Restoring voluntary grasping function in individuals with incomplete chronic spinal cord injury: pilot study.
Restoring voluntary grasping function in individuals with incomplete chronic spinal cord injury: pilot study.
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DOI：
10.1310/sci1904-279
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发表时间：
2013-01-01
影响因子：
2.9
通讯作者：
Popovic, Milos R
中科院分区：
文献类型：
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作者：
Kapadia, Naaz;Zivanovic, Vera;Popovic, Milos R
背景技术背景：功能性电刺激（FES）治疗已被证明是改善亚急性颈髓损伤（SCI）患者自主抓握功能的最有前途的方法之一。目的：确定FES治疗与传统职业治疗（COT）相比在改善慢性手功能障碍患者的随意手功能方面的有效性。（伤后≥24个月）、不完全（美国脊髓损伤协会损伤量表[AIS] B-D）、C4至C7 SCI。方法：8名参与者随机分为干预组（FES治疗; n = 5）或对照组（COT; n = 3）。两组在13至16周内接受39小时的治疗。主要结局指标为多伦多康复研究所-手功能测试（TRI-HFT），次要结局指标为力量感觉和知觉分级重新定义评估（GRASSP）、功能独立性测量（Functional Independence Measure，SCIM）自我护理子评分和脊髓独立性测量（Spinal Cord Independence Measure，SCIM）自我护理子评分。结果评估进行了基线，治疗39届会议后，并在6个月后的基线assessment.RESULTS：治疗39届会议后，干预组改善了5.8点的TRI-HFT的对象操作任务，而对照组仅改变了1.17点。同样，经过39个疗程的治疗，干预组改善了4.6分的自我护理分项评分，而对照组没有改变在所有.CONCLUSION：试点数据的结果证明了一项临床试验，比较FES治疗和COT单独改善慢性不完全性四肢瘫痪的个人自愿手功能。
BACKGROUND: Functional electrical stimulation (FES) therapy has been shown to be one of the most promising approaches for improving voluntary grasping function in individuals with subacute cervical spinal cord injury (SCI).OBJECTIVE: To determine the effectiveness of FES therapy, as compared to conventional occupational therapy (COT), in improving voluntary hand function in individuals with chronic (≥24 months post injury), incomplete (American Spinal Injury Association Impairment Scale [AIS] B-D), C4 to C7 SCI.METHODS: Eight participants were randomized to the intervention group (FES therapy; n = 5) or the control group (COT; n = 3). Both groups received 39 hours of therapy over 13 to 16 weeks. The primary outcome measure was the Toronto Rehabilitation Institute-Hand Function Test (TRI-HFT), and the secondary outcome measures were Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP), Functional Independence Measure (FIM) self-care subscore, and Spinal Cord Independence Measure (SCIM) self-care subscore. Outcome assessments were performed at baseline, after 39 sessions of therapy, and at 6 months following the baseline assessment.RESULTS: After 39 sessions of therapy, the intervention group improved by 5.8 points on the TRI-HFT's Object Manipulation Task, whereas the control group changed by only 1.17 points. Similarly, after 39 sessions of therapy, the intervention group improved by 4.6 points on the FIM self-care subscore, whereas the control group did not change at all.CONCLUSION: The results of the pilot data justify a clinical trial to compare FES therapy and COT alone to improve voluntary hand function in individuals with chronic incomplete tetraplegia.