Functional Electrical Stimulation Therapy of Voluntary Grasping Versus Only Conventional Rehabilitation for Patients With Subacute Incomplete Tetraplegia: A Randomized Clinical Trial
Functional Electrical Stimulation Therapy of Voluntary Grasping Versus Only Conventional Rehabilitation for Patients With Subacute Incomplete Tetraplegia: A Randomized Clinical Trial
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DOI：
10.1177/1545968310392924
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发表时间：
2011-06-01
影响因子：
4.2
通讯作者：
McGillivray, Colleen
中科院分区：
文献类型：
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作者：
Popovic, Milos R.;Kapadia, Naaz;McGillivray, Colleen
背景功能性电刺激疗法（FET）有可能改善继发于创伤性脊髓损伤（SCI）的四肢瘫痪患者的自主抓握能力。Objective.这项单中心随机对照试验研究了40小时FET与传统职业治疗（COT）相比，单独使用COT改善抓握的疗效。方法. 24名亚急性创伤性不完全性SCI（C4-C7，AIS B-D）受试者同意参加为期8周的40小时治疗，超出常规康复计划。受试者随机接受FET + COT（n = 9）或COT（n = 12）。关键结局是基线和随访时进行的功能独立性测量（Functional Independence Measure，简称SCIM）自我护理分项评分、脊髓独立性测量（Spinal Cord Independence Measure，简称SCIM）自我护理分项评分和多伦多康复研究所手功能测试（TRI-HFT）的变化。结果治疗结束时，FET + COT组的平均自我护理分项评分变化为20.1，COT组为10（P = 0.015）。随机分配至FET + COT组的受试者在SCIM和TRI-HFT方面的改善也更大。长期随访不可行。结论FET显着减少残疾和改善自愿掌握超出了相当大的传统上肢治疗的影响，四肢瘫痪的个人。
Background. Functional electrical stimulation therapy (FET) has a potential to improve voluntary grasping among individuals with tetraplegia secondary to traumatic spinal cord injury (SCI). Objective. This single-site, randomized controlled trial examined the efficacy of 40 hours of FET with conventional occupational therapy (COT) compared with COT alone to improve grasping. Methods. Twenty-four subjects with subacute traumatic incomplete SCI (C4-C7, AIS B-D) consented to participate in 40 hours of therapy over 8 weeks, beyond the conventional rehabilitation program. Subjects were randomized to receive FET + COT (n = 9) or COT (n = 12). The key outcomes were changes in Functional Independence Measure (FIM) self-care subscores, Spinal Cord Independence Measure (SCIM) self-care subscores, and Toronto Rehabilitation Institute Hand Function Test (TRI-HFT) performed at baseline and follow-up. Results. At the end of the treatments, the change in mean FIM self-care subscore for the FET + COT group was 20.1 versus 10 (P = .015) for the COT group. Subjects randomized to FET + COT also had greater improvements in the SCIM and TRI-HFT. No longer term follow-up was feasible. Conclusion. FET significantly reduced disability and improved voluntary grasping beyond the effects of considerable conventional upper extremity therapy in individuals with tetraplegia.