Hara Yukihiro, Ogawa Shinji, Muraoka Yoshihiro
Department of Rehabilitation Medicine, Nippon Medical School, Chiba Hokusoh Hospital, Japan.
Am J Phys Med Rehabil. 2006 Dec;85(12):977-85. doi: 10.1097/01.phm.0000247853.61055.f8.
The effect on spastic hemiparesis of a hybrid therapy consisting of functional electrical stimulation and block therapy was examined.
Sixteen consecutively enrolled stroke patients who had spastic upper-extremity impairments more than 1 yr after stroke were recruited for this nonblinded randomized controlled trial. Patients underwent hybrid functional electrical stimulation therapy on their extensor carpi radialis longus and brevis, extensor digitorum communis, and extensor indicis proprius muscles once or twice a week for 4 mos after motor point blocks at the spastic finger flexor muscles. Surface electrodes picked up the electromyography signal and stimulated those muscles in proportion to the integrated electromyography signal obtained by the functional electrical stimulation device. The root mean square of the extensor carpi radialis longus and extensor digitorum communis maximum voluntary electromyography, active range of motion of wrist extension, finger extension, Modified Ashworth Scale, and two clinical tests were examined before and after training.
Root mean square, active range of motion, Modified Ashworth Scale, and two clinical tests showed marked improvement in all patients as compared with the control subjects.
The hybrid therapy was effective for patients with chronic spastic hemiparesis. Proprioceptional sensory feedback may have an important role in power-assisted functional electrical stimulation therapy.
研究功能性电刺激与阻滞疗法相结合的综合疗法对痉挛性偏瘫的影响。
在这项非盲随机对照试验中，招募了16例连续入选的中风患者，这些患者在中风后1年以上存在上肢痉挛性损伤。患者在痉挛性指屈肌运动点阻滞术后，每周接受1次或2次对桡侧腕长伸肌、桡侧腕短伸肌、指总伸肌和示指固有伸肌的综合功能性电刺激治疗，共持续4个月。表面电极采集肌电图信号，并根据功能性电刺激设备获得的积分肌电图信号对这些肌肉进行刺激。在训练前后，检测桡侧腕长伸肌和指总伸肌最大自主肌电图的均方根、腕背伸和指背伸的主动活动范围、改良Ashworth量表以及两项临床测试。
与对照组相比，所有患者的均方根、主动活动范围、改良Ashworth量表以及两项临床测试均有显著改善。
综合疗法对慢性痉挛性偏瘫患者有效。本体感觉反馈可能在动力辅助功能性电刺激治疗中起重要作用。
