Daly Janis J, Roenigk Kristen L, Butler Kristen M, Gansen Jennifer L, Fredrickson Eric, Marsolais E Byron, Rogers Jean, Ruff Robert L
Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
J Rehabil Res Dev. 2004 Nov-Dec;41(6A):807-20. doi: 10.1682/jrrd.2003.08.0120.
After stroke, persistent gait deficits cause debilitating falls and poor functional mobility. Gait restoration can preclude these outcomes. Sixteen subjects (>12 months poststroke) were randomized to two gait training groups. Group 1 received 12 weeks of treatment, 4 times a week, 90 min per session, including 30 min strengthening and coordination, 30 min over-ground gait training, and 30 min weight-supported treadmill training. Group 2 received the same treatment, but also used functional neuromuscular stimulation (FNS) with intramuscular (IM) electrodes (FNS-IM) for each aspect of treatment. Outcome measures were kinematics of gait swing phase. Both groups showed no significant pre-/posttreatment gains in peak swing hip flexion. Group 1 (no FNS) had no significant gains in other gait components at posttreatment or at follow-up. Group 2 (FNS-IM) had significant gains in peak swing knee flexion and mid-swing ankle dorsiflexion (p < 0.05) that were maintained for 6 months.
中风后,持续的步态缺陷会导致使人衰弱的跌倒和较差的功能移动性。恢复步态可以避免这些后果。16名受试者(中风后超过12个月)被随机分为两个步态训练组。第1组接受为期12周的治疗,每周4次,每次90分钟,包括30分钟的强化和协调训练、30分钟的地面步态训练以及30分钟的减重支持跑步机训练。第2组接受相同的治疗,但在治疗的每个环节还使用了带有肌内(IM)电极的功能性神经肌肉刺激(FNS)(FNS-IM)。结果测量指标为步态摆动期的运动学。两组在治疗前后摆动期髋关节屈曲峰值均无显著改善。第1组(无FNS)在治疗后及随访时其他步态指标均无显著改善。第2组(FNS-IM)在摆动期膝关节屈曲峰值和摆动中期踝关节背屈方面有显著改善(p<0.05),且持续了6个月。