Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan.
Spaulding Neuromodulation Center, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Sci Rep. 2018 Jun 15;8(1):9217. doi: 10.1038/s41598-018-27553-4.
The peripheral sensory system is critical to regulating motor plasticity and motor recovery. Peripheral electrical stimulation (ES) can generate constant and adequate sensory input to influence the excitability of the motor cortex. The aim of this proof of concept study was to assess whether ES prior to each hand function training session for eight weeks can better improve neuromuscular control and hand function in chronic stroke individuals and change electroencephalography-electromyography (EEG-EMG) coherence, as compared to the control (sham ES). We recruited twelve subjects and randomly assigned them into ES and control groups. Both groups received 20-minute hand function training twice a week, and the ES group received 40-minute ES on the median nerve of the affected side before each training session. The control group received sham ES. EEG, EMG and Fugl-Meyer Assessment (FMA) were collected at four different time points. The corticomuscular coherence (CMC) in the ES group at fourth weeks was significantly higher (p = 0.004) as compared to the control group. The notable increment of FMA at eight weeks and follow-up was found only in the ES group. The eight-week rehabilitation program that implemented peripheral ES sessions prior to function training has a potential to improve neuromuscular control and hand function in chronic stroke individuals.
周围感觉系统对于调节运动可塑性和运动恢复至关重要。周围电刺激（ES）可以产生恒定且充足的感觉输入，从而影响运动皮层的兴奋性。本概念验证研究的目的是评估在八周的手部功能训练前进行 ES 是否能比对照（假 ES）更好地改善慢性中风患者的神经肌肉控制和手部功能，并改变脑电图-肌电图（EEG-EMG）相干性。我们招募了 12 名受试者，并将他们随机分配到 ES 和对照组。两组均接受每周两次 20 分钟的手部功能训练，ES 组在每次训练前接受患侧正中神经 40 分钟的 ES。对照组接受假 ES。在四个不同的时间点收集脑电图、肌电图和 Fugl-Meyer 评估（FMA）。与对照组相比，ES 组在第四周的皮质肌电相干性（CMC）显著升高（p=0.004）。仅在 ES 组中发现 FMA 在八周和随访时显著增加。在功能训练前实施周围 ES 治疗的八周康复方案可能改善慢性中风患者的神经肌肉控制和手部功能。
