di tipo cognitivo. Il progetto di ricerca si è sviluppato in 2 studi principali per un totale di 4 esperimenti. Tali studi hanno previsto l’acquisizione e la successiva analisi sia di dati comportamentali (tempi di reazione, accuratezza), che di indici psicofisiologici (conduttanza cutanea, diametro pupillare). I risultati hanno evidenziato che è possibile modulare l’arousal con dei “bursts” di stimolazione elettrica transcranica, somministrati in concomitanza di stimoli salienti per il soggetto. Tale modulazione si è manifestata con una riduzione dei tempi di reazione ed un contemporaneo aumento della risposta di conduttanza cutanea. Questi dati supportano la possibilità di utilizzare questo protocollo in pazienti con difficoltà di attenzione o altri problemi cognitivi per aumentare l’efficacia di interventi di riabilitazione. / The thesis analyzed the role of the arousal as a psychophysiological index of activation, and the application of non-invasive transcranial electrical stimulation (tES) technique with the aim to modulate this index. In this work we investigated if the application of tES could increase the performance of healthy young subjects during cognitive tasks. The thesis is based on 2 main studies for a total of 4 experiments with the recording of behavioural (reaction times, accuracy) and psychophysiological (skin conductance, pupil diameter) indeces. The results showed that it is possible to modulate arousal with bursts of tES, administered during the presentation of salient stimuli for the subject. This modulation resulted in a reduction of reaction times and an increase of the skin conductance response. These data support the possibility to use this protocol of stimulation with patients with attentional and other cognitive deficits in a rehabilitative context.

Objectifs: Hepatocyte Growth Factor (HGF) améliore la régénération axonale et la survie des motoneurones lors du développement embryonnaire. Son rôle dans la régénération des nerfs périphériques lésés chez l’adulte n’a pas encore été étudié. Notre objectif est de déterminer l’expression de HGF dans la moelle épinière murine suite à une axotomie, avec ou sans stimulation électrique, directe ou transcutanée. Méthodes: Soixante souris C57BL/6 adultes ont été divisées en 5 groupes : Contrôle (n=12), Placebo (n=12), Axotomie (n=12, lacération et réparation immédiate du nerf sciatique), Directe (n=12, lacération, réparation immédiate et stimulation électrique directe proximale du nerf sciatique, 1h, 20 Hz) et Transcutanée (n=12, lacération, réparation immédiate et stimulation électrique transcutanée proximale du nerf sciatique, 1h, 20 Hz). Les moelles épinières ont été recueillies 1, 3, 7 et 14 jours suivant l’intervention. L’expression de HGF a été évaluée par technique d’hybridation in situ. Résultats: Nos résultats démontrent une augmentation de l’expression de HGF dans les moelles épinières murines suite à l’axotomie. Cette augmentation est plus rapide suite à la stimulation électrique, autant directe que transcutanée. L’expression de HGF devient localisée aux zones motrices de la moelle épinière murine dans les groupes Axotomie, Directe et Transcutanée. Conclusions: HGF, facteur neurotrophique impliqué de le développement et la survie des motoneurones, a une expression altérée suite à la lacération du nerf sciatique. Ceci suggère fortement qu’il participe aussi à la régénération des nerfs moteurs. De plus, l’expression plus rapide de HGF suite à la stimulation électrique suggère son implication dans l’augmentation de la régénération nerveuse. / Purpose: Hepatocyte Growth Factor (HGF) plays a role in promoting axonal growth and survival of motoneurons during embryonic development. This factor might also be important in directing the regeneration of adult motoneurons following laceration. We aim to identify the expression patterns of HGF following axotomy, with or without direct or transcutaneous electrical nerve stimulation in a mouse model. Methods: Sixty adult C57BL/6 mice were divided into 5 groups: Control (n=12), Sham (n=12), Axotomy (n=12, sciatic nerve laceration and immediate repair), Direct (n=12, sciatic nerve laceration, immediate repair and application of direct electrical stimulation on the proximal nerve end, 1h, 20 Hz) and Transcutaneous (n=12, nerve laceration and immediate repair followed by proximal transcutaneous electrical stimulation, 1h, 20 Hz). Spinal cords were harvested at 1, 3, 7 and 14 days post-surgery. The expression patterns of HGF were measured using in situ hybridization. Results: Our results showed an upregulation of HGF expression in mouse spinal cords following sciatic nerve axotomy. This occurred more quickly following electrical stimulation in both Direct and Transcutaneous groups. The expression pattern of HGF became localized to the motor neuron pools in the Axotomy, Direct and Transcutaneous groups. Conclusions: HGF, a growth factor involved in directing the outgrowth of motor axons in development, has an altered expression pattern following sciatic nerve laceration, suggesting it may also play a role in directing motoneuron regeneration. Furthermore, rapid change in the expression pattern of HGF following electrical stimulation suggests it may also be involved in the upregulation of nerve regeneration following electrical stimulation.

