Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan Graduate School of Health Science, Kio University, Nara, Japan.
Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan.
NeuroRehabilitation. 2014;34(2):235-44. doi: 10.3233/NRE-131038.
Mirror therapy (MT) and electromyography-triggered neuromuscular stimulation (ETMS) are both effective treatments for impaired upper limbs following stroke. A combination of these two treatments (ETMS-MT) may result in greater gain than either treatment alone.
The feasibility and possible effects of ETMS-MT upon upper extremity function were investigated in stroke patients.
Thirteen post-acute stroke patients were randomly assigned to an immediate ETMS-MT group or a delayed ETMS-MT group and then underwent an 8-week training program. The immediate ETMS-MT group received ETMS-MT in addition to physical and occupational therapy (PT+OT) for 4 weeks. They then received only PT+OT for the next 4 weeks. In the delayed ETMS-MT group, interventions were provided in the reverse order. The main outcome measure was the Fugl-Meyer Assessment (FMA).
The immediate ETMS-MT group showed significantly greater gain in FMA in the first 4 weeks. The delayed ETMS-MT group showed significantly greater gain in active range of motion during the latter 4 weeks. No adverse effects were reported following ETMS-MT.
ETMS-MT might be as effective as independent MT or ETMS without causing any side effects. Future research should focus upon the direct comparisons between independent and combined interventions.
镜像疗法（MT）和肌电图触发神经肌肉电刺激（ETMS）都是治疗脑卒中后上肢功能障碍的有效方法。两种治疗方法联合（ETMS-MT）可能比单独使用任何一种方法都能取得更大的效果。
研究 ETMS-MT 对脑卒中患者上肢功能的可行性和可能影响。
将 13 名急性脑卒中后患者随机分为即刻 ETMS-MT 组和延迟 ETMS-MT 组，然后接受 8 周的训练计划。即刻 ETMS-MT 组在接受物理治疗和作业治疗（PT+OT）的同时，还接受 ETMS-MT 治疗 4 周。然后，他们只接受 PT+OT 治疗 4 周。在延迟 ETMS-MT 组中，干预措施的顺序相反。主要观察指标是 Fugl-Meyer 评估（FMA）。
即刻 ETMS-MT 组在第 1 至 4 周内 FMA 的增益明显更大。延迟 ETMS-MT 组在随后的 4 周内主动活动范围的增益明显更大。在接受 ETMS-MT 治疗后，没有报告任何不良反应。
ETMS-MT 可能与独立的 MT 或 ETMS 一样有效，且不会引起任何副作用。未来的研究应重点关注独立干预和联合干预之间的直接比较。
