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量化多发性硬化症新使用者功能性电刺激的步态运动学和行走能力。

Quantification of gait kinematics and walking ability of people with multiple sclerosis who are new users of functional electrical stimulation.

机构信息

School of Health Science, Queen Margaret University, EH21 6UU Edinburgh, UK.

出版信息

J Rehabil Med. 2013 Apr;45(4):364-9. doi: 10.2340/16501977-1109.

Abstract

OBJECTIVE

To assess whether the application of Functional Electrical Stimulation improves gait kinematics and walking ability in people with multiple sclerosis who experience foot drop.

DESIGN

Acute open labelled comparative observation trial.

PARTICIPANTS

Twelve people (3 females, 9 males, EDSS 2-4) with relapsing remitting multiple sclerosis (47.8 years (standard deviation 6.6)) who were new users of functional electrical stimulation.

METHODS

Gait kinematics were recorded using 3D gait analysis. Walking ability was assessed through the 10-m walk test and the 6-min walk test. All assessments were performed with and without the assistance of functional electrical stimulation. The effect of functional electrical stimulation was analysed using paired t-tests.

RESULTS

Ankle dorsiflexion at initial contact (p = 0.026), knee flexion at initial contact (p = 0.044) and peak knee flexion during swing (p = 0.011) were significantly greater whilst walking with Functional Electrical Stimulation. The increased peak dorsiflexion in swing of nearly 4 degrees during functional electrical stimulation assisted walking approached significance (p = 0.069). The 10-m walk time was significantly improved by functional electrical stimulation (p = 0.004) but the 6 min walk test was not.

CONCLUSION

The acute application of functional electrical stimulation resulted in an orthotic effect through a change in ankle and knee kinematics and increased walking speed over a short distance in people with multiple sclerosis who experience foot drop.

摘要

目的

评估功能性电刺激的应用是否能改善患有足下垂的多发性硬化症患者的步态运动学和行走能力。

设计

急性开放标签比较观察试验。

参与者

12 名(3 名女性,9 名男性,EDSS 2-4)新发使用功能性电刺激的复发性缓解型多发性硬化症患者(47.8 岁(标准差 6.6))。

方法

使用 3D 步态分析记录步态运动学。通过 10 米步行测试和 6 分钟步行测试评估行走能力。所有评估均在有无功能性电刺激辅助的情况下进行。使用配对 t 检验分析功能性电刺激的效果。

结果

在初始接触时,踝关节背屈(p=0.026)、初始接触时的膝关节屈曲(p=0.044)和摆动时的最大膝关节屈曲(p=0.011)显著增加,而在功能性电刺激辅助下行走时。摆动时功能性电刺激辅助下的背屈峰值增加近 4 度接近显著水平(p=0.069)。功能性电刺激显著改善了 10 米步行时间(p=0.004),但 6 分钟步行测试没有改善。

结论

急性应用功能性电刺激通过改变踝关节和膝关节运动学,在患有足下垂的多发性硬化症患者中产生矫形效果,并在短距离内提高行走速度。

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