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功能性电刺激对中风患者上肢和肩胛间肌肉的应用以改善伸手动作:一项可行性研究

The Use of Functional Electrical Stimulation on the Upper Limb and Interscapular Muscles of Patients with Stroke for the Improvement of Reaching Movements: A Feasibility Study.

作者信息

Cuesta-Gómez Alicia, Molina-Rueda Francisco, Carratala-Tejada Maria, Imatz-Ojanguren Eukene, Torricelli Diego, Miangolarra-Page Juan Carlos

机构信息

Motion Analysis, Ergonomics, Biomechanics and Motor Control Laboratory (LAMBECOM), Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Spain.

Tecnalia, San Sebastián, Spain.

出版信息

Front Neurol. 2017 May 10;8:186. doi: 10.3389/fneur.2017.00186. eCollection 2017.

Abstract

INTRODUCTION

Reaching movements in stroke patients are characterized by decreased amplitudes at the shoulder and elbow joints and greater displacements of the trunk, compared to healthy subjects. The importance of an appropriate and specific contraction of the interscapular and upper limb (UL) muscles is crucial to achieving proper reaching movements. Functional electrical stimulation (FES) is used to activate the paretic muscles using short-duration electrical pulses.

OBJECTIVE

To evaluate whether the application of FES in the UL and interscapular muscles of stroke patients with motor impairments of the UL modifies patients' reaching patterns, measured using instrumental movement analysis systems.

DESIGN

A cross-sectional study was carried out.

SETTING

The VICON Motion System was used to conduct motion analysis.

PARTICIPANTS

Twenty-one patients with chronic stroke.

INTERVENTION

The Compex electric stimulator was used to provide muscle stimulation during two conditions: a placebo condition and a FES condition.

MAIN OUTCOME MEASURES

We analyzed the joint kinematics (trunk, shoulder, and elbow) from the starting position until the affected hand reached the glass.

RESULTS

Participants receiving FES carried out the movement with less trunk flexion, while shoulder flexion elbow extension was increased, compared to placebo conditions.

CONCLUSION

The application of FES to the UL and interscapular muscles of stroke patients with motor impairment of the UL has improved reaching movements.

摘要

引言

与健康受试者相比,中风患者的伸手动作特点是肩关节和肘关节的幅度减小,而躯干的位移更大。肩胛间肌和上肢(UL)肌肉进行适当且特定的收缩对于实现正确的伸手动作至关重要。功能性电刺激(FES)用于通过短时长电脉冲激活瘫痪肌肉。

目的

评估对上肢存在运动障碍的中风患者的上肢和肩胛间肌应用FES是否会改变患者的伸手模式,采用仪器运动分析系统进行测量。

设计

开展了一项横断面研究。

设置

使用VICON运动系统进行运动分析。

参与者

21名慢性中风患者。

干预

使用Compex电刺激器在两种情况下提供肌肉刺激:安慰剂情况和FES情况。

主要观察指标

我们分析了从起始位置到患手触及玻璃杯期间的关节运动学(躯干、肩部和肘部)情况。

结果

与安慰剂情况相比,接受FES的参与者在进行动作时躯干屈曲程度较小,而肩部屈曲和肘部伸展增加。

结论

对上肢存在运动障碍的中风患者的上肢和肩胛间肌应用FES改善了伸手动作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ed9/5423909/eb8b9d13879b/fneur-08-00186-g001.jpg

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