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[电刺激治疗脑卒中后痉挛性偏瘫手:一项随机研究]

[Electrical stimulation in the treatment of the spastic hemiplegic hand after stroke: a randomized study].

作者信息

Sentandreu Mañó Trinidad, Salom Terrádez José Ricardo, Tomás José Manuel, Meléndez Moral Juan Carlos, de la Fuente Fernández Trinidad, Company José Carlos

机构信息

Escuela Universitaria de Fisioterapia, Universitat de València, Valencia, España.

出版信息

Med Clin (Barc). 2011 Sep 17;137(7):297-301. doi: 10.1016/j.medcli.2010.10.024. Epub 2011 Feb 22.

Abstract

BACKGROUND AND OBJECTIVE

It has been claimed that neuromuscular electrical stimulation (NMES) may enhance hand motor recovery after a stroke. The aim of this study was to examine the effect of an electrostimulation protocol on range of motion and strength of the hand in a group of elderly patients with spastic hemiplegia after a stroke.

PATIENTS AND METHOD

20 elderly patients 60 years old and over with hand impairment due to stroke were randomly assigned to either the experimental group (conventional rehabilitation and NMES) or control group (conventional rehabilitation). NMES was applied on wrist and finger extensors 30 min 3 days/week for 8 weeks. Outcome measurements included goniometry and dynamometry tests. The patients were evaluated at baseline, after 4 and 8 weeks of treatment.

RESULTS

After the treatment, the experimental group showed significant improvements (p<0,05) in range of motion: resting wrist angle, active wrist extension, passive wrist extension and resting metacarpophalangeal angle of fingers; and strength of hand: grip and pinch strength.

CONCLUSION

The observed changes seem to be associated with the presence of intervention and they suggest that the NMES protocol applied could be a useful complementary rehabilitation treatment to improve hand motor impairment in carefully selected patients after a stroke.

摘要

背景与目的

据称,神经肌肉电刺激(NMES)可能会促进中风后手运动功能的恢复。本研究旨在探讨电刺激方案对一组中风后痉挛性偏瘫老年患者手部活动范围和力量的影响。

患者与方法

20名60岁及以上因中风导致手部功能障碍的老年患者被随机分为实验组(传统康复治疗加NMES)或对照组(传统康复治疗)。NMES应用于手腕和手指伸肌,每周3天,每次30分钟,共8周。结果测量包括角度测量和测力计测试。在治疗开始时、治疗4周和8周后对患者进行评估。

结果

治疗后,实验组在活动范围方面有显著改善(p<0.05):静息腕关节角度、主动腕关节伸展、被动腕关节伸展以及手指静息掌指关节角度;手部力量方面:握力和捏力。

结论

观察到的变化似乎与干预措施有关,这表明所应用的NMES方案可能是一种有用的辅助康复治疗方法,可改善精心挑选的中风后患者的手部运动障碍。

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