Lindquist Ana R R, Prado Christiane L, Barros Ricardo M L, Mattioli Rosana, da Costa Paula H Lobo, Salvini Tania F
Department of Physical Therapy, Federal University of Rio Grande do Norte, Brazil.
Phys Ther. 2007 Sep;87(9):1144-54. doi: 10.2522/ptj.20050384. Epub 2007 Jul 3.
Treadmill training with harness support is a promising, task-oriented approach to restoring locomotor function in people with poststroke hemiparesis. Although the combined use of functional electrical stimulation (FES) and treadmill training with body-weight support (BWS) has been studied before, this combined intervention was compared with the Bobath approach as opposed to BWS alone. The purpose of this study was to evaluate the effects of the combined use of FES and treadmill training with BWS on walking functions and voluntary limb control in people with chronic hemiparesis.
Eight people who were ambulatory after chronic stroke were evaluated.
An A(1)-B-A(2) single-case study design was applied. Phases A(1) and A(2) included 3 weeks of gait training on a treadmill with BWS, and phase B included 3 weeks of treadmill training plus FES applied to the peroneal nerve. The Stroke Rehabilitation Assessment of Movement was used to assess motor recovery, and a videography analysis was used to assess gait parameters.
An improvement (from 54.9% to 71.0%) in motor function was found during phase B. The spatial and temporal variables cycle duration, stance duration, and cadence as well as cycle length symmetry showed improvements when phase B was compared with phases A(1) and A(2).
The combined use of FES and treadmill training with BWS led to an improvement in motor recovery and seemed to improve the gait pattern of subjects with hemiparesis, indicating the utility of this combination method during gait rehabilitation. In addition, this single-case series showed that this alternative method of gait training--treadmill training with BWS and FES--may decrease the number of people required to carry out the training.
使用吊带辅助的跑步机训练是一种很有前景的、以任务为导向的方法，用于恢复中风后偏瘫患者的运动功能。尽管之前已经对功能性电刺激（FES）与带体重支持（BWS）的跑步机训练的联合使用进行了研究，但这种联合干预是与Bobath方法进行比较，而不是仅与BWS进行比较。本研究的目的是评估FES与带BWS的跑步机训练联合使用对慢性偏瘫患者步行功能和自主肢体控制的影响。
对8名慢性中风后能够行走的患者进行了评估。
采用A(1)-B-A(2)单病例研究设计。A(1)期和A(2)期包括在带有BWS的跑步机上进行3周的步态训练，B期包括3周的跑步机训练加施加于腓总神经的FES。使用运动中风康复评估来评估运动恢复情况，并使用摄像分析来评估步态参数。
在B期发现运动功能有改善（从54.9%提高到71.0%）。与A(1)期和A(2)期相比，B期的空间和时间变量周期持续时间、站立持续时间、步频以及周期长度对称性均有改善。
FES与带BWS的跑步机训练联合使用导致运动恢复得到改善，并且似乎改善了偏瘫患者的步态模式，表明这种联合方法在步态康复中的实用性。此外，这个单病例系列表明，这种替代的步态训练方法——带BWS和FES的跑步机训练——可能会减少进行训练所需的人数。
