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[功能性电刺激治疗足下垂:临床结果]

[Functional electrostimulation for drop foot treatment : Clinical outcome].

作者信息

Yao D, Jakubowitz E, Ettinger S, Claassen L, Plaass C, Stukenborg-Colsman C, Daniilidis K

机构信息

Department Fuß- und Sprunggelenkschirurgie, Orthopädie der Medizinischen Hochschule Hannover im DIAKOVERE Annastift, Anna-von-Borries-Straße 1-7, 30625, Hannover, Deutschland.

Labor für Biomechanik und Biomaterialien, Orthopädischen Klinik der Medizinischen Hochschule Hannover, Hannover, Deutschland.

出版信息

Orthopade. 2017 Mar;46(3):227-233. doi: 10.1007/s00132-016-3371-5.

DOI:10.1007/s00132-016-3371-5
PMID:27995271
Abstract

INTRODUCTION

Neurologic paralysis of the foot due to damage to the central nervous system is primarily caused by a cerebral insult. The ankle-foot orthosis (AFO), which is the classical conservative treatment option, is associated with drawbacks, e.g., increased contractures, limited mobilization from the sitting position, and cosmetic aspects.

METHODS

Functional external electrostimulation (FES) is an suitable treatment method for patients with a central lesion and intact peroneal nerve. Based on this method, the neuroprosthesis is a dynamic therapy option in the form of an implantable nerve stimulator (ActiGait® system, Otto Bock, Duderstadt, Germany) which is placed directly on the motor branch of the peroneus nerve and results in active foot lifting. The aim of the present study is to evaluate the clinical effect of the ActiGait® system with regard to its suitability for everyday use by means of gait tests with an emphasis on time-distance parameters and to compare it with the current literature.

RESULTS AND CONCLUSION

In this retrospective study, the clinical results after implantation of the ActiGait® system are presented and evaluated. In summary, the implantation of a neuroprosthesis in patients with stroke-related drop foot represents a sensible and promising therapy option.

摘要

引言

中枢神经系统损伤导致的足部神经麻痹主要由脑部损伤引起。踝足矫形器(AFO)是经典的保守治疗选择,但存在一些缺点,例如挛缩增加、从坐姿起身时活动受限以及外观问题。

方法

功能性外部电刺激(FES)是适用于中枢性病变且腓总神经完整患者的一种治疗方法。基于该方法,神经假体是一种动态治疗选择,采用可植入神经刺激器(ActiGait®系统,奥托博克公司,德国杜德施塔特)的形式,直接放置在腓神经运动支上,可实现足部主动抬起。本研究的目的是通过侧重于时间 - 距离参数的步态测试,评估ActiGait®系统在日常使用适用性方面的临床效果,并与现有文献进行比较。

结果与结论

在这项回顾性研究中,展示并评估了ActiGait®系统植入后的临床结果。总之,为与中风相关的足下垂患者植入神经假体是一种合理且有前景的治疗选择。

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1
[Functional electrostimulation for drop foot treatment : Clinical outcome].[功能性电刺激治疗足下垂:临床结果]
Orthopade. 2017 Mar;46(3):227-233. doi: 10.1007/s00132-016-3371-5.
2
Restoration of ankle movements with the ActiGait implantable drop foot stimulator: a safe and reliable treatment option for permanent central leg palsy.使用ActiGait植入式垂足刺激器恢复踝关节活动:永久性中枢性腿部麻痹的一种安全可靠的治疗选择。
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Towards physiological ankle movements with the ActiGait implantable drop foot stimulator in chronic stroke.使用 ActiGait 可植入式足下垂刺激器实现慢性中风患者的生理性踝关节运动。
Restor Neurol Neurosci. 2013;31(5):557-69. doi: 10.3233/RNN-120283.
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[Foot drop treatment by implantation of a neuroprosthesis (ActiGait®)].[通过植入神经假体(ActiGait®)治疗足下垂]
Oper Orthop Traumatol. 2017 Jun;29(3):266-278. doi: 10.1007/s00064-017-0494-8. Epub 2017 May 4.
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Effects of implantable peroneal nerve stimulation on gait quality, energy expenditure, participation and user satisfaction in patients with post-stroke drop foot using an ankle-foot orthosis.植入式腓总神经刺激对使用踝足矫形器的中风后足下垂患者步态质量、能量消耗、参与度及用户满意度的影响
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Effect of peroneal electrical stimulation versus an ankle-foot orthosis on obstacle avoidance ability in people with stroke-related foot drop.腓肠肌电刺激与踝足矫形器对脑卒中后足下垂患者障碍物回避能力的影响。
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引用本文的文献

