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直流电前庭刺激能否降低临床完全性脊髓损伤患者的痉挛程度?

Does galvanic vestibular stimulation decrease spasticity in clinically complete spinal cord injury?

作者信息

Čobeljić Radoje D, Ribarič-Jankes Ksenija, Aleksić Antonina, Popović-Maneski Lana Z, Schwirtlich Laszlo B, Popović Dejan B

机构信息

Department of Neuro-Orthopedic Rehabilitation, Clinic for Rehabilitation 'Dr. Miroslav Zotović'.

Euromedik Hospital.

出版信息

Int J Rehabil Res. 2018 Sep;41(3):251-257. doi: 10.1097/MRR.0000000000000297.

Abstract

The aim of this study was to determine changes in clinical and biomechanical measures of spasticity after administering galvanic vestibular stimulation in patients with a complete spinal cord injury (SCI). The spasticity in the lower limbs was assessed using the Modified Ashworth Scale and the pendulum test in seven SCI patients (grade A on the ASIA Impairment Scale) before (0), immediately after (0), and at 5 and 30 min after the real versus sham galvanic vestibular stimulation (15 s each, anode over the right mastoid). Overall, the changes in spasticity were not significantly different between the real and sham galvanic vestibular stimulation. However, the Modified Ashworth Scale and the pendulum test indicated a reduction in spasticity in two out of seven patients. The results suggest that galvanic vestibular stimulation may modify spasticity in some patients with complete SCI, presumably through the residual vestibulospinal influences. Future studies should determine clinical and neurophysiological profiles of responders versus nonresponders and optimize parameters of galvanic vestibular stimulation.

摘要

本研究的目的是确定在完全性脊髓损伤(SCI)患者中给予直流电前庭刺激后痉挛的临床和生物力学指标的变化。在7名SCI患者(美国脊髓损伤协会损伤分级为A级)中,于实际直流电前庭刺激(每次15秒,阳极置于右侧乳突)和假刺激之前(0分钟)、之后立即(0分钟)以及之后5分钟和30分钟,使用改良Ashworth量表和钟摆试验评估下肢痉挛情况。总体而言,实际直流电前庭刺激和假刺激之间痉挛的变化没有显著差异。然而,改良Ashworth量表和钟摆试验表明,7名患者中有2名患者的痉挛有所减轻。结果表明,直流电前庭刺激可能会改变一些完全性SCI患者的痉挛情况,推测是通过残余的前庭脊髓影响。未来的研究应确定反应者与无反应者的临床和神经生理学特征,并优化直流电前庭刺激参数。

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