Elokda A S, Nielsen D H, Shields R K
University of Iowa, Physical Therapy Graduate Program, Iowa City 52242-1008, USA.
J Rehabil Res Dev. 2000 Sep-Oct;37(5):535-42.
The purpose of the study was to evaluate the cardiovascular responses of functional neuromuscular stimulation (FNS) on postural-related orthostatic stress in individuals with acute spinal cord injury. Two tetraplegics and three paraplegics participated in this study. A repeated measure design was used in which subjects underwent two graded-tilt table (0 degrees, 15 degrees, 30 degrees, 45 degrees, 60 degrees) orthostatic stress tests with and without FNS (randomized treatment order) of the knee extensors and foot plantar flexors. Successive one-minute digital readings of heart rate (HR) and blood pressure were obtained with an electronic pulse oximeter and automated blood pressure monitor, respectively. Analysis of covariance (ANCOVA) revealed significant test position (tilt angle) and treatment condition (with or without FNS) main effects, but no significant interactions. Between-treatment pairwise contrasts showed that systolic blood pressure was lower without FNS for 15 degrees, 30 degrees, 45 degrees g, and 60 degrees of tilt, while diastolic blood pressure was lower without FNS at 30 degrees and 45 degrees of tilt. In contrast, HR showed a progressive rise with increasing tilt angle. Functional neuromuscular stimulation may be an important treatment adjunct to minimize cardiovascular changes during postural orthostatic stress in individuals with acute spinal cord injury.
本研究的目的是评估功能性神经肌肉电刺激（FNS）对急性脊髓损伤患者姿势相关直立应激的心血管反应。两名四肢瘫痪患者和三名截瘫患者参与了本研究。采用重复测量设计，受试者在有和没有对膝伸肌和足底屈肌进行FNS（随机治疗顺序）的情况下，接受两次分级倾斜台（0度、15度、30度、45度、60度）直立应激测试。分别使用电子脉搏血氧仪和自动血压监测仪连续一分钟读取心率（HR）和血压的数字读数。协方差分析（ANCOVA）显示出显著的测试位置（倾斜角度）和治疗条件（有或没有FNS）主效应，但没有显著的交互作用。治疗组间的两两对比显示，在15度、30度、45度和60度倾斜时，无FNS时收缩压较低，而在30度和45度倾斜时，无FNS时舒张压较低。相比之下，HR随着倾斜角度的增加而逐渐升高。功能性神经肌肉电刺激可能是一种重要的治疗辅助手段，可将急性脊髓损伤患者姿势直立应激期间的心血管变化降至最低。
