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慢性中风患者上肢新型神经肌肉电刺激系统:一项可行性研究。

Novel neuromuscular electrical stimulation system for the upper limbs in chronic stroke patients: a feasibility study.

作者信息

Noma Tomokazu, Matsumoto Shuji, Shimodozono Megumi, Iwase Yoshiaki, Kawahira Kazumi

机构信息

From the Department of Rehabilitation, Kirishima Rehabilitation Center of Kagoshima University Hospital, Kagoshima, Japan (TN); and Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences (SM, MS, KK), and Department of Basic Occupational Therapy, School of Health Sciences, Faculty of Medicine (YI), Kagoshima University, Kagoshima, Japan.

出版信息

Am J Phys Med Rehabil. 2014 Jun;93(6):503-10. doi: 10.1097/PHM.0000000000000056.

Abstract

OBJECTIVE

The aim of this study was to assess the feasibility of applying a novel neuromuscular electrical stimulation system, targeting shoulder flexion, elbow extension, wrist extension, and individual finger extensions, to improve motor control and function of the hemiparetic upper limbs in chronic stroke patients.

DESIGN

Fifteen participants with chronic (>1 yr after cerebrovascular accident) upper limb hemiparesis were enrolled. The subjects underwent upper limb training for 60 mins per day, 6 days per week, for 2 wks, using both a shoulder-and-elbow stimulation device and a wrist-and-finger stimulation device developed by the study investigators. Outcomes were assessed using the upper extremity component of the Fugl-Meyer assessment, the action research arm test, and the modified Ashworth scale before and after intervention.

RESULTS

All patients completed the training successfully using the neuromuscular electrical stimulation system without any safety incidents or other complications reported. Nonparametric statistical analyses indicated significant improvements in the upper extremity component of the Fugl-Meyer assessment and action research arm test scores, both at P < 0.01. There were also significant reductions in modified Ashworth scale scores for the elbow and the wrist flexor, both at P < 0.01.

CONCLUSIONS

The multimuscle stimulation approach and method presented in this study seem feasible, and the improvements of upper limb motor control and functional test in chronic stroke patients justify further controlled investigation.

摘要

目的

本研究旨在评估应用一种新型神经肌肉电刺激系统的可行性,该系统针对肩屈曲、肘伸展、腕伸展和各手指伸展,以改善慢性卒中患者偏瘫上肢的运动控制和功能。

设计

招募了15名患有慢性(脑血管意外后>1年)上肢偏瘫的参与者。受试者使用研究人员开发的肩部和肘部刺激装置以及腕部和手指刺激装置,每周6天,每天进行60分钟的上肢训练,共2周。在干预前后,使用Fugl-Meyer评估的上肢部分、动作研究臂测试和改良Ashworth量表对结果进行评估。

结果

所有患者均成功使用神经肌肉电刺激系统完成训练,未报告任何安全事件或其他并发症。非参数统计分析表明,Fugl-Meyer评估的上肢部分和动作研究臂测试得分均有显著改善,P均<0.01。肘部和腕部屈肌的改良Ashworth量表得分也显著降低,P均<0.01。

结论

本研究中提出的多肌肉刺激方法和手段似乎可行,慢性卒中患者上肢运动控制和功能测试的改善证明有必要进行进一步的对照研究。

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