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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.

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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