Does electrical stimulation reduce spasticity after stroke? A randomized controlled study
Does electrical stimulation reduce spasticity after stroke? A randomized controlled study
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DOI：
10.1177/0269215507084008
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发表时间：
2008-05-01
影响因子：
3
通讯作者：
Fatemy, Elham
中科院分区：
文献类型：
--
作者：
Bakhtiary, Amir H.;Fatemy, Elham
目的：探讨电刺激对脑卒中患者跖屈肌痉挛的治疗效果。设计：随机对照临床试验研究。单位：塞姆南医科大学康复诊所。研究对象：40例伴有踝关节跖屈肌痉挛的中风患者（年龄42 ~ 65岁）。干预：实验组采用15分钟的抑制性Bobath技术，另一组采用9分钟背屈肌电刺激和抑制性Bobath技术相结合，每天20次。主要测量方法：被动踝关节背屈运动幅度、背屈力量测试、改良Ashworth量表测跖屈肌张力、比目鱼肌h反射。结果：联合治疗组被动踝关节背屈度平均变化11.4度（SD 4.79）比6.1度（SD 3.09），差异有统计学意义（P = 0.001）。联合治疗组改良Ashworth量表测得的跖屈肌张力平均变化为-1.6 (SD 0.5)，而Bobath组为-1.1 (SD 0.31) （P = 0.001）。与Bobath组（0.4 +/- 0.23）相比，联合治疗组背屈肌力量（0.7 +/- 0.37）也显著增加（P = 0.04）。然而，在联合治疗组（-0.41 +/- 0.29）和Bobath组（-0.3 +/- 0.28）之间，h反射振幅没有明显变化。结论：脑卒中患者采用Bobath抑制技术和电刺激相结合的治疗方法可有效减轻痉挛。
Objective: To investigate the therapeutic effect of electrical stimulation on plantarflexor spasticity in stroke patients.Design: A randomized controlled clinical trial study.Setting: Rehabilitation clinic of Semnan University of Medical Sciences.Subjects: Forty stroke patients (aged from 42 to 65 years) with ankle plantarflexor spasticity. Intervention: Fifteen minutes of inhibitory Bobath techniques were applied to one experimental group and a combination of 9 minutes of electrical stimulation on the dorsiflexor muscles and inhibitory Bobath techniques was applied to another group for 20 sessions daily.Main measures: Passive ankle joint dorsiflexion range of motion, dorsiflexion strength test, plantarflexor muscle tone by Modified Ashworth Scale and soleus muscle H-reflex.Results: The mean change of passive ankle joint dorsiflexion in the combination therapy group was 11.4 (SD 4.79) degrees versus 6.1 (SD 3.09) degrees, which was significantly higher (P = 0.001). The mean change of plantarflexor muscle tonicity measured by the Modified Ashworth Scale in the combination therapy group was -1.6 (SD 0.5) versus -1.1 (SD 0.31) in the Bobath group (P = 0.001). Dorsiflexor muscle strength was also increased significantly (P = 0.04) in the combination therapy group (0.7 +/- 0.37) compared with the Bobath group (0.4 +/- 0.23). However, no significant change in the amplitude of H-reflex was found between combination therapy (-0.41 +/- 0.29) and Bobath (-0.3 +/- 0.28) groups.Conclusion: Therapy combining Bobath inhibitory technique and electrical stimulation may help to reduce spasticity effectively in stroke patients.