功能性电刺激促进首次急性卒中患者下肢运动康复和行走能力:一项随机安慰剂对照试验  

Functional electrical stimulation improves motor recovery of the lower extremity and walking ability of subjects with first acute stroke: A randomized placebo-controlled trial

作　　者：Hui- Chan C.W.Y. Li L.S.W. 沈才飞 

机构地区：[1]Dept. of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hum, Kowloon, Hong Kong Dr.

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第6期55-56,共2页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Background and Purpose - The effectiveness of functional electrical stimulation (FES) has been investigated in chronic hemiplegia. The present study examines whether FES, given during acute stroke, was more effective in promoting motor recovery of the lower extremity and walking ability than standard rehabilitation alone. Methods - Forty- six subjects, 70.9± 8.0 years old and 9.2± 4.1 days after stroke, were assigned randomly to 1 of 3 groups receiving standard rehabilitation with FES or placebo stimulation or alone (control). FES was applied 30 minutes and placebo stimulation 60 minutes, 5 days per week for 3 weeks. Outcome measurements included composite spasticity score, maximum isometric voluntary contraction of ankle dorsi- flexors and planter- flexors, and walking ability. They were recorded before treatment, weekly during the 3- week treatment, and at week 8 after stroke. Results - No significant differences were found in the baseline measurements. After 3 weeks of treatment, there was a significant reduction in the percentage of composite spasticity score, and a significant improvement in the ankle dorsiflexion torque, accompanied by an increase in agonist electromyogram and a reduction in electromyogram cocontraction ratio in the FES group, when compared with the other 2 groups (P < 0.05). All subjects in the FES group were able to walk after treatment, and 84.6% of them returned home, in comparison with the placebo (53.3% ) and control (46.2% , P < 0.05) groups. Conclusions - Fifteen sessions of FES, applied to subjects with acute stroke plus standard rehabilitation, improved their motor and walking ability to the degree that more subjects were able to return to home.Background and Purpose - The effectiveness of functional electrical stimulation (FES) has been investigated in chronic hemiplegia. The present study examines whether FES, given during acute stroke, was more effective in promoting motor recovery of the lower extremity and walking ability than standard rehabilitation alone. Methods - Forty- six subjects, 70.9± 8.0 years old and 9.2± 4.1 days after stroke, were assigned randomly to 1 of 3 groups receiving standard rehabilitation with FES or placebo stimulation or alone (control). FES was applied 30 minutes and placebo stimulation 60 minutes, 5 days per week for 3 weeks. Outcome measurements included composite spasticity score, maximum isometric voluntary contraction of ankle dorsi- flexors and planter- flexors, and walking ability. They were recorded before treatment, weekly during the 3- week treatment, and at week 8 after stroke. Results - No significant differences were found in the baseline measurements. After 3 weeks of treatment, there was a significant reduction in the percentage of composite spasticity score, and a significant improvement in the ankle dorsiflexion torque, accompanied by an increase in agonist electromyogram and a reduction in electromyogram cocontraction ratio in the FES group, when compared with the other 2 groups (P < 0.05). All subjects in the FES group were able to walk after treatment, and 84.6% of them returned home, in comparison with the placebo (53.3% ) and control (46.2% , P < 0.05) groups. Conclusions - Fifteen sessions of FES, applied to subjects with acute stroke plus standard rehabilitation, improved their motor and walking ability to the degree that more subjects were able to return to home.

关 键 词：功能性电刺激 急性卒中 下肢运动 行走能力 安慰剂对照 康复治疗 证实有效 屈肌 背侧 收缩情况 

分 类 号：R743.3[医药卫生—神经病学与精神病学]