La stimulation électrique directe (SED), pour une heure, améliore la régénération de nerfs périphériques chez le rat après la réparation. Cliniquement, ceci augmenterait le temps opératoire, rehaussant les risques de complications périopératoires. Objectif: Cette étude examine si la stimulation électrique transcutanée (SETC) est aussi efficace à améliorer la régénération de nerfs périphériques que la stimulation électrique directe. Méthode: Le nerf sciatique droit de 28 souris a été axotomisé. Une réparation par microsuture est effectuée. Quatre groupes sont étudiés : (1) sham; (2) suture seulement; (3) suture et SED; (4) suture et SETC. La stimulation est appliquée pour 1 heure à 20 Hz. Les souris sont étudiées pour un total de 12 semaines. La récupération sciatique est évaluée aux semaines 0, 1, 2 et aux 2 semaines par la suite par analyse de démarche sur la poutre. Résultats: La cinématique post-récupération démontre un index fonctionnel sciatique et angle de décollement significativement améliorés pour les groupes SED et SETC aux semaines 8, 10 et 12. Conclusions: 12 semaines après l’axotomie du nerf sciatique, la récupération fonctionnelle est significativement améliorée avec la SED et la SETC. Donc, la SETC est aussi bénéfique pour la promotion de la régénération nerveuse et réinnervation musculaire fonctionnelle que la SED. / Direct electrical stimulation (DES) for one hour increases the rate of peripheral nerve regeneration in rats after nerve repair. Clinically, this would lengthen surgery time, increasing risks of perioperative complications. Purpose: This study examines whether transcutaneous electrical stimulation (TCES) is as effective at improving peripheral nerve regeneration as direct electrical stimulation. Methods: The right sciatic nerve was axotomized in 28 mice. End-to-end microsuture repair was undertaken. Four groups were studied: (1) sham; (2) suture only; (3) suture and DES; (4) suture and TCES. Stimulation was applied for 1 hour, at 20 Hz. The mice were studied for a total of 12 weeks. Hind-limb recovery was evaluated at weeks 0, 1, 2 and then every 2 weeks by walking-track analysis. Results: Post recovery kinematic showed significantly improved functional sciatic index and foot-base angles at weeks 8, 10 and 12 for both DES and TCES groups. Conclusions: 12 weeks after sciatic nerve axotomy, functional recovery was improved significantly in both DES and TCES groups. Therefore, TCES is as beneficial in promoting nerve regeneration and functional muscle reinnervation as is DES.

