The Hong Kong Polytechnic University, Hong Kong.
J Neurol Phys Ther. 2010 Dec;34(4):208-13. doi: 10.1097/NPT.0b013e3181fe0ab0.
Impaired walking function and spasticity are common sequelae of stroke. Prior studies have shown that a rehabilitation program combining transcutaneous electrical stimulation (TES) with task-related training (TRT) improves motor function in individuals with stroke. However, it is unclear if this approach is beneficial for individuals with long-standing stroke.
The subject of this case study was a 61-year-old man who was 7 years poststroke. He exhibited limitations of walking function, impaired strength of the ankle muscles, and severe plantarflexor spasticity.
For 4 weeks, the patient performed a 5-day/wk home program consisting of 60 minutes of TES (below motor threshold) to the acupoints in the affected lower leg, followed by 60 minutes of TRT. He documented his daily home program activities in a log, and 3 times a week he received a call from the therapist to verify his adherence. The patient also had 8 clinic visits, which focused on instruction to ensure adherence to the (TES + TRT) protocol and progression of the program.
After the 4-week program, plantarflexor spasticity decreased and ankle dorsi- and plantarflexor strength improved. More important, there were notable improvements in gait velocity, walking endurance, and functional mobility. These gains were maintained at 4 weeks posttreatment.
This accessible home program was safe and effective for decreasing impairment and improving function in an individual with long-term, chronic stroke. The gains were maintained 4 weeks posttreatment. Details are provided for developing a home program integrating somatosensory TES and TRT.
行走功能障碍和痉挛是中风的常见后遗症。先前的研究表明，经皮电刺激（TES）与任务相关训练（TRT）相结合的康复方案可改善中风患者的运动功能。然而，目前尚不清楚这种方法是否对患有长期中风的患者有益。
本病例研究的对象是一名 61 岁男性，中风后 7 年。他表现出行走功能受限、踝关节肌肉力量减弱和严重的跖屈肌痉挛。
在 4 周内，患者每周进行 5 天的家庭计划，包括 60 分钟的 TES（低于运动阈值）刺激患侧小腿的穴位，然后进行 60 分钟的 TRT。他在日志中记录了每天的家庭计划活动，并每周接受 3 次治疗师的电话，以验证他的依从性。患者还进行了 8 次就诊，重点是指导，以确保遵守（TES+TRT）方案和计划的进展。
在 4 周的方案后，跖屈肌痉挛减轻，踝背屈和跖屈肌力量改善。更重要的是，步态速度、行走耐力和功能性移动能力有显著提高。这些改善在治疗后 4 周仍保持。
这个可访问的家庭计划对于患有长期慢性中风的患者来说是安全有效的，可以降低损伤程度并改善功能。在治疗后 4 周仍保持。提供了整合体感 TES 和 TRT 的家庭计划的详细信息。
