Department of Physical Medicine and Rehabilitation, Medical University of Vienna,Vienna, Austria.
J Rehabil Med. 2012 Feb;44(2):99-105. doi: 10.2340/16501977-0941.
The aim of this educational review is to provide an overview of the clinical application of transcutaneous electrical stimulation of the extremities in patients with upper motor neurone lesions. In general two methods of electrical stimulation can be distinguished: (i) therapeutic electrical stimulation, and (ii) functional electrical stimulation. Therapeutic electrical stimulation improves neuromuscular functional condition by strengthening muscles, increasing motor control, reducing spasticity, decreasing pain and increasing range of motion. Transcutaneous electrical stimulation may be used for neuromuscular electrical stimulation inducing repetitive muscle contraction, electromyography-triggered neuromuscular electrical stimulation, position-triggered electrical stimulation and subsensory or sensory transcutaneous electric stimulation. Functional electrical stimulation provokes muscle contraction and thereby produces a functionally useful movement during stimulation. In patients with spinal cord injuries or stroke, electrical upper limb neuroprostheses are applied to enhance upper limb and hand function, and electrical lower limb neuroprostheses are applied for restoration of standing and walking. For example, a dropped foot stimulator is used to trigger ankle dorsiflexion to restore gait function. A review of the literature and clinical experience of the use of therapeutic electrical stimulation as well as of functional electrical stimulation in combination with botulinum toxin, exercise therapy and/or splinting are presented. Although the evidence is limited we conclude that neuromuscular electrical stimulation in patients with central nervous system lesions can be an effective modality to improve function, and that combination with other treatments has an additive therapeutic effect.
本教育综述旨在概述经皮肢体电刺激在上运动神经元损伤患者中的临床应用。一般来说，可以区分两种电刺激方法：（i）治疗性电刺激，和（ii）功能性电刺激。治疗性电刺激通过增强肌肉、增加运动控制、减少痉挛、减轻疼痛和增加运动范围来改善神经肌肉功能状况。经皮电刺激可用于神经肌肉电刺激以诱导重复肌肉收缩、肌电图触发神经肌肉电刺激、位置触发电刺激和亚感觉或感觉经皮电刺激。功能性电刺激引起肌肉收缩，从而在刺激过程中产生功能上有用的运动。在脊髓损伤或中风患者中，应用上肢电神经假体来增强上肢和手的功能，应用下肢电神经假体来恢复站立和行走。例如，使用下垂足刺激器来触发踝关节背屈以恢复步态功能。本文综述了治疗性电刺激以及与肉毒毒素、运动疗法和/或夹板联合应用的功能性电刺激的文献复习和临床经验。尽管证据有限，但我们得出结论，中枢神经系统损伤患者的神经肌肉电刺激是一种有效改善功能的方法，并且与其他治疗方法联合具有附加的治疗效果。