La douleur est une expérience subjective multidimensionnelle accompagnée de réponses physiologiques. Ces dernières sont régulées par des processus cérébraux qui jouent un rôle important dans la modulation spinale et cérébrale de la douleur. Cependant, les mécanismes de cette régulation sont encore mal définis et il est essentiel de bien les comprendre pour mieux traiter la douleur. Les quatre études de cette thèse avaient donc comme objectif de préciser les mécanismes endogènes de modulation de la douleur par la contreirritation (inhibition de la douleur par une autre douleur) et d’investiguer la dysfonction de ces mécanismes chez des femmes souffrant du syndrome de l’intestin irritable (Sii). Dans un premier temps, un modèle expérimental a été développé pour mesurer l’activité cérébrale en imagerie par résonance magnétique fonctionnelle concurremment à l’enregistrement du réflexe nociceptif de flexion (RIII : index de nociception spinale) et des réponses de conductance électrodermale (SCR : index d’activation sympathique) évoqués par des stimulations électriques douloureuses. La première étude indique que les différences individuelles d’activité cérébrale évoquée par les stimulations électriques dans les cortex orbitofrontal (OFC) et cingulaire sont associées aux différences individuelles de sensibilité à la douleur, de réactivité motrice (RIII) et de réactivité autonomique (SCR) chez des sujets sains. La deuxième étude montre que l’analgésie par contreirritation produite chez des sujets sains est accompagnée de l’inhibition de l’amygdale par OFC et d’une modulation du réflexe RIII par la substance grise périaqueducale (PAG) et le cortex somesthésique primaire (SI). Dans les troisième et quatrième études, il est montré que la contreirritation ne produit pas d’inhibition significative de la douleur et du réflexe RIII chez les patientes Sii en comparaison aux contrôles. De plus, les résultats indiquent que la sévérité des symptômes psychologiques est associée au déficit de modulation de la douleur et à une hypersensibilité diffuse chez les patientes Sii. Dans l’ensemble, cette thèse précise le rôle de certaines structures cérébrales dans les multiples composantes de la douleur et dans l’analgésie par contreirritation et montre que les patientes Sii présentent une dysfonction des mécanismes spinaux et cérébraux impliqués dans la perception et la modulation de la douleur. / Pain is a subjective experience comprising multiple dimensions and is accompanied by physiological responses. These responses are regulated by neural processes that play a crucial role in cerebral and spinal modulation of pain. However, the mechanisms of this regulation are still not clear and a better understanding of these processes is essential in order to treat pain effectively. The four studies of this thesis were intended to define the central mechanisms of endogenous pain modulation by counterirritation (application of two competing noxious stimuli) and to investigate the dysfunction of these mechanisms in female patients with irritable bowel syndrome (IBS). First, an experimental model was developed in which functional magnetic resonance imaging was used to measure brain activity concurrently to the recording of the nociceptive flexion reflex (RIII: an index of spinal nociceptive processes) and skin conductance responses (SCR: an index of sympathetic activation). The first study indicates that individual differences in shock-evoked brain activity in the orbitofrontal (OFC) and cingulate cortices are associated with individual differences in pain sensitivity, motor reactivity (RIII), and autonomic reactivity (SCR) in healthy volunteers. In the second study, it is shown that counterirritation analgesia produced in healthy volunteers is accompanied by the inhibition of the amygdala by the OFC, and the inhibition of the RIII reflex by the periacqueductal gray matter (PAG) and the primary somatosensory cortex (SI). In the third and fourth studies, pain and RIII reflex were not significantly modulated by counterirritation in patients with IBS in comparison to healthy controls. Furthermore, the severity of psychological symptoms was associated with pain modulation deficits and diffuse hypersensitivity in IBS patients. Together, the results of these studies clarify the functions of pain-related activity in specific brain structures and the mechanisms underlying counterirritation analgesia. Moreover, it is concluded that patients with IBS show a dysfunction of cerebral and spinal processes involved in both the perception and modulation of pain.

