Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Physiother Theory Pract. 2021 Dec;37(12):1368-1376. doi: 10.1080/09593985.2019.1685035. Epub 2019 Oct 30.
: Stroke causes multi-joint gait deficits, so a major objective of post-stroke rehabilitation is to regain normal gait function. : A case series completed at a neuroscience institute. : The aim of the study was to determine the concurrent impact of functional electrical stimulation (FES) during treadmill walking on gait speed, knee extensors spasticity and ankle plantar flexors spasticity in post-stroke survivors. : Six post-stroke survivors with altered gait patterns and ankle plantar flexors spasticity (4 = male; age 56.8 ± 4.8 years; Body Mass Index (BMI) 26.2 ± 4.3; since onset of stroke: 30.8 ± 10.4 months; side of hemiplegia [L/R]: 3:3) were recruited. : Nine treatment sessions using FES bilaterally while walking on a treadmill. : Primary outcome measures included the Modified Modified Ashworth Scale (MMAS), Timed Up and Go test (TUG), 10-m walking test, gait speed, and Functional ambulation category (FAC). Secondary outcome measures included the Step Length Test (SLT), and active range of motion (ROM) of the affected ankle and the knee. Measurements were taken at baseline (T0), at the end of last treatment (T1), and 1 month after the final treatment session (T2). : The TUG, 10-m walking test, gait speed, FAC, active ROM, and SLT all significantly improved following treatment (< .05), while ankle plantar flexors spasticity ( = .135), and knee extensors spasticity ( = .368) did not show any significant decrease. : A short duration of bilateral FES in conjugation with treadmill walking contributed to significant improvement in gait speed, functional mobility, functional ambulation, range of motion and step length in post-stroke survivors. In contrast, no significant decreases were identified in the spasticity of the ankle plantar flexors and knee extensors muscles.
中风会导致多关节步态障碍,因此中风后康复的主要目标是恢复正常的步态功能。这是在神经科学研究所完成的一系列病例研究。本研究旨在确定在中风幸存者进行跑步机行走时同时使用功能性电刺激(FES)对步态速度、膝关节伸肌痉挛和踝关节跖屈肌痉挛的影响。6 名步态模式改变和踝关节跖屈肌痉挛的中风幸存者(4 名男性;年龄 56.8 ± 4.8 岁;体重指数(BMI)26.2 ± 4.3;中风后发病时间:30.8 ± 10.4 个月;偏瘫侧[左/右]:3:3)被招募。使用双侧 FES 在跑步机上行走 9 次治疗。主要结果测量包括改良改良 Ashworth 量表(MMAS)、计时起立行走测试(TUG)、10 米步行测试、步态速度和功能性步行分类(FAC)。次要结果测量包括步长测试(SLT)和受影响踝关节和膝关节的主动活动范围(ROM)。在基线(T0)、最后一次治疗结束时(T1)和最后一次治疗结束后 1 个月(T2)进行测量。治疗后 TUG、10 米步行测试、步态速度、FAC、主动 ROM 和 SLT 均显著改善(<.05),而踝关节跖屈肌痉挛( =.135)和膝关节伸肌痉挛( =.368)没有明显下降。双侧 FES 与跑步机行走相结合的短时间治疗有助于中风幸存者的步态速度、功能移动性、功能性步行、活动范围和步长显著改善。相比之下,踝关节跖屈肌和膝关节伸肌的痉挛没有明显减轻。