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任务相关训练结合经皮神经电刺激促进慢性脑卒中患者上肢功能恢复。

Task-related training combined with transcutaneous electrical nerve stimulation promotes upper limb functions in patients with chronic stroke.

机构信息

The Post-Professional DPT Program, The Richard Stockton College of New Jersey.

出版信息

Tohoku J Exp Med. 2013 Oct;231(2):93-100. doi: 10.1620/tjem.231.93.

Abstract

Severe upper limb paresis is a major contributor to disability after stroke. This study investigated the efficacy of task-related training (TRT) with transcutaneous electrical nerve stimulation (TENS) on recovery of upper limb motor function in chronic-stroke survivors. Thirty patients with chronic stroke were randomly allocated two groups: the TRT+TENS group (n = 15) and the TRT+placebo (TRT+PLBO) group (n = 15). Patients in the TRT+TENS group received TENS stimulation (two to three times the sensory threshold), while subjects in the TRT+PLBO group received TENS without real electrical stimulation. TENS was applied to muscle belly of triceps and wrist extensors, while placebo (PLBO) stimulation was administrated without real electrical stimulation. Both interventions were given for 30 minutes per day, 5 days per week, for a period of 4 weeks. The primary outcomes were assessed with Fugl-Meyer assessment scores (FMA), Manual function test (MFT), Box and block test (BBT), and Modified Ashworth scale (MAS), each of which was performed one day before and one day after intervention. Both groups showed significant improvements in FMA, MFT, and BBT after intervention. When compared with the TRT+PLBO group, the TRT+TENS group showed significantly greater improvements in FMA (p = 0.034), MFT (p = 0.037), and BBT (p = 0.042). In MAS score, significant improvement was observed only in the TRT+TENS group (p = 0.011). Our findings indicate that TRT with TENS can reduce motor impairment and improve motor activity in stroke survivors with chronic upper limb paresis, highlighting the benefits of somatosensory stimulation from TENS.

摘要

严重的上肢瘫痪是中风后残疾的主要原因。本研究探讨了经皮神经电刺激(TENS)联合任务相关训练(TRT)对慢性中风幸存者上肢运动功能恢复的疗效。30 名慢性中风患者被随机分为两组:TRT+TENS 组(n=15)和 TRT+安慰剂(TRT+PLBO)组(n=15)。TRT+TENS 组患者接受 TENS 刺激(两到三倍的感觉阈),而 TRT+PLBO 组患者接受 TENS 但无真实电刺激。TENS 应用于三头肌和腕伸肌的肌腹,而 PLBO 刺激(PLBO)则无真实电刺激。两种干预措施均每天进行 30 分钟,每周 5 天,持续 4 周。主要结局评估采用 Fugl-Meyer 评估评分(FMA)、手动功能测试(MFT)、箱式和积木测试(BBT)和改良 Ashworth 量表(MAS),每组在干预前一天和干预后一天进行评估。两组干预后 FMA、MFT 和 BBT 均显著改善。与 TRT+PLBO 组相比,TRT+TENS 组的 FMA(p=0.034)、MFT(p=0.037)和 BBT(p=0.042)改善更显著。MAS 评分仅在 TRT+TENS 组观察到显著改善(p=0.011)。我们的研究结果表明,TENS 联合 TRT 可以减少慢性上肢瘫痪中风幸存者的运动障碍,提高运动活动能力,突出了 TENS 体感刺激的益处。

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