Master of Occupational Therapy Program, Xavier University, Cincinnati, OH, USA.
Am J Occup Ther. 2010 Sep-Oct;64(5):720-6. doi: 10.5014/ajot.2010.08137.
Conventional methods for managing upper-extremity (UE) spasticity are invasive, usually require readministration after a certain time period, and do not necessarily increase UE function. This study examined efficacy of combining two singularly efficacious modalities-UE bracing and electrical stimulation-with functional training to reduce UE spasticity and improve function.
Two chronic stroke patients exhibiting UE spasticity were administered the Modified Ashworth Scale (MAS), the upper-extremity section of the Fugl-Meyer Impairment Scale (FM), the Box and Block Test (B&B), and the Arm Motor Ability Test (AMAT). They were then individually fitted for a brace and subsequently participated in treatment sessions occurring 2 days/wk for 5 wk, consisting of (1) 30-min clinical sessions, during which the UE was braced in a functional position while cyclic electrical stimulation was applied to the antagonist extensors of the tricep and forearm, and (2) 15-min, clinically based training sessions, occurring directly after the clinical session.
After intervention, participants exhibited 1-point reductions in MAS scores for the affected fingers, FM score increases, and increased ability to perform AMAT activities,. Three months later, both participants retained these changes.
Data point to a noninvasive, promising method of managing spasticity and rendering functional changes.
传统的上肢（UE）痉挛管理方法具有侵入性，通常在一定时间后需要再次给药，并且不一定能增加 UE 功能。本研究探讨了将两种单一有效的方法——UE 矫形器和电刺激——与功能训练相结合，以减少 UE 痉挛并改善功能的效果。
对两名患有 UE 痉挛的慢性中风患者进行改良 Ashworth 量表（MAS）、Fugl-Meyer 损伤量表（FM）上肢部分、Box 和 Block 测试（B&B）和上肢运动能力测试（AMAT）评估。然后为他们分别定制矫形器，随后参加为期 5 周、每周 2 次的治疗课程，包括（1）30 分钟的临床课程，在此期间，UE 以功能位置固定，同时对三头肌和前臂的拮抗伸肌施加循环电刺激，（2）15 分钟的临床为基础的训练课程，在临床课程后直接进行。
干预后，患者的 MAS 受影响手指评分降低 1 分，FM 评分增加，并且能够更好地进行 AMAT 活动。三个月后，两名患者都保留了这些变化。
数据表明，这是一种非侵入性、有前途的管理痉挛并实现功能变化的方法。
