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[功能性电刺激疗法对脑卒中患者上肢功能运动恢复的影响——我们的经验与未来方向]

[Effects of functional electrical therapy on upper extremity functional motor recovery in patients after stroke--our experience and future directions].

作者信息

Plavsić Aleksandra, Svirtlih Laslo, Stefanović Aleksandra, Jović Stevan, Durović Aleksandar, Popović Mirjana

机构信息

Loewenstein Rehabilitation Hospital, Raanana, Israel.

出版信息

Med Pregl. 2011 May-Jun;64(5-6):299-303. doi: 10.2298/mpns1106299p.

Abstract

INTRODUCTION

New neurorehabilitation together with conventional techniques provide methods and technologies for maximizing what is preserved from the sensory motor system after cerebrovascular insult. The rehabilitation technique named functional electrical therapy was investigated in more than 60 patients in acute, subacute and chronic phase after cerebrovascular insult. The functional sensory information generated by functional electrical therapy was hypothesized to result in the intensive functional brain training of the activities performed.

FUNCTIONAL ELECTRICAL THERAPY

Functional electrical therapy is a combination of functional exercise and electrical therapy. The functional electrical therapy protocol comprises voluntary movement of the paretic arm in synchrony with the electrically assisted hand functions in order to perform typical daily activities. The daily treatment of 30 minutes lasts three weeks. The outcome measures include several tests for the evaluation of arm/hand functionality: upper extremity function test, drawing test, modified Aschworth scale, motor activity log and passive range of movement.

RESULTS OF FUNCTIONAL ELECTRICAL THERAPY STUDIES

Results from our several clinical studies showed that functional electrical therapy, if applied in acute and subacute stroke patients, leads to faster and greater improvement of functioning of the hemiplegic arm/hand compared to the control group. The outcomes were significantly superior at all times after the treatment for the higher functioning group.

DISCUSSION

Additional well-planned clinical studies are needed to determine the adequate dose of treatment (timing, duration, intensity) with functional electrical therapy regarding the patient's status. A combination with other techniques should be further investigated.

摘要

引言

新的神经康复技术与传统技术相结合,为最大限度地保留脑血管损伤后感觉运动系统的功能提供了方法和技术。对60多名脑血管损伤急性期、亚急性期和慢性期患者进行了名为功能性电疗法的康复技术研究。据推测,功能性电疗法产生的功能性感觉信息会导致对所执行活动进行强化的功能性大脑训练。

功能性电疗法

功能性电疗法是功能性锻炼与电疗法的结合。功能性电疗法方案包括患侧手臂的自主运动与电辅助手部功能同步,以完成典型的日常活动。每天30分钟的治疗持续三周。结果测量包括多项评估手臂/手部功能的测试:上肢功能测试、绘画测试、改良Ashworth量表、运动活动日志和被动活动范围。

功能性电疗法研究结果

我们多项临床研究的结果表明,与对照组相比,功能性电疗法应用于急性和亚急性中风患者时,能使偏瘫手臂/手部功能更快、更大程度地改善。在治疗后的所有时间里,功能较高组的结果均显著优于其他组。

讨论

需要进一步精心设计的临床研究,以确定针对患者状况的功能性电疗法的适当治疗剂量(时机、持续时间、强度)。应进一步研究其与其他技术的结合。

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