Garzon Luisa C, Switzer Lauren, Musselman Kristin E, Fehlings Darcy
Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.
2Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, East York, Canada.
J Rehabil Assist Technol Eng. 2018 May 14;5:2055668318768402. doi: 10.1177/2055668318768402. eCollection 2018 Jan-Dec.
Grasping and manipulating objects are common problems for children with hemiplegic cerebral palsy. Multichannel-functional electrical stimulation may help facilitate upper limb movements and improve function.
To evaluate the feasibility of multichannel-functional electrical stimulation to improve grasp and upper limb function in children with hemiplegic cerebral palsy to inform the development of a clinical trial.
A prospective pre-/post-test/follow-up (six months) design with three children, aged 6-13 years, was used. Multichannel-functional electrical stimulation (mFES) was applied to the hemiplegic upper limb for up to 48 sessions over 16 weeks. Feasibility indicators included recruitment of participants and adherence rates, safety, and discomfort/pain. Effectiveness was assessed using the grasp domain of the Quality of Upper Extremity Skills Test, and other secondary clinical outcome measures with "success" criteria set .
Participant recruitment target was not met but adherence was high, and multichannel-functional electrical stimulation was found to be safe and comfortable. Of the three participants, two improved in grasp at post-test, whereas one child's ability deteriorated. Only one child met success criteria on most outcomes at post-test.
Feasibility indicators met success criteria, except for participant recruitment. Treatment effectiveness was mixed. A future case comparison investigation with a larger but more selected sample is suggested.
对于偏瘫型脑瘫患儿来说,抓握和操作物体是常见问题。多通道功能性电刺激可能有助于促进上肢运动并改善功能。
评估多通道功能性电刺激改善偏瘫型脑瘫患儿抓握及上肢功能的可行性,为开展一项临床试验提供依据。
采用前瞻性前后测/随访(6个月)设计,纳入3名6至13岁儿童。多通道功能性电刺激(mFES)应用于偏瘫上肢,在16周内进行多达48次治疗。可行性指标包括受试者招募情况、依从率、安全性以及不适/疼痛情况。使用上肢技能测试质量的抓握领域以及设定了“成功”标准的其他次要临床结局指标评估有效性。
未达到受试者招募目标,但依从性较高,且发现多通道功能性电刺激安全且舒适。3名受试者中,2名在测试后抓握能力有所改善,而1名儿童的能力下降。仅1名儿童在测试后大多数结局指标上达到成功标准。
除受试者招募外,可行性指标均达到成功标准。治疗效果不一。建议未来进行一项针对更具选择性的更大样本的病例对照研究。