Chang Ya-Ju, Hsu Miao-Ju, Chen Shin-Man, Lin Cheng-Hsiang, Wong Alice M K
Department of Physical Therapy and Graduate Institute of Rehabilitation Science, Chang Gung University, Taoyuan, Taiwan.
J Rehabil Res Dev. 2011;48(5):555-64. doi: 10.1682/jrrd.2010.03.0038.
Effective treatments for multiple sclerosis (MS)-associated central fatigue have not been established. Surface functional electrical stimulation (FES), which can challenge the peripheral neuromuscular system without overloading the central nervous system, is a relatively safe therapeutic strategy. We investigated the effect of 8 weeks of surface FES training on the levels of general, central, and peripheral fatigue in MS patients. Seven of nine individuals with MS (average age: 42.86 +/- 13.47 years) completed 8 weeks of quadriceps muscle surface FES training. Maximal voluntary contraction, voluntary activation level, twitch force, General Fatigue Index (FI), Central Fatigue Index (CFI), Peripheral Fatigue Index, and Modified Fatigue Impact Scale (MFIS) scores were determined before and after training. The results showed that FI (p = 0.01), CFI (p = 0.02), and MFIS (p = 0.02) scores improved significantly after training. Improvements in central fatigue contributed significantly to improvements in general fatigue (p < 0.01). The results of the current study showed that central fatigue was a primary limitation in patients with MS during voluntary exercise and that 8 weeks of surface FES training for individuals with MS led to significantly reduced fatigue, particularly central fatigue.
目前尚未确定针对多发性硬化症（MS）相关中枢性疲劳的有效治疗方法。表面功能性电刺激（FES）可以刺激外周神经肌肉系统，而不会使中枢神经系统负担过重，是一种相对安全的治疗策略。我们研究了为期8周的表面FES训练对MS患者全身、中枢和外周疲劳水平的影响。9名MS患者中有7名（平均年龄：42.86 +/- 13.47岁）完成了为期8周的股四头肌表面FES训练。在训练前后分别测定最大自主收缩、自主激活水平、抽搐力、一般疲劳指数（FI）、中枢疲劳指数（CFI）、外周疲劳指数和改良疲劳影响量表（MFIS）评分。结果显示，训练后FI（p = 0.01）、CFI（p = 0.02）和MFIS（p = 0.02）评分显著改善。中枢疲劳的改善对全身疲劳的改善有显著贡献（p < 0.01）。本研究结果表明，中枢性疲劳是MS患者进行自主运动时的主要限制因素，对MS患者进行为期8周的表面FES训练可显著减轻疲劳，尤其是中枢性疲劳。