Encore en 2015, un grand nombre d’individus décèdent de pathologies du rythme cardiaque non contrôlées ou d’un manque de disponibilité de donneurs d’organes compatibles. Le génie tissulaire en créant, réparant ou améliorant la fonction des tissus est une option prometteuse afin de diminuer la mortalité associée à ces pathologies. L’objectif global de mon projet de recherche était de développer des outils et d’étudier l’impact fonctionnel des différents stimuli (mécanique et électrique) de l’environnement cardiaque dans le but de définir des conditions optimisées de culture pour la fabrication de tissu de remplacement par génie tissulaire. Cette thèse présente le développement d’un bioréacteur; un système qui optimise les conditions pour la culture cellulaire. L’efficacité du bioréacteur est validée par des expériences de culture cellulaire qui se concentrent sur la prolifération cellulaire, l’organisation cellulaire, l’expression génique et protéique de même que sur l’activité contractile spontanée. En premier lieu, nos résultats montrent, bien que la fréquence de contraction moyenne mesurée reste inchangée, une augmentation significative du nombre de cas de réentrées pour les cultures sur verre comparativement aux cultures sur Polydimethylsiloxane. Une augmentation de l’instabilité spatiotemporelle a été démontrée lorsque les cardiomyocytes étaient déposés sur un support de Polydimethylsiloxane et cette dernière corrèle avec une diminution non-significative de l’ARNm de la connexine-43 et une augmentation significative de l’ARNm pour CaV3.1 et HCN2. La culture sur Polydimethylsiloxane est également associée avec une plus forte réponse à l’isoprotérénol (β-adrénergique) et à l’acétylcholine (parasympathique). En second lieu, nous présentons les résultats du développement de notre bioréacteur en mettant l’emphase sur les caractéristiques (composantes accessibles, étirement uniaxial, électrode de carbone, stimulation biphasique) tout en validant notre approche pour optimiser les conditions de culture et améliorer la rentabilité des étapes de production du tissu de remplacement. Pour finir, nous partageons une nouvelle approche d’évaluation des caractéristiques contractiles de cellules cardiaques en culture. Nous avons développé des algorithmes qui utilisent les données de vidéomicroscopie pour valider l’impact de stimuli, évaluer l’hétérogénéité du signal enregistré et détecter des conditions favorables au développement d’arythmies. / In 2015, there are still a large number of people who die due to diseases of uncontrolled heart rhythm or due to lack of availability of compatible donor organs. Tissue engineering aim to create, repair or improve the function by different techniques. Tissue engineering is a viable option to reduce the mortality associated with many heart conditions. The overall goal of my PhD research was to study the functional impact of different stimuli in cardiac environment (mechanical and electrical stimulation) on cardiac cell cultures. This, in order to define optimized culture conditions for the production of replacement tissue using tissue engineering. This thesis presents the stages of creation and development of a bioreactor; a system that permits the culture of cardiac cells by integrating various stimuli. The optimization of culture conditions by using the bioreactor was confirmed by cell culture experiments that focus on cell proliferation, cell organization, gene and protein expression as well as on spontaneous activity. In the first place, our results show that although mean frequency of spontaneous activity remained unaltered, incidence of reentrant activity was significantly higher in samples cultured on glass compared to PDMS substrates. Higher spatial and temporal instability of the spontaneous rate activation was found when cardiomyocytes were cultured on PDMS, and correlated with decreased connexin-43 (unsignificant) and a significant increased CaV3.1 and HCN2 mRNA levels. Compared to cultures on glass, cultures on PDMS were associated with the strongest response to isoproterenol (β-adrenergic) and acetylcholine (parasympathetic). Secondly, we present the design of our bioreactor with an emphasis on its characteristics and by putting in perspective the relevance of our approach to optimize culture conditions and to improve profitability culture experiences and production stages of replacement heart tissue. Finally, a new approach is proposed to evaluate the characteristics of the contractile cells in culture which allows to validate the functional impact of stimuli, evaluate the heterogeneity in the beating behavior of the cells and to detect localized abnormal activity that could favour arrhythmia.

