Surface peroneal nerve stimulation in lower limb hemiparesis: effect on quantitative gait parameters.
Surface peroneal nerve stimulation in lower limb hemiparesis: effect on quantitative gait parameters.
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DOI：
10.1097/phm.0000000000000269
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发表时间：
2015-05
影响因子：
3
通讯作者：
Chae J
中科院分区：
文献类型：
--
作者：
Sheffler LR;Taylor PN;Bailey SN;Gunzler DD;Buurke JH;IJzerman MJ;Chae J
评估功能改善的可能机制，并通过定量步态分析比较腓表面神经刺激 (PNS) 与常规护理 (UC) 的步行训练。随机对照临床试验。学术医疗中心教学医院。 110 名患有单侧偏瘫的慢性中风幸存者（中风后 > 12 周）。受试者被随机分配接受表面 PNS 装置或 UC 干预。受试者接受 12 周的治疗，并在治疗后随访 6 个月。步态的时空、运动学和动力学参数。踏频 (F3,153=5.81, p=.012)、步幅 (F3,179=20.01, p<.001)、步行速度 (F3,167=18.2, p<.001)、前后地面反作用力 (F3,164=6.61, p=.004)、预摆动峰值髋部力量(F3,156=8.76, p<.001) 和蹬地时的峰值脚踝力量 (F3,149=6.38, p=.005) 均随时间而改善。然而，摆动时的峰值踝关节 DF (F3,184=4.99，p=.031) 恶化。一般来说，所有参数的最大变化发生在治疗期间。对于任何时空、运动学或动力学参数，治疗组均不存在显着的时间相互作用效应。 PNS 步态训练和常规护理与挥杆前峰值髋部力量和蹬地时踝部峰值力量的改善相关，这可能导致步频、步幅和步行速度的改善；然而，治疗组之间没有差异。两个治疗组的摆动时踝关节 DF 峰值均有所下降，但这一发现的临床意义尚不清楚。
To evaluate possible mechanisms for functional improvement and compare ambulation training with surface peroneal nerve stimulation (PNS) versus usual care (UC) via quantitative gait analysis. Randomized controlled clinical trial. Teaching hospital of academic medical center. 110 chronic stroke survivors (> 12-wks post-stroke) with unilateral hemiparesis. Subjects were randomized to a surface PNS device or UC intervention. Subjects were treated for 12-wks and followed for 6-months post-treatment. Spatiotemporal, kinematic, and kinetic parameters of gait. Cadence (F3,153=5.81, p=.012), stride length (F3,179=20.01, p<.001), walking speed (F3,167=18.2, p<.001), anterior posterior ground reaction force (F3,164=6.61, p=.004), peak hip power in pre-swing (F3,156=8.76, p<.001), and peak ankle power at push-off (F3,149=6.38, p=.005) all improved with respect to time. However, peak ankle DF in swing (F3,184=4.99, p=.031) worsened. In general, the greatest change for all parameters occurred during the treatment period. There was no significant treatment group by time interaction effects for any of the spatiotemporal, kinematic, or kinetic parameters. Gait training with PNS and usual care was associated with improvements in peak hip power in pre-swing and peak ankle power at push-off, which may have resulted in improved cadence, stride length, and walking speed; however, there were no differences between treatment groups. Both treatment groups also experienced a decrease in peak ankle DF in swing, though the clinical implications of this finding are unclear.