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神经肌肉电刺激对慢性脑卒中偏瘫下肢康复临床改善的影响:一项单盲、随机、对照试验。

The effects of neuromuscular electrical stimulation on clinical improvement in hemiplegic lower extremity rehabilitation in chronic stroke: a single-blind, randomised, controlled trial.

机构信息

PM&R Department, Van Ercis State Hospital, Van, Turkey.

出版信息

Disabil Rehabil. 2009;31(24):2047-54. doi: 10.3109/09638280902893626.

Abstract

OBJECTIVE

In this study, the effectiveness of neuromuscular electrical stimulation (NMES) was evaluated in lower extremity rehabilitation in patients with chronic stroke.

METHOD

The study enrolled 40 patients with chronic stroke. Twenty patients each were assigned to the treatment group and the control group. All patients received a conventional rehabilitation program for a 4-week period. In addition to this rehabilitation program, patients in the treatment group received NMES treatment for hemiplegic foot dorsiflexor muscles for 4 weeks, 5 days a week. The sessions were performed as one session per day and added to a total of 20 sessions. Clinical parameters were evaluated before and after the treatment.

RESULTS

Pre-treatment and post-treatment evaluations showed a significant increase in ankle dorsiflexion and a significant decrease in the level of spasticity in the treatment group (p < 0.05); however, there were no significant differences in the control group between the pre-treatment and post-treatment measures. Although Brunnstrom Stage, Rivermead leg and trunk score and Functional Independence Measurement motor subscore showed a significant improvement in pre- and post-treatment comparisons for both groups, the treatment group's scores were significantly higher than the control group (p < 0.05). Functional Ambulation Categories showed a significant improvement in both groups following the treatment; however, there was no significant difference between the two groups (p > 0.05).

CONCLUSIONS

Use of NMES in hemiplegic foot dorsiflexion can contribute to the clinical improvement of patients when used in combination with rehabilitation programs.

摘要

目的

本研究评估了神经肌肉电刺激(NMES)在慢性脑卒中患者下肢康复中的有效性。

方法

该研究纳入了 40 例慢性脑卒中患者。将 20 例患者分为治疗组和对照组,每组各 20 例。所有患者均接受为期 4 周的常规康复方案。除了常规康复方案外,治疗组患者还接受了为期 4 周、每周 5 天的偏瘫足背屈肌 NMES 治疗,每天进行一次治疗,总共进行 20 次。在治疗前后评估临床参数。

结果

治疗前和治疗后评估显示,治疗组的踝关节背屈明显增加,痉挛程度明显降低(p<0.05);然而,对照组在治疗前后测量中没有显著差异。虽然 Brunnstrom 分期、Rivermead 腿部和躯干评分以及功能性独立测量运动子评分在两组的治疗前后比较中均显示出显著改善,但治疗组的评分明显高于对照组(p<0.05)。功能性步行分类在两组治疗后均有显著改善,但两组之间无显著差异(p>0.05)。

结论

在康复方案中联合使用 NMES 治疗偏瘫足背屈,可以促进患者的临床改善。

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