Linn S L, Granat M H, Lees K R
Bioengineering Unit, University of Strathclyde, Glasgow, Scotland.
Stroke. 1999 May;30(5):963-8. doi: 10.1161/01.str.30.5.963.
Subluxation is a significant problem in poststroke hemiplegia, resulting in pain and loss of function. Current treatments are not proved and not considered effective. It has been demonstrated that cyclical electrical stimulation of the shoulder muscles can reduce existing subluxation. The purpose of this study was to determine whether electrical stimulation could prevent subluxation in both the short and long terms.
A prospective, randomized controlled study was used to determine the efficacy of electrical stimulation in preventing shoulder subluxation in patients after cerebrovascular accidents. Forty patients were selected and randomly assigned to a control or treatment group. They had their first assessment within 48 hours of their stroke, and those in the treatment group were immediately put on a regimen of electrical stimulation for 4 weeks. All patients were assessed at 4 weeks after stroke and then again at 12 weeks after stroke. Assessments were made of shoulder subluxation, pain, and motor control.
The treatment group had significantly less subluxation and pain after the treatment period, but at the end of the follow-up period there were no significant differences between the 2 groups.
Electrical stimulation can prevent shoulder subluxation, but this effect was not maintained after the withdrawal of treatment.
半脱位是脑卒中后偏瘫的一个重要问题，会导致疼痛和功能丧失。目前的治疗方法未经证实且效果不佳。已有研究表明，对肩部肌肉进行周期性电刺激可减轻现有的半脱位。本研究的目的是确定电刺激在短期和长期内是否能预防半脱位。
采用前瞻性随机对照研究来确定电刺激对预防脑血管意外后患者肩部半脱位的疗效。选取40例患者并随机分为对照组和治疗组。他们在中风后48小时内进行首次评估，治疗组患者立即接受为期4周的电刺激治疗方案。所有患者在中风后4周进行评估，然后在中风后12周再次评估。评估内容包括肩部半脱位、疼痛和运动控制。
治疗组在治疗期后半脱位和疼痛明显减轻，但在随访期末，两组之间无显著差异。
电刺激可预防肩部半脱位，但治疗停止后这种效果未持续存在。
