A randomized controlled trial of functional neuromuscular stimulation in chronic stroke subjects
A randomized controlled trial of functional neuromuscular stimulation in chronic stroke subjects
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DOI：
10.1161/01.str.0000195129.95220.77
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发表时间：
2006-01-01
期刊：
影响因子：
8.3
通讯作者：
Ruff, RL
中科院分区：
文献类型：
--
作者：
Daly, JJ;Roenigk, K;Ruff, RL
背景和目的--常规疗法不能恢复许多中风后患者的正常步态。这项研究的目的是测试协调运动、地面步态训练和负重跑步机训练的反应，包括使用和不使用肌肉内电极(FNS-IM)的功能性神经肌肉刺激(FNS-IM)。方法：在一项随机对照试验中，32名受试者(卒中后1年)被分配到两组中的一组：FNS-IM组或无FNS组。纳入标准包括独立行走的能力，但不能执行正常的挥杆或站立阶段。所有受试者均接受每周4次治疗，疗程12周。根据Tinetti步态量表，由盲人评估者获得的主要结果测量是步态组件的执行情况。次要指标为协调性、平衡性和6分钟步行距离。结果：在治疗前，两组患者在年龄、卒中开始时间、卒中严重程度以及每项研究指标方面均无显著差异。在步态执行(P=0.003；参数估计2.9；95%CI，1.2~4.6)和膝关节屈曲协调(P=0.049)方面，FNS-IM组的增益显著高于非FNS组。结论在改善卒中后步态组件和膝关节屈曲协调性方面，FNS-IM组比非FNS组具有显著优势。
Background and Purpose - Conventional therapies fail to restore normal gait to many patients after stroke. The study purpose was to test response to coordination exercise, overground gait training, and weight-supported treadmill training, both with and without functional neuromuscular stimulation (FNS) using intramuscular (IM) electrodes (FNS-IM).Methods - In a randomized controlled trial, 32 subjects (> 1 year after stroke) were assigned to 1 of 2 groups: FNS-IM or No-FNS. Inclusion criteria included ability to walk independently but inability to execute a normal swing or stance phase. All subjects were treated 4 times per week for 12 weeks. The primary outcome measure, obtained by a blinded evaluator, was gait component execution, according to the Tinetti gait scale. Secondary measures were coordination, balance, and 6-minute walking distance.Results - Before treatment, there were no significant differences between the 2 groups for age, time since stroke, stroke severity, and each study measure. FNS-IM produced a statistically significant greater gain versus No-FNS for gait component execution (P = 0.003; parameter estimate 2.9; 95% CI, 1.2 to 4.6) and knee flexion coordination (P = 0.049).Conclusion - FNS-IM can have a significant advantage versus No-FNS in improving gait components and knee flexion coordination after stroke.