Physical Medicine and Rehabilitation Department, Selcuk University, Meram Faculty of Medicine, Meram, Konya, Turkey.
Disabil Rehabil. 2012;34(2):151-6. doi: 10.3109/09638288.2011.593679. Epub 2011 Oct 15.
The purpose of this study is to evaluate the efficacy of surface electrical stimulation on the spasticity occurring in the wrist flexor muscles after a cerebrovascular event.
Hemiplegic patients with stage 2-3 spasticity in the wrist muscles based on the Ashworth scale were divided into two groups. Both groups were applied stretching. One group was additionally administered neuromuscular electrical stimulation (NMES) to the wrist extensors, in the form of pulsed current, 100 Hz, with a pulse duration of 0.1 msec, and a resting duration of 9 seconds, for 15 minutes to provide the maximum muscular contraction. The efficacy of the treatment was evaluated using the following: modified Ashworth scale (MAS), Fmax/Mmax ratio, Hmax/Mmax ratio, wrist extension range of motion (ROM). The daily activities were assessed by Functional Independence Measurement (FIM) and the motor recovery was evaluated by Brunnstrom motor staging.
Both groups revealed a significant recovery after the treatment based on the MAS, the electrophysiological evaluation results, wrist ROM, FIM and Brunnstrom motor staging. The group receiving the combined treatment showed a better recovery in terms of MAS, wrist ROM, FIM and Brunnstrom motor staging compared to the group doing the stretching alone.
The results of this study showed that NMES given together with stretching of the wrist extensor muscles was more effective than stretching of the wrist extensor muscles alone in reducing spasticity.
本研究旨在评估表面电刺激对脑血管意外后腕屈肌痉挛的疗效。
根据 Ashworth 量表,将 2 级至 3 级腕部肌肉痉挛的偏瘫患者分为两组。两组均行牵伸治疗。一组在此基础上,采用 100Hz 脉冲电流对腕伸肌行神经肌肉电刺激(NMES),脉冲宽度 0.1msec,间歇 9 秒,持续 15 分钟,以达到最大肌肉收缩。采用改良 Ashworth 量表(MAS)、Fmax/Mmax 比值、Hmax/Mmax 比值、腕关节伸展活动范围(ROM)评估治疗效果。采用功能独立性测量(FIM)评估日常活动能力,采用 Brunnstrom 运动分期评估运动恢复情况。
两组患者在 MAS、电生理评估结果、腕关节 ROM、FIM 和 Brunnstrom 运动分期方面均有显著改善。与单纯牵伸组相比,联合治疗组在 MAS、腕关节 ROM、FIM 和 Brunnstrom 运动分期方面的恢复更好。
本研究结果表明,与单纯牵伸腕伸肌相比,电刺激联合牵伸腕伸肌更能有效降低痉挛程度。