Department of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, OH 44109, USA.
Arch Phys Med Rehabil. 2013 Jun;94(6):1007-14. doi: 10.1016/j.apmr.2013.01.024. Epub 2013 Feb 8.
To compare the motor relearning effect of a surface peroneal nerve stimulator (PNS) versus usual care on lower limb motor impairment, activity limitation, and quality of life among chronic stroke survivors.
Single-blinded randomized controlled trial.
Teaching hospital of academic medical center.
Chronic stroke survivors (N=110; >12wk poststroke) with unilateral hemiparesis and dorsiflexion strength of ≤4/5 on the Medical Research Council scale.
Subjects were stratified by motor impairment level and then randomly assigned to ambulation training with either a surface PNS device or usual care (ankle-foot orthosis or no device) intervention. Subjects were treated for 12 weeks and followed up for 6 months posttreatment.
Lower limb portion of the Fugl-Meyer (FM) Assessment (motor impairment), the modified Emory Functional Ambulation Profile (mEFAP) performed without a device (functional ambulation), and the Stroke Specific Quality of Life (SSQOL) scale.
There was no significant treatment group main effect or treatment group by time interaction effect on FM, mEFAP, or SSQOL raw scores (P>.05). The time effect was significant for the 3 raw scores (P<.05). However, when comparing average change scores from baseline (t1) to end of treatment (t2, 12wk), and at 12 weeks (t3) and 24 weeks (t4) after end of treatment, significant differences were noted only for the mEFAP and SSQOL scores. The change in the average scores for both mEFAP and SSQOL occurred between t1 and t2, followed by relative stability thereafter.
There was no evidence of a motor relearning effect on lower limb motor impairment in either the PNS or usual-care groups. However, both the PNS and usual-care groups demonstrated significant improvements in functional mobility and quality of life during the treatment period, which were maintained at 6-month follow-up.
比较表面腓总神经刺激器（PNS）与常规护理对慢性脑卒中幸存者下肢运动障碍、活动受限和生活质量的再学习效果。
单盲随机对照试验。
学术医学中心教学医院。
慢性脑卒中幸存者（N=110；脑卒中后>12 周），单侧偏瘫，MRC 量表背屈强度≤4/5。
根据运动障碍程度对受试者进行分层，然后随机分配至步行训练与表面 PNS 装置或常规护理（踝足矫形器或无装置）干预。受试者接受 12 周治疗，并在治疗后 6 个月进行随访。
下肢 Fugl-Meyer（FM）评估（运动障碍）、无装置的改良 Emory 功能步行量表（mEFAP）和脑卒中专用生活质量量表（SSQOL）。
FM、mEFAP 和 SSQOL 原始评分均无显著治疗组主效应或治疗组与时间交互效应（P>.05）。3 个原始评分的时间效应有统计学意义（P<.05）。然而，当比较从基线（t1）到治疗结束（t2，12 周）、治疗结束后 12 周（t3）和 24 周（t4）的平均变化分数时，mEFAP 和 SSQOL 评分仅存在显著差异。mEFAP 和 SSQOL 的平均评分变化发生在 t1 和 t2 之间，此后相对稳定。
PNS 组和常规护理组均未观察到下肢运动障碍的运动再学习效果。然而，PNS 组和常规护理组在治疗期间均显著提高了功能性移动能力和生活质量，且在 6 个月随访时仍保持。