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Subjective outcome following neurostimulator implantation as drop foot therapy due to lesions in the central nervous system-midterm results.因中枢神经系统病变导致的足下垂接受神经刺激器植入术后的主观疗效-中期结果。
Musculoskelet Surg. 2020 Apr;104(1):93-99. doi: 10.1007/s12306-019-00604-3. Epub 2019 May 3.
2
[Foot drop treatment by implantation of a neuroprosthesis (ActiGait®)].[通过植入神经假体(ActiGait®)治疗足下垂]
Oper Orthop Traumatol. 2017 Jun;29(3):266-278. doi: 10.1007/s00064-017-0494-8. Epub 2017 May 4.

本文引用的文献

1
Restoration of ankle movements with the ActiGait implantable drop foot stimulator: a safe and reliable treatment option for permanent central leg palsy.使用ActiGait植入式垂足刺激器恢复踝关节活动:永久性中枢性腿部麻痹的一种安全可靠的治疗选择。
J Neurosurg. 2016 Jan;124(1):70-6. doi: 10.3171/2014.12.JNS142110. Epub 2015 Jul 24.
2
The effects of peroneal nerve functional electrical stimulation versus ankle-foot orthosis in patients with chronic stroke: a randomized controlled trial.慢性卒中患者中腓总神经功能性电刺激与踝足矫形器的效果比较:一项随机对照试验
Neurorehabil Neural Repair. 2014 Sep;28(7):688-97. doi: 10.1177/1545968314521007. Epub 2014 Feb 13.
3
Towards physiological ankle movements with the ActiGait implantable drop foot stimulator in chronic stroke.
使用 ActiGait 可植入式足下垂刺激器实现慢性中风患者的生理性踝关节运动。
Restor Neurol Neurosci. 2013;31(5):557-69. doi: 10.3233/RNN-120283.
4
Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.291 种疾病和伤害导致的伤残调整生命年(DALYs)在 21 个地区,1990-2010 年:全球疾病负担研究 2010 的系统分析。
Lancet. 2012 Dec 15;380(9859):2197-223. doi: 10.1016/S0140-6736(12)61689-4.
5
Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010.1990年和2010年20个年龄组中235种死因的全球和区域死亡率:全球疾病负担研究2010的系统分析
Lancet. 2012 Dec 15;380(9859):2095-128. doi: 10.1016/S0140-6736(12)61728-0.
6
The decline in stroke mortality: exploration of future trends in 7 Western European countries.卒中死亡率下降:7 个西欧国家未来趋势探讨。
Stroke. 2011 Aug;42(8):2126-30. doi: 10.1161/STROKEAHA.110.599712. Epub 2011 Jun 23.
7
Evaluation of the effect of ankle-foot orthosis use on balance and mobility in hemiparetic stroke patients.评估踝足矫形器使用对偏瘫脑卒中患者平衡和移动能力的影响。
Disabil Rehabil. 2011;33(15-16):1433-9. doi: 10.3109/09638288.2010.533243. Epub 2010 Nov 22.
8
Comprehensive overview of nursing and interdisciplinary rehabilitation care of the stroke patient: a scientific statement from the American Heart Association.中风患者护理与跨学科康复护理的全面概述:美国心脏协会的科学声明
Stroke. 2010 Oct;41(10):2402-48. doi: 10.1161/STR.0b013e3181e7512b. Epub 2010 Sep 2.
9
Effect of AFO design on walking after stroke: impact of ankle plantar flexion contracture.踝足矫形器设计对脑卒中后步行的影响:踝关节跖屈挛缩的作用
Prosthet Orthot Int. 2010 Sep;34(3):277-92. doi: 10.3109/03093646.2010.501512.
10
Is transcutaneous peroneal stimulation beneficial to patients with chronic stroke using an ankle-foot orthosis? A within-subjects study of patients' satisfaction, walking speed and physical activity level.经皮腓神经刺激对使用踝足矫形器的慢性脑卒中患者是否有益?一项关于患者满意度、行走速度和身体活动水平的自身对照研究。
J Rehabil Med. 2010 Feb;42(2):117-21. doi: 10.2340/16501977-0489.