Ganesh G Shankar, Kumari Ranjita, Pattnaik Monalisa, Mohanty Patitapaban, Mishra Chittaranjan, Kaur Parminder, Dakshinamoorthy Anandhi
Composite Regional Centre for Persons with Disabilities, Lucknow, Uttar Pradesh, India.
Burnpur Hospital, SAIL-ISP, Asansol, West Bengal, India.
Physiother Res Int. 2018 Apr;23(2):e1705. doi: 10.1002/pri.1705. Epub 2018 Feb 8.
Spasticity is a major disabling symptom in patients post stroke. Though studies have demonstrated that electrical stimulation (ES) can reduce spasticity and improve passive ankle range of motion (ROM), not many studies have evaluated the effectiveness of ES on active ankle ROM. The purpose of this study was to determine the effectiveness of Faradic and Russian currents in the reduction of ankle plantar-flexor spasticity and improving motor recovery in patients post stroke.
Eighty-three patients (29 females and 54 males; mean age of 57.12 years) were randomly assigned to Group 1 (task-oriented exercises), Group 2 (Faradic current for 10 min and task-oriented exercises), and Group 3 (Russian current for 10 min and task-oriented exercises) for a period of 5 sessions per week for 6 weeks. All patients were assessed for soleus and gastrocnemius muscles spasticity measured by modified modified Ashworth scale; active and passive range ROM measured by goniometer; and functional ambulation measured by modified Emory Functional Ambulation Profile at the time of recruitment to study and after 6 weeks.
Both the types of stimulation and exercises were not associated with improvements in modified Emory Functional Ambulation Profile (p > 0.05). The results showed that all the groups are effective in improving passive ankle ROM (p < 0.05) and reducing soleus and gastrocnemius muscles spasticity (p < 0.05). Though all the groups were effective in improving active ankle ROM, no group was found to be superior to another after treatment CONCLUSION: Adding ES to exercises are associated with low to medium effect sizes (<0.5) in reducing spasticity and improving ankle ROM.
痉挛是中风患者的主要致残症状。尽管研究表明电刺激（ES）可减轻痉挛并改善踝关节被动活动范围（ROM），但评估ES对踝关节主动ROM有效性的研究并不多。本研究的目的是确定法拉第电流和俄罗斯电流在减轻中风后患者踝关节跖屈肌痉挛及改善运动恢复方面的有效性。
83例患者（29例女性，54例男性；平均年龄57.12岁）被随机分为第1组（任务导向性锻炼）、第2组（法拉第电流刺激10分钟加任务导向性锻炼）和第3组（俄罗斯电流刺激10分钟加任务导向性锻炼），每周进行5次治疗，共6周。在入组研究时和6周后，对所有患者进行评估，包括用改良Ashworth量表测量比目鱼肌和腓肠肌的痉挛程度；用角度计测量主动和被动活动范围ROM；用改良的埃默里功能步行量表测量功能性步行能力。
两种刺激方式及锻炼均与改良的埃默里功能步行量表的改善无关（p>0.05）。结果显示，所有组在改善踝关节被动ROM（p<0.05）和减轻比目鱼肌及腓肠肌痉挛方面均有效（p<0.05）。尽管所有组在改善踝关节主动ROM方面均有效，但治疗后未发现有一组优于另一组。结论：在锻炼中加入ES在减轻痉挛和改善踝关节ROM方面的效应大小为低到中等（<0.5）。
