The Centre for Musculoskeletal Studies, School of Surgery, The University of Western Australia, Perth, WA, Australia.
Restor Neurol Neurosci. 2013;31(6):681-91. doi: 10.3233/RNN-130319.
We examined the feasibility and outcome of electromyographically triggered electrical muscle stimulation (EMG-ES) plus unilateral or bilateral task specific practice on arm function in chronic stroke survivors with moderate-severe hemiplegia. Transcranial magnetic stimulation was used to examine inter-hemispheric inhibition (IHI) acting on the stroke-affected hemisphere in a subset of eight participants.
Twenty-one stroke survivors (14 males; mean time post stroke 57.9 months) participated in this pilot investigation. Participants underwent a six-week program of daily EMG-ES training with random assignment to concurrent task practice using the stroke-affected hand only or both hands. The upper-extremity subscale of the Fugl-Meyer (FMUE) and the Arm Motor Ability Test (AMAT) were completed at baseline, 0-, 1-, and 3-months post-intervention.
Following the intervention, FMUE (F(3, 57) = 3.89, p = .01, ηp2 = .17) and AMAT (F(3, 57) = 12.6, p = .01, ηp2 = .39) scores improved, and remained better than baseline at three months re-assessment. The difference between groups was not significant. A non-significant decrease in IHI was observed post-intervention.
An intensive program of EMG-ES assisted functional training is feasible, well tolerated, and leads to improvements in moderate-severe deficits of arm function post stroke. Larger placebo controlled studies are needed to explore any advantage of bilateral over unilateral EMG-ES assisted training.
我们研究了肌电图触发电肌肉刺激（EMG-ES）联合单侧或双侧任务特异性练习对中度至重度偏瘫慢性脑卒中幸存者上肢功能的可行性和结果。在 8 名参与者的亚组中，使用经颅磁刺激来检查作用于脑卒中影响半球的半球间抑制（IHI）。
21 名脑卒中幸存者（14 名男性；脑卒中后平均时间 57.9 个月）参与了这项初步研究。参与者接受了为期六周的每日 EMG-ES 训练计划，随机分配进行同时使用患侧手或双手进行任务练习。在基线、0 个月、1 个月和 3 个月时完成了 Fugl-Meyer 上肢量表（FMUE）和上肢运动能力测试（AMAT）的上肢子量表。
干预后，FMUE（F（3,57）= 3.89，p =.01，ηp2 =.17）和 AMAT（F（3,57）= 12.6，p =.01，ηp2 =.39）评分均有所提高，且在三个月的重新评估中仍优于基线。组间差异无统计学意义。干预后观察到 IHI 有非显著性下降。
密集的 EMG-ES 辅助功能训练计划是可行的、耐受性良好的，可改善脑卒中后上肢功能的中重度缺损。需要更大规模的安慰剂对照研究来探索双侧 EMG-ES 辅助训练相对于单侧训练的任何优势。
