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Rehabilitation by power-assisted functional electrical stimulation with parameter memory function for hemiparetic upper extremity in stroke patients

具有参数记忆功能的助力功能性电刺激对脑卒中偏瘫上肢的康复治疗

基本信息

批准号：
18500425
负责人：
HARA Yukihiro
金额：
$ 2.52万
依托单位：
Nippon Medical School
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2006
资助国家：
日本
起止时间：
2006 至 2007
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-18500425/
关键词：
Stroke Electric stimulation Rehabilitation Hemiparesis Brain plasticity Neural function 機能的電気剌激

项目摘要

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 nonblinded 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 deltoideus (Del). Patients underwent 30-60 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.

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。方法：共招募20例连续入组的卒中后1年痉挛性上肢损伤患者进行非盲随机对照试验。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30-60分钟FES治疗，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。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。结论：日常动力辅助FES家庭项目治疗能有效改善腕指伸、肩屈。本体感觉反馈可能在动力辅助FES治疗中发挥重要作用。