Neuromuscular electrical stimulation versus volitional isometric strength training in children with spastic Diplegic cerebral palsy: A preliminary study
Neuromuscular electrical stimulation versus volitional isometric strength training in children with spastic Diplegic cerebral palsy: A preliminary study
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DOI：
10.1177/1545968306298932
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发表时间：
2007-11-01
影响因子：
4.2
通讯作者：
Lee, Samuel C. K.
中科院分区：
文献类型：
--
作者：
Stackhouse, Scott K.;Binder-Macleod, Stuart A.;Lee, Samuel C. K.
背景到目前为止，还没有报告研究神经肌肉电刺激（NMES），以增加使用高力量收缩和低重复的脑瘫（CP）儿童的肌肉力量产生。Objective.本研究的目的是确定CP儿童的等长NMES或意志训练是否可以增加肌肉力量和步行速度，并检查可能有助于增加力量产生的机制。方法. 11名患有痉挛性双瘫的儿童被分配到NMES训练组或意志训练组。NMES组的参与者被植入了电极，以激活股四头肌和小腿三头肌。意志组训练最大的努力收缩。两组都进行了为期12周的等长力量训练计划。在力量训练前后测量最大随意等长收缩（MVIC）力、随意肌肉激活、股四头肌和小腿三头肌横截面积（CSA）和步行速度。结果NMES训练组在股四头肌和小腿三头肌的标准化力量产生方面有更大的增加。同样，只有NMES组在训练后行走速度有所增加。随意肌肉激活的变化分别解释了NMES和意志组MVIC中观察到的变化的约67%和37%。仅NMES组的股四头肌最大CSA显著增加。结论.这项研究是第一个定量显示在CP儿童中使用NMES的力量增加。这些结果支持未来的实验研究，将检查NMES力量训练的临床有效性的需要。
Background. To date, no reports have investigated neuromuscular electrical stimulation (NMES) to increase muscle force production of children with cerebral palsy (CP) using high-force contractions and low repetitions. Objective. The aims of this study were to determine if isometric NMES or volitional training in children with CP could increase muscle strength and walking speed and to examine the mechanisms that may contribute to increased force production. Methods. Eleven children with spastic diplegia were assigned to an NMES training group or to a volitional training group. Participants in the NMES group had electrodes implanted percutaneously to activate the quadriceps femoris and triceps surae muscles. The volitional group trained with maximal effort contractions. Both groups performed a 12-week isometric strength-training program. Maximum voluntary isometric contraction (MVIC) force, voluntary muscle activation, quadriceps and triceps surae cross-sectional area (CSA), and walking speed were measured pre- and post-strength training. Results. The NMES-trained group had greater increases in normalized force production for both the quadriceps femoris and triceps surae. Similarly, only the NMES group showed an increase in walking speed after training. Changes in voluntary muscle activation explained approximately 67% and 37% of the changes seen in the MVIC of the NMES and volitional groups, respectively. Quadriceps femoris maximum CSA increased significantly for the NMES group only. Conclusions. This study was the first to quantitatively show strength gains with the use of NMES in children with CP. These results support the need for future experimental studies that will examine the clinical effectiveness of NMES strength training.