La bioélectronique est un domaine interdisciplinaire qui étudie les interconnexions et les interactions entre entités biologiques (cellules, tissus, organes) et systèmes électroniques,par l’intermédiaire du transducteur adéquat. Pour des cellules ou des tissus excitables (neurones, muscles, ...), le transducteur prend la forme d’une simple électrode, car ces tissus produisent une activité électrique spontanée ou, dans le sens inverse, peuvent être excités par un signal électrique externe. Cette communication bidirectionnelle donne lieu à deux schémas expérimentaux : l’acquisition et la stimulation. L’acquisition consiste à enregistrer, traiter et analyser les bio-signaux alors que la stimulation consiste à appliquer le courant électrique adéquat aux tissus vivants, pour déclencher une réaction. Cette thèse se concentre sur ce dernier point : deux générations de système de stimulation ont été développées, chacune basée sur un circuit intégré spécifique et adaptée à différents contextes applicatifs.Tout d’abord, le cadre scientifique a été celui du projet CENAVEX, axé sur la stimulation électrique fonctionnelle pour réhabiliter la fonction respiratoire, suite à une lésion de la moelle épinière. Ensuite, les objectifs de conception ont été étendus pour couvrir de nouveaux besoins d’application : la surveillance de l’impédance électrique in situ et l’exploration des formes d’onde de stimulation originales. Le premier pourrait être une solution pour suivre la réaction tissulaire après l’implantation d’une électrode, contribuant ainsi à la biocompatibilité à long terme des implants ; le second propose d’aller au-delà dela conventionnelle impulsion biphasique carrée et d’explorer de nouvelles formes d’ondes qui pourraient être plus efficaces en termes de consommation d’énergie, pour un effet physiologique donné.Le travail présenté dans ce manuscrit contribue à la conception, à la fabrication et au test de dispositifs de stimulation innovants. Cela a conduit au développement de deux circuits intégrés et de deux dispositifs de stimulation permettant une stimulation multicanal.Les caractérisations électriques et les validations biologiques, de la faisabilité in vitro aux expériences in vivo, ont été menées et sont décrites dans ce manuscrit. / Bioelectronics is a cross-disciplinary field that studies interconnections and interactions between biological entities (cells, tissues, organs) and electronic systems, using the adequate transducer. For excitable cells or tissues (neurons, muscles, . . . ), the transducer takes the form of a simple electrode, as these tissues produce a spontaneous electrical activity or,in the opposite way, may be excited by an external electrical signal. This bi-directional communication gives rise to two experimental schemes: acquisition and stimulation. Acquisition consists in recording, processing and analyzing bio-signals whereas stimulation consists in applying the adequate electrical current to living tissues in order to trigger a reaction. This thesis focuses on the latter: two generations of stimulation systems have been developed, both being centered on an Application Specific Integrated Circuit, and adapted to different application contexts. First, the scientific framework was given by the CENAVEX project, focusing on Functional Electrical Stimulation to rehabilitate the respiratory function, following a Spinal Cord Injury. Then, the design objectives were extended to cover new application needs:in situ electrical impedance monitoring and exploration of original stimulation wave forms.The first one could be a solution to follow the tissue reaction after electrode implantation,hence contributing to long-term biocompatibility of implants; the second one proposes to go further the conventional constant biphasic pulse and explore new wave forms that couldbe most efficient in terms of energy consumption, for a given physiological effect.The work presented in this manuscript is a contribution to the design, fabrication and test of innovative stimulation devices. It leaded to the development of two integrated circuits and two stimulation devices permitting multichannel stimulation. Both electrical characterizations and biological validations, from in vitro feasibility to in vivo experiments, have been conducted and are described in this manuscript.

