A home-based rehabilitation program for the hemiplegic upper extremity by power-assisted functional electrical stimulation
A home-based rehabilitation program for the hemiplegic upper extremity by power-assisted functional electrical stimulation
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DOI：
10.1080/09638280701265539
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发表时间：
2008-01-01
影响因子：
2.2
通讯作者：
Muraoka, Yoshihiro
中科院分区：
文献类型：
--
作者：
Hara, Yukihiro;Ogawa, Shinji;Muraoka, Yoshihiro
目的。目的：评价每日动力辅助功能电刺激（FES）家庭项目治疗慢性脑卒中的效果。在这项非盲随机对照试验中，共招募了20名卒中后1年伴有痉挛性上肢损伤的连续入组卒中患者。将受试者分为对照组和FES组，随访5个月。FES组使用动力辅助的FES装置，通过电刺激诱导更大的肌肉收缩，与表面电极接收到的综合肌电图（EMG）信号成比例。靶肌为桡侧腕长伸肌（ECRL）、桡侧腕短伸肌（ECRB）、指共伸肌（EDC）、食指固有伸肌（EIP）和三角肌（Del）。患者在家中接受30次类似的60分钟FES疗程，每周约6天。观察FES训练前后患者ECRL、EDC、Del最大自主肌电信号均方根（RMS）、腕、指伸、肩屈活动范围（ROM）、改良Ashworth量表（MAS）及临床试验结果。FES组在RMS、活动ROM、MAS和手部功能测试中表现出更大的改善，并且能够顺利地使用偏瘫的上肢进行日常生活活动。日常动力辅助FES家庭项目治疗可有效改善腕、指伸和肩部屈曲。本体感觉反馈可能在动力辅助FES治疗中发挥重要作用。
Purpose. To assess the effects of daily power-assisted functional electrical stimulation (FES) home program therapy in chronic stroke.Methods. A total of 20 consecutively enrolled stroke patients with spastic upper-extremity impairments > 1 year after stroke were recruited for this non-blinded randomized controlled trial. Subjects were assigned to control and FES groups and followed for 5 months. The FES group used a power-assisted FES device to induce greater muscle contraction by electrical stimulation in proportion to the integrated electromyography (EMG) signal picked up on surface electrodes. Target muscles were the extensor carpi radialis longus (ECRL) and extensor carpi radialis brevis (ECRB), extensor digitorum communis (EDC), extensor indicis proprius (EIP), and deltoid (Del). Patients underwent 30 similar to 60 min FES sessions at home about 6 days/week. Root mean square (RMS) of ECRL, EDC and Del maximum voluntary EMGs, active range of motion (ROM) of wrist and finger extension and shoulder flexion, modified Ashworth scale (MAS), and clinical tests were investigated before and after FES training.Results. The FES group displayed significantly greater improvements in RMS, active ROM, MAS and functional hand tests, and was able to smoothly perform activities of daily life using the hemiplegic upper extremities.Conclusions. Daily power-assisted FES home program therapy can effectively improve wrist and finger extension and shoulder flexion. Proprioceptional sensory feedback might play an important role in power-assisted FES therapy.