Mills Patricia Branco, Dossa Farhana
From the ICORD (International Collaboration on Repair Discoveries) (PBM, FD); Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia (PBM); GF Strong Rehabilitation Center (PBM); and Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver Coastal Health, Vancouver, BC, Canada (PBM).
Am J Phys Med Rehabil. 2016 Apr;95(4):309-18. doi: 10.1097/PHM.0000000000000437.
The purpose of this systematic review was to summarize the effect of transcutaneous electrical nerve stimulation (TENS) for management of limb spasticity. Randomized controlled trials were searched using electronic databases through July 2015. Fourteen randomized controlled trials were included, involving 544 participants. Intervention protocols fit within three categories: 1) TENS vs. no TENS or placebo TENS (n = 7), 2) TENS vs. another TENS protocol or another intervention for spasticity management (n = 7), and 3) TENS as an adjunct to another intervention for spasticity management (n = 4). There was level 1 and 2 evidence for TENS improving spasticity-related outcome measures within the International Classification of Functioning, Disability, and Health domains of body structure and function (e.g., Modified Ashworth Scale) as well as activity (e.g., gait). Better responses in outcome measures in the International Classification of Functioning, Disability, and Health activity domain were seen when TENS was used in combination with active therapy (e.g., exercise and task-related training) vs. as a single therapeutic modality.
本系统评价的目的是总结经皮电刺激神经疗法（TENS）对肢体痉挛管理的效果。通过检索电子数据库，纳入截至2015年7月的随机对照试验。共纳入14项随机对照试验，涉及544名参与者。干预方案分为三类：1）TENS与无TENS或安慰剂TENS对比（n = 7），2）TENS与另一种TENS方案或另一种痉挛管理干预措施对比（n = 7），3）TENS作为痉挛管理的另一种干预措施的辅助手段（n = 4）。有1级和2级证据表明，TENS可改善《国际功能、残疾和健康分类》中身体结构和功能（如改良Ashworth量表）以及活动（如步态）领域内与痉挛相关的结局指标。当TENS与主动治疗（如运动和任务相关训练）联合使用时，与作为单一治疗方式相比，在《国际功能、残疾和健康分类》活动领域的结局指标中观察到更好的反应。