O objetivo deste estudo foi avaliar o efeito do biofeedback (BIO) associado à terapia ocupacional (TO) e à estimulação elétrica funcional (FES) na espasticidade, movimento ativo e função do membro superior de pacientes hemiplégicos. Este estudo foi realizado na Divisão de Medicina de Reabilitação do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Cinqüenta e nove pacientes acometidos por acidente vascular cerebral participaram do estudo por um ano; 31 receberam TO+FES duas vezes por semana + BIO uma vez por semana e 28 receberam somente TO+FES duas vezes por semana. Os pacientes foram avaliados inicialmente, após 6 meses e após 1 ano através da Avaliação da Função Manual, do Teste de Destreza Manual Minnesota, do Teste de Amplitude de Movimento e da Escala de Ashworth modificada. TO+FES+BIO melhoraram significativamente a amplitude de movimento e função dos membros superiores após 6 meses e 12 meses, quando comparado com somente TO+FES. Ambos os grupos melhoraram significativamente a espasticidade, após 6 meses e 12 meses, com diferença não significante entre eles. O uso adicional do biofeedback mostrou efeito positivo em amplitude de movimento e recuperação da função do membro superior no grupo estudado e pode representar uma importante ferramenta para a reabiltação de pacientes hemiplégicos / The objective of this was to study the effect of biofeedback (BIO) associated to occupational therapy (OT) and functional electrical stimulation (FES) on spasticity, range of motion and upper extremity function of hemiplegic patients. The study took part at the Division of Rehabilitation Medicine of the Hospital das Clínicas of the University of São Paulo School of Medicine. Fifty-nine stroke patients were studied for one year; 31 received OT+FES twice a week + BIO once-a-week and 28 received only OT+FES twice-aweek. The patients were evaluated initially, after six months and after one year with the use of Manual Function Evaluation, Minnesota Manual Dexterity Test, Range of Joint Motion Test and Modified Ashworth Scale. OT+FES+BIO significantly improved range of motion and upper extremity function after 6 months and 12 months, compared to only OT+FES. Both groups showed significant improvement of spasticity, after 6 months and 12 months, with no significant difference between them. The additional use of BIO had a positive effect in range of motion and function recovery of upper extremity in the studied group and may represent an important therapeutic tool for stroke rehabilitation

Pacientes lesados medulares frequentemente mencionam dores nos ombros, devido à elevada demanda dos membros superiores. Estes pacientes se submetem a diferentes tipos de reabilitação, no entanto é importante avaliar os métodos utilizados em tais programas para evitar possíveis prejuízos. O objetivo deste trabalho é avaliar o esforço e a atividade muscular dos ombros em pacientes paraplégicos caminhando com Estimulação Elétrica Neuro Muscular (EENM) e um andador em seções de reabilitação e comparar com duas atividades diárias executadas por estes indivíduos: propulsão da cadeira de rodas e elevação para alívio da pressão. Quinze homens adultos com paraplegia foram avaliados. Os movimentos em 3 dimensões foram obtidos com um sistema de 6 câmeras de infravermelho, e a atividade mioelétrica de 6 músculos dos ombros foi obtida bilateralmente por eletrodos de superfície ativos. Um andador instrumentalizado capturou a força durante a marcha, e a força nas outras duas atividades foi obtida por dinâmica inversa utilizando os dados cinemáticos e antropométricos. Os dados cinéticos e da atividade muscular foram avaliados estatisticamente utilizando análise de variância (ANOVA) e o teste das diferenças menos significativas de Tukey com nível de significância p<0,05. Foram obtidos picos de força quatro vezes maiores durante a marcha comparando-se à propulsão da cadeira de rodas. O esforço do ombro durante a marcha e a elevação foi equivalente, porém o lado direito durante a marcha apresentou maiores valores. O músculo mais ativo durante a marcha foi o tríceps, seguido pelo peitoral maior, deltóide anterior e trapézio inferior. A ação geral dos músculos durante a marcha também foi maior comparada aos outros exercícios executados. A marcha com EENM e andador, realizada por lesados medulares durante as seções de reabilitação, requer esforços significativos dos membros superiores, podendo gerar complicações nas articulações do ombro. Lesados medulares submetidos a seções de reabilitação que executam esforços significativos devem ser frequentemente monitorados, por métodos de ultra-som ou ressonância magnética, para evitar o comprometimento dos membros superiores e a consequente perda das funções de independência remanescentes / Spinal Cord Injured subjects often refer pain in their shoulders, due to the increased demand of the upper limbs. These subjects usually go through different rehabilitation strategies. Therefore, it becomes rather important to assess those methods in order to avoid further injuries to the patients. The goal of this work was to evaluate the shoulder effort and muscular activity in paraplegic subjects during gait with Neuromuscular Electrical Stimulation (NMES) with the aid of a walker and to compare it with two daily activities: wheelchair start up and