Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA.
Clin Rehabil. 2012 Nov;26(11):1010-20. doi: 10.1177/0269215512442915. Epub 2012 May 4.
Sensory amplitude electrical stimulation (SES) and repetitive task practice reduce impairments and arm dysfunction when delivered separately following stroke.
To determine if home-based, task-specific arm exercise was more effective when administered concurrent with SES.
Thirty-eight subjects with chronic stroke and mean Fugl-Meyer Assessment (FMA) score 28/66 (15-45) participated. Subjects were randomly assigned to an SES (n = 20) or sham stimulation (n = 18) group. Subjects engaged in task-based home exercise for 30 minutes, twice daily, for four weeks while wearing a glove electrode on the impaired hand. Experimental subjects received SES while control subjects received sham stimulation during exercise.
FMA and Arm Motor Ability Test (AMAT).
There were no significant between-group differences for outcome measures. There was a significant difference between the pre- and post-test scores in the SES group AMAT median time (P = 0.003 95% confidence interval (CI): -14.304, -6.365; effect size: 0.84). Practice time was not associated with changes in outcomes. Subjects with more sensorimotor dysfunction had significantly greater improvements on AMAT median time (P = 0.037). There was a significant relationship between baseline FMA score and FMA change score (r = 0.402; P = 0.006).
This study describes a unique SES delivery system via glove electrode that enabled delivery of SES during home-based arm task practice in stroke survivors. Task practice with concurrent SES did not demonstrate significantly better effects than task practice with sham stimulation, however there was a trend for greater improvement in one activity measure.
感觉幅度电刺激(SES)和重复性任务练习在中风后分别进行时可以减少损伤和手臂功能障碍。
确定当与 SES 同时进行时,基于家庭的、特定于任务的手臂运动是否更有效。
38 名患有慢性中风且平均 Fugl-Meyer 评估(FMA)得分为 28/66(15-45)的患者参加了该研究。患者被随机分配到 SES(n = 20)或假刺激(n = 18)组。患者在佩戴受损手上的手套电极的情况下,每天在家中进行两次、每次 30 分钟的基于任务的运动。实验组接受 SES,对照组在运动期间接受假刺激。
FMA 和手臂运动能力测试(AMAT)。
两组之间在结局测量上没有显著差异。SES 组 AMAT 中位数时间(P = 0.003,95%置信区间(CI):-14.304,-6.365;效应量:0.84)的前后测试得分有显著差异。练习时间与结果的变化无关。感觉运动功能障碍程度较高的患者 AMAT 中位数时间的改善显著更大(P = 0.037)。基线 FMA 评分与 FMA 变化评分之间存在显著关系(r = 0.402;P = 0.006)。
本研究描述了一种通过手套电极进行的独特 SES 传递系统,使 SES 能够在中风幸存者的家庭手臂任务练习期间传递。与假刺激相比,任务练习结合 SES 并没有显示出明显更好的效果,但在一项活动测量中存在更大改善的趋势。