Roessingh Research and Development, Roessingh Research and Development and Roessingh Rehabilitation Centre, Enschede, The Netherlands.
J Rehabil Med. 2018 Aug 22;50(8):719-724. doi: 10.2340/16501977-2367.
To explore whether functional electrical stimulation of the hamstrings results in improved knee kinematics in chronic stroke survivors walking with a stiff knee gait.
Quasi-experimental.
Sixteen adult chronic stroke survivors.
Survivors received functional electrical stimulation of the hamstrings, 3 times a week for 1 h during a period of 5 weeks. 3D kinematics was calculated before the training period and after 5 weeks of training. Knee kinematics of walking without stimulation before the training period was compared with walking with stimulation after 5 weeks of training. (intervention effect). In addition, knee kinematics of walking without stimulation before the training period was compared with walking without stimulation after the training period (therapeutic effect).
The intervention effect showed a significant increase, of mean 8.7° (standard deviation (SD) 8.3, p = 0.001), in peak knee flexion. The therapeutic effect showed a significant increase in peak knee flexion, of mean 3.1° (SD 4.7, p = 0.021) Conclusion: The results of this exploratory study suggest an increase in knee kinematics in swing after functional electrical stimulation of the hamstrings in stroke survivors walking with a stiff knee gait. The largest improvement in peak knee flexion in swing was seen when participants walked with hamstring stimulation. Participants with low neurological impairment responded better to hamstring stimulation, and there are indications that the effect of hamstring stimulation can be predicted during a single session. The effect of functional electrical stimulation is comparable to that of more invasive treatment options, such as botulinum toxin or soft-tissue surgery. This makes functional electrical stimulation a feasible treatment option for daily clinical practice.
探讨在慢性脑卒中幸存者僵硬膝关节步态行走时，对腘绳肌进行功能性电刺激是否能改善膝关节运动学。
准实验设计。
16 名成年慢性脑卒中幸存者。
在 5 周的时间里，每周 3 次，每次 1 小时，对幸存者进行腘绳肌功能性电刺激。在训练前和训练 5 周后计算 3D 运动学。在训练前无刺激行走时的膝关节运动学与训练 5 周后的刺激行走进行比较（干预效果）。此外，在训练前无刺激行走时的膝关节运动学与训练后的无刺激行走进行比较（治疗效果）。
干预效果显示，峰值膝关节屈曲显著增加，平均 8.7°（标准差 8.3，p=0.001）。治疗效果显示，峰值膝关节屈曲显著增加，平均 3.1°（标准差 4.7，p=0.021）。
这项探索性研究的结果表明，在僵硬膝关节步态行走的脑卒中幸存者中，对腘绳肌进行功能性电刺激后，摆动期膝关节运动学增加。当参与者在行走时使用腘绳肌刺激时，峰值膝关节屈曲的最大改善。神经损伤程度较低的参与者对腘绳肌刺激的反应更好，并且有迹象表明，在单次治疗中可以预测腘绳肌刺激的效果。功能性电刺激的效果可与更具侵入性的治疗选择（如肉毒杆菌毒素或软组织手术）相媲美。这使得功能性电刺激成为日常临床实践中的一种可行治疗选择。