weight relief raise. Fifteen adult male paraplegics were part of this study. The three-dimensional motions were acquired with six infrared cameras, and surface-active electrodes recorded the electromyography activity of 6 shoulder muscles, bilaterally. The vertical reaction force during walking was measured with a strain gauge instrumented walker, and the horizontal (wheelchair start-up) and vertical (weight relief raise) forces were obtained by inverse dynamics from kinematics and anthropometric data. The statistics of kinetic and electromyography data were done by analysis of variance (ANOVA) and the Tukey least significant differences post hoc test with significance level of p<0,05. Results have shown NMES gait force peaks being about four times higher than the values obtained for wheelchair start-up. The shoulder effort (force and torque) during walking and weight relief was similar, although the right side during NMES gait presented greater values. The triceps was the most active muscle during NMES walking, followed by pectoralis major, anterior deltoid and lower trapezius. The overall muscular activity during NMES walking was again higher than the other tasks executed. The NMES walking, when performed by spinal cord injured subjects can lead to injuries to the shoulder girdle. Due to the results obtained, continuous supervision of paraplegic upper limb effort should therefore be part of any rehabilitation center and for that ultrasound or magnetic resonance imaging may be recommended

A lesão medular pode prejudicar a marcha de um indivíduo. Para estes casos, uma técnica de reabilitação que tem se tornado mais popular é a Estimulação Elétrica Neuro Muscular (EENM). Na marcha assistida por EENM tradicional, o controle da estimulação é realizado utilizando-se acionamento manual, um fato que ajuda a torná-la distante da marcha saudável. Este trabalho propõe um sistema que monitora variáveis da marcha - ângulos da articulação do joelho, e forças de reação do solo (retropé e antepé) - e as utiliza como entradas para uma rede neural artificial (RNA), a fim de poder controlar automaticamente a EENM na marcha. Os transdutores utilizados para medir ângulos foram eletrogoniômetros, montados nos membros inferiores do indivíduo utilizando tiras de velcro. Para medição das forças, os transdutores utilizados foram células de carga construídas com strain gages, montadas em sandálias instrumentadas. Os métodos para construção do hardware de aquisição de dados (transdutores e interface) e do software estão descritos, bem como os métodos de calibração dos transdutores. Todos os transdutores apresentaram comportamento linear. Testes iniciais foram realizados, utilizando primeiramente um indivíduo saudável, e depois dois pacientes que normalmente realizam treinamento de marcha com suspensão de peso (assistida por EENM ou não). Os resultados mostraram que o módulo de monitoramento permite gravar os dados coletados, e realizar comparações entre padrões de marcha de diferentes indivíduos, bem como diferentes estágios de reabilitação para um mesmo indivíduo. O treinamento da RNA para o indivíduo saudável apresentou uma taxa de acerto próxima de 90%, e para os pacientes lesados medulares a taxa foi de cerca de 80%. O módulo de controle apresentou resultados promissores nos testes práticos realizados, com respostas rápidas e corretas para o indivíduo saudável. Sugestões para trabalhos futuros foram dadas, para que testes práticos de controle possam ser realizados utilizando pacientes lesados medulares. / Spinal cord injury (SCI) may impair an individual\'s gait. For these cases, a rehabilitation technique that has become more popular is functional electrical stimulation (FES). On traditional FES-assisted gait, the stimulation control is performed with manual triggering, a fact that helps make it distant from healthy gait. This work proposes a system that monitors gait variables - knee joint angles, and ground reaction forces (rearfoot and forefoot) - and uses them as inputs for an Artificial Neural Network (ANN), in order to be able to automatically control gait FES. The transducers used for angle measurement were electrogoniometers, mounted on the individuals lower limbs using Velcro straps. For force measurement, the transducers used were load cells built with strain gages, mounted on instrumented sandals. The methods for building the data acquisition hardware (transducers and interface) and software are described, along with the transducer calibration methods. All transducers presented linear behavior. Initial tests were performed, using first a healthy individual, and then a couple of patients that normally undergo suspended gait raining (FES-assisted or not). The results showed that the monitoring module allows recording the data collected, and making comparison between different individuals\' gait patterns, as well as different rehabilitation stages for the same individual. The ANN training for the healthy individual presented an accuracy rate close to 90%, and for the SCI patients the rate was about 80%. The control module showed promising results on practical tests performed, with quick and accurate responses for the healthy individual. Suggestions for future works were given, so that practical control tests can be performed using SCI patients.