Anderson S I, Whatling P, Hudlicka O, Gosling P, Simms M, Brown M D
Department of Physiology, University of Birmingham, UK.
Eur J Vasc Endovasc Surg. 2004 Feb;27(2):201-9. doi: 10.1016/j.ejvs.2003.10.003.
To assess whether electrical stimulation of ischaemic calf muscles in claudicants causes a systemic inflammatory response and to evaluate effects of its chronic application on muscle function and walking ability.
Prospective randomised controlled trial of calf muscle stimulation.
Stable claudicants were randomised to receive either active chronic low frequency (6 Hz) motor stimulation (n=15) or, as a control treatment, submotor transcutaneous electrical nerve (TENS) stimulation (n=15) of calf muscles in one leg, 3 x 20 min per day for four weeks. Leucocyte activation was quantified by changes in cell morphology, vascular permeability by urinary albumin:creatinine ratio (ACR), calf muscle function by isometric twitch contractions and walking ability by treadmill performance pre- and post-intervention.
Acute active muscle stimulation activated leucocytes less (28% increase) than a standard treadmill test (81% increase) and did not increase ACR. Chronic calf muscle stimulation significantly increased pain-free walking distance by 35 m (95% CI 17, 52, P<0.001) and maximum walking distance by 39 m (95% CI 7, 70, P<0.05) while control treatment had no effect. Active stimulation prevented fatigue of calf muscles during isometric electrically evoked contractions by abolishing the slowing of relaxation that was responsible for loss of force.
Chronic electrical muscle stimulation is an effective treatment for alleviating intermittent claudication which, by targeted activation of a small muscle mass, does not engender a significant systemic inflammatory response.
评估对间歇性跛行患者的缺血小腿肌肉进行电刺激是否会引起全身炎症反应，并评估长期应用该刺激对肌肉功能和步行能力的影响。
小腿肌肉刺激的前瞻性随机对照试验。
将病情稳定的间歇性跛行患者随机分为两组，一组接受慢性低频（6赫兹）主动运动刺激（n = 15），另一组作为对照治疗，接受单腿小腿肌肉的亚运动阈经皮电神经刺激（TENS）（n = 15），每天3次，每次20分钟，共四周。通过细胞形态变化对白细胞活化进行定量，通过尿白蛋白：肌酐比值（ACR）评估血管通透性，通过等长抽搐收缩评估小腿肌肉功能，通过干预前后的跑步机表现评估步行能力。
急性主动肌肉刺激引起的白细胞活化程度（增加28%）低于标准跑步机测试（增加81%），且未增加ACR。慢性小腿肌肉刺激使无痛步行距离显著增加35米（95%置信区间17, 52，P<0.001），最大步行距离增加39米（95%置信区间7, 70，P<0.05），而对照治疗无效果。主动刺激通过消除导致力量丧失的舒张减慢，防止了等长电诱发收缩期间小腿肌肉的疲劳。
慢性肌肉电刺激是缓解间歇性跛行的有效治疗方法，通过有针对性地激活小块肌肉，不会引发显著的全身炎症反应。
