Springer Shmuel, Vatine Jean-Jacques, Lipson Ronit, Wolf Alon, Laufer Yocheved
Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, 31905 Haifa, Israel.
ScientificWorldJournal. 2012;2012:530906. doi: 10.1100/2012/530906. Epub 2012 Oct 11.
The study objective was to assess the effect of functional electrical stimulation (FES) applied to the peroneal nerve and thigh muscles on gait performance in subjects with hemiparesis. Participants were 45 subjects (age 57.8 ± 14.8 years) with hemiparesis (5.37 ± 5.43 years since diagnosis) demonstrating a foot-drop and impaired knee control. Thigh stimulation was applied either to the quadriceps or hamstrings muscles, depending on the dysfunction most affecting gait. Gait was assessed during a two-minute walk test with/without stimulation and with peroneal stimulation alone. A second assessment was conducted after six weeks of daily use. The addition of thigh muscles stimulation to peroneal stimulation significantly enhanced gait velocity measures at the initial and second evaluation. Gait symmetry was enhanced by the dual-channel stimulation only at the initial evaluation, and single-limb stance percentage only at the second assessment. For example, after six weeks, the two-minute gait speed with peroneal stimulation and with the dual channel was 0.66 ± 0.30 m/sec and 0.70 ± 0.31 m/sec, respectively (P < 0.0001). In conclusion, dual-channel FES may enhance gait performance in subjects with hemiparesis more than peroneal FES alone.
本研究的目的是评估对腓总神经和大腿肌肉施加功能性电刺激(FES)对偏瘫患者步态表现的影响。研究对象为45名偏瘫患者(年龄57.8±14.8岁),自确诊以来已有5.37±5.43年,存在足下垂和膝关节控制障碍。根据对步态影响最大的功能障碍情况,对股四头肌或腘绳肌进行大腿刺激。在有/无刺激以及仅进行腓总神经刺激的两分钟步行测试期间评估步态。在每天使用六周后进行第二次评估。在初始评估和第二次评估时,在腓总神经刺激基础上加用大腿肌肉刺激可显著提高步态速度指标。仅在初始评估时双通道刺激可增强步态对称性,仅在第二次评估时可提高单腿站立百分比。例如,六周后,仅进行腓总神经刺激和进行双通道刺激时的两分钟步态速度分别为0.66±0.30米/秒和0.70±0.31米/秒(P<0.0001)。总之,双通道功能性电刺激对偏瘫患者步态表现的改善可能优于单纯腓总神经功能性电刺激。