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矫形治疗性电刺激对急性颈脊髓损伤伴轻瘫患者的治疗效果:一项随机对照试验

Effects of orthotic therapeutic electrical stimulation in the treatment of patients with paresis associated with acute cervical spinal cord injury: a randomized control trial.

作者信息

Iwahashi K, Hayashi T, Watanabe R, Nishimura A, Ueta T, Maeda T, Shiba K

机构信息

Department of Rehabilitation Medicine, Japan Organization of Occupational Health and Safety, Spinal Injuries Center, Fukuoka, Japan.

Department of Orthopedic Surgery, Japan Organization of Occupational Health and Safety, Spinal Injuries Center, Fukuoka, Japan.

出版信息

Spinal Cord. 2017 Dec;55(12):1066-1070. doi: 10.1038/sc.2017.74. Epub 2017 Jun 27.

Abstract

STUDY DESIGN

A randomized controlled trial.

OBJECTIVES

To determine the effects of orthotic therapeutic electrical stimulation (TES) on the hand in patients with paresis associated with acute cervical spinal cord injury.

SETTING

Spinal Injuries Center, Fukuoka, Japan.

METHODS

The study included patients treated for spinal cord injuries (Frankel classification, grades B and C) at our institution within 1 week post injury between May 2011 and December 2014. The patients were allocated randomly to TES and control groups at the time of admission and underwent TES+conventional training or conventional training alone, respectively. Both hands of each patient were treated in the same way. The primary outcome was total passive motion (TPM) of the fingers (degrees). The secondary outcomes were edema (cm) and the upper-extremity motor scores of the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI). After randomization, outcomes were assessed at 1 week, 1 month and 3 months post injury in both groups.

RESULTS

Twenty-nine individuals were assessed at 3 months (15, TES; 14, control). There were no significant between-group differences for TPM of the fingers, edema and upper-extremity motor scores at 1 week, 1 month and 3 months after injury, although TPM of the fingers tended to be lower in the control group.

CONCLUSIONS

It is unclear from the results of this study whether TES has a therapeutic effect on TPM, edema or the upper-extremity motor score of the ISNCSCI. The results of this study provide useful data for future meta-analyses.

摘要

研究设计

一项随机对照试验。

目的

确定矫形治疗性电刺激(TES)对急性颈脊髓损伤所致轻瘫患者手部的影响。

地点

日本福冈脊髓损伤中心。

方法

本研究纳入了2011年5月至2014年12月期间在我院伤后1周内接受脊髓损伤治疗(Frankel分级,B级和C级)的患者。患者在入院时被随机分配到TES组和对照组,分别接受TES+传统训练或单纯传统训练。每位患者的双手均采用相同方式治疗。主要结局指标为手指总被动活动度(TPM,度)。次要结局指标为水肿(厘米)和脊髓损伤神经学分类国际标准(ISNCSCI)的上肢运动评分。随机分组后,两组均在伤后1周、1个月和3个月评估结局指标。

结果

29例患者在3个月时接受评估(TES组15例,对照组14例)。伤后1周、1个月和3个月时,两组在手指TPM、水肿和上肢运动评分方面无显著组间差异,尽管对照组手指TPM往往较低。

结论

本研究结果尚不清楚TES对ISNCSCI的TPM、水肿或上肢运动评分是否具有治疗作用。本研究结果为未来的荟萃分析提供了有用数据。

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