[Effects of functional electrical stimulation on the improvement of motor function of patients with acute stroke: a randomized controlled trial].
[Effects of functional electrical stimulation on the improvement of motor function of patients with acute stroke: a randomized controlled trial].
复制标题
功能性电刺激对急性脑卒中患者运动功能改善的影响：随机对照试验
DOI：
10.3760/j:issn:0376-2491.2006.37.009
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发表时间：
2006
影响因子：
--
通讯作者：
Le Li
中科院分区：
文献类型：
--
作者：
T. Yan;C. Hui;Le Li
目标
探讨功能性电刺激（FES）对急性脑卒中患者下肢运动和步行能力改善的影响。
方法
46 例脑卒中（包括脑梗死和出血）患者，年龄 71 +/- 8（45 - 84），发病后 2 周（9 +/- 4 天）内住院，治疗前基线测量相互匹配，随机分为 3 组：FES 组（n = 13），接受标准康复结合 FES 每天 30 分钟，每周 5 天，持续 3 周，安慰剂刺激组（n = 15) 接受标准康复结合安装 FES 装置，以与上述相同的方式操作，但没有真正的电刺激，对照组 (n = 13) 单独接受标准康复。测量复合痉挛量表（CSS）评分，肌电图测量踝背屈肌和跖屈肌的最大等长自主收缩（MIVC），并通过治疗前、治疗3周期间每周以及卒中发病后8周定时“Up and Go”测试步行能力。
结果
治疗3周后，FES组CSS评分百分比为31%+/-35%，显着低于安慰剂组和对照组（分别为50%+/-88%和65%+/-65%，均P<0.05）； FES 组 MIVC 踝背屈扭矩为 9 Nm ± 5 Nm，显着高于安慰剂组和对照组（分别为 5 Nm ± 3 Nm 和 4 Nm ± 5 Nm，均 P < 0.05）；FES 组肌电图共同收缩率为 8% ± 5%，显着低于安慰剂组和对照组（27% ± 5%）。分别为 26% 和 28% +/- 19%，均 P < 0.05）。 FES组中风发作后恢复行走能力所需的时间为18+/-8天，比安慰剂组和对照组（分别为20+/-7天和21+/-8天）短2约3天。 FES组治疗3周后能够拄拐杖行走的患者比例为85%，显着高于安慰剂组和对照组（分别为60%和46%，P < 0.05）。 FES组的患者回家率为84.6%，显着高于安慰剂组和对照组（分别为53%和46%，P < 0.05）。
结论
FES 加上标准康复治疗，可有效改善急性中风患者的运动和行走能力，使大多数患者康复并能够回家。
OBJECTIVE
To investigate the effects of functional electrical stimulation (FES) on the improvement of motor and walking ability of the lower extremities of the patients with acute stroke.
METHODS
Forty-six patients with stroke (including cerebral infarction and hemorrhage), aged 71 +/- 8 (45 - 84), hospitalized within 2 weeks (9 +/- 4 days) after the onset, matched with one another in the baseline measurements before treatment, were assigned randomly into 3 groups: FES group (n = 13), receiving standard rehabilitation combined with FES 30 minutes per day, 5 days per week for 3 weeks, placebo stimulation group (n = 15) receiving standard rehabilitation combined with the installment of the FES apparatus, operated in the same manner as mentioned above, however, without real electric stimulation, and control group (n = 13), receiving standard rehabilitation alone. The score of the composite spasticity scale (CSS) was measured, electromyography was conducted to measure the maximum isometric voluntary contraction (MIVC) of the ankle dorsi-flexors and plantar-flexors, and walking ability by the test of timed "Up and Go" before treatment, weekly during the 3-week treatment, and 8 weeks after the onset of stroke.
RESULTS
After 3 weeks of treatment, the percentage of CSS score of the FES group was 31% +/- 35%, significantly lower than those of the placebo and control groups (50% +/- 88% and 65% +/- 65% respectively, both P < 0.05); the ankle dorsiflexion torque of MIVC of the FES group was 9 Nm +/- 5 Nm, significantly higher than those of the placebo and control groups (5 Nm +/- 3 Nm and 4 Nm +/- 5 Nm respectively, both P < 0.05), and the electromyogram co-contraction ratio of the FES group was 8% +/- 5%, significantly lower than those of the placebo and control groups (27% +/- 26% and 28% +/- 19% respectively, both P < 0.05). The time needed to recover the walking ability after the stroke onset of the FES group was 18 +/- 8 days, shorter by 2 approximately 3 days than those of the placebo and control groups (20 +/- 7 and 21 +/- 8 days respectively). The percentage of the patients able to walk with the help of a stick 3 weeks after treatment of the FES group was 85%, significantly higher than those of the placebo and control groups (60% and 46% respectively, both P < 0.05). 84.6% of the patients of the FES group returned home, a percentage significantly higher than those of the placebo and control groups (53% and 46% respectively, both P < 0.05).
CONCLUSION
FES, plus standard rehabilitation, is effective in improving the motor and walking ability of the patients with acute stroke, to the degree that most patients are recovered to be able to return home.