Popovic Dejan B, Popovic Mirjana B, Sinkjaer Thomas, Stefanovic Aleksandra, Schwirtlich Laszlo
Center for Sensory-Motor Interaction, Aalborg University, Fredrik Bajersvej 7-D3, DK-9220 Aalborg Øst, Denmark.
Can J Physiol Pharmacol. 2004 Aug-Sep;82(8-9):749-56. doi: 10.1139/y04-057.
There are indications that both intensive exercise and electrical stimulation have a beneficial effect on arm function in post-stroke hemiplegic patients. We recommend the use of Functional Electrical Therapy (FET), which combines electrical stimulation of the paretic arm and intensive voluntary movement of the arm to exercise daily functions. FET was applied 30 min daily for 3 weeks. Forty-one acute hemiplegics volunteered in the 18-months single blinded cross-over study (CoS). Nineteen patients (Group A) participated in FET during their acute hemiplegia, and 22 patients (Group B) participated in FET during their chronic phase of hemiplegia. Group B patients were controls during FET in acute hemiplegia, and Group A patients were controls during the FET in chronic hemiplegia. Thirty-two patients completed the study. The outcomes of the Upper Extremity Function Test (UEFT) were used to assess the ability of patients to functionally use objects, as were the Drawing Test (DT) (used to assess the coordination of the arm), the Modified Ashworth Scale, the range of movement, and the questionnaire estimating the patients' satisfaction with the usage of the paretic arm. Patients who participated in the FET during the acute phase of hemiplegia (Group A) reached functionality of the paretic arm, on average, in less than 6 weeks, and maintained this near-normal use of the arm and hand throughout the follow-up. The gains in all outcome scores were significantly larger in Group A after FET and at all follow-ups compared with the scores before the treatment. The gains in patients who participated in the FET in the chronic phase of hemiplegia (Group B) were measurable, yet not significant. The speed of recovery was larger during the period of the FET compared with the follow-up period. The gains in Group A were significantly larger compared with the gains in Group B. The FET greatly promotes the recovery of the paretic arm if applied during the acute phase of post-stroke hemiplegia.
有迹象表明，高强度运动和电刺激对中风后偏瘫患者的手臂功能均有有益影响。我们推荐使用功能性电疗法（FET），该疗法将对瘫痪手臂的电刺激与手臂的高强度自主运动相结合，以锻炼日常功能。FET每天应用30分钟，持续3周。41名急性偏瘫患者自愿参加了这项为期18个月的单盲交叉研究（CoS）。19名患者（A组）在急性偏瘫期间接受FET治疗，22名患者（B组）在偏瘫慢性期接受FET治疗。B组患者在急性偏瘫期接受FET治疗时为对照组，A组患者在偏瘫慢性期接受FET治疗时为对照组。32名患者完成了研究。上肢功能测试（UEFT）的结果用于评估患者功能性使用物品的能力，绘图测试（DT）（用于评估手臂的协调性）、改良Ashworth量表、活动范围以及评估患者对瘫痪手臂使用满意度的问卷也用于此。在偏瘫急性期接受FET治疗的患者（A组）平均在不到6周的时间内实现了瘫痪手臂的功能，并且在整个随访期间保持了手臂和手部接近正常的使用。与治疗前的分数相比，A组在FET治疗后以及所有随访中的所有结果分数的提高均显著更大。在偏瘫慢性期接受FET治疗的患者（B组）的提高是可测量的，但不显著。与随访期相比，在FET治疗期间恢复速度更快。A组的提高与B组相比显著更大。如果在中风后偏瘫的急性期应用FET，可极大地促进瘫痪手臂的恢复。
