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对侧控制功能性电刺激与神经肌肉电刺激对亚急性期脑卒中患者上肢运动功能恢复的疗效比较:一项随机对照试验。

Effectiveness of Contralaterally Controlled Functional Electrical Stimulation versus Neuromuscular Electrical Stimulation on Upper Limb Motor Functional Recovery in Subacute Stroke Patients: A Randomized Controlled Trial.

机构信息

Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 20000, China.

Department of Rehabilitation Medicine, Huashan Hospital North, Fudan University, Shanghai 20000, China.

出版信息

Neural Plast. 2021 Dec 22;2021:1987662. doi: 10.1155/2021/1987662. eCollection 2021.

DOI:10.1155/2021/1987662
PMID:34976049
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8716238/
Abstract

PURPOSE

To compare the effectiveness of contralaterally controlled functional electrical stimulation (CCFES) versus neuromuscular electrical stimulation (NMES) on motor recovery of the upper limb in subacute stroke patients.

MATERIALS AND METHODS

Fifty patients within six months poststroke were randomly assigned to the CCFES group ( = 25) and the NMES group ( = 25). Both groups underwent routine rehabilitation plus 20-minute stimulation on wrist extensors per day, five days a week, for 3 weeks. Fugl-Meyer Assessment of upper extremity (FMA-UE), action research arm test (ARAT), Barthel Index (BI), and surface electromyography (sEMG) were assessed at baseline and end of intervention.

RESULTS

After a 3-week intervention, FMA-UE and BI increased in both groups ( < 0.05). ARAT increased significantly only in the CCFES group ( < 0.05). The changes of FMA-UE, ARAT, and BI in the CCFES group were not greater than those in the NMES group. The improvement in sEMG response of extensor carpi radialis by CCFES was greater than that by NMES ( = 0.026). The cocontraction ratio (CCR) of flexor carpi radialis did not decrease in both groups.

CONCLUSIONS

CCFES improved upper limb motor function, but did not show better treatment effect than NMES. CCFES significantly enhanced the sEMG response of paretic extensor carpi radialis compared with NMES, but did not decrease the cocontraction of antagonist.

摘要

目的

比较对侧控制功能性电刺激(CCFES)与神经肌肉电刺激(NMES)对亚急性脑卒中患者上肢运动功能恢复的效果。

材料与方法

50 例脑卒中后 6 个月内的患者被随机分为 CCFES 组(n=25)和 NMES 组(n=25)。两组均接受常规康复治疗,并每天接受 20 分钟腕伸肌刺激,每周 5 天,共 3 周。在基线和干预结束时,采用 Fugl-Meyer 上肢运动功能评估(FMA-UE)、动作研究上肢测试(ARAT)、Barthel 指数(BI)和表面肌电图(sEMG)进行评估。

结果

经过 3 周的干预,两组 FMA-UE 和 BI 均增加( < 0.05)。仅 CCFES 组的 ARAT 显著增加( < 0.05)。CCFES 组 FMA-UE、ARAT 和 BI 的变化并不大于 NMES 组。与 NMES 相比,CCFES 对桡侧腕伸肌的 sEMG 反应改善更大( = 0.026)。两组桡侧腕屈肌的协同收缩比(CCR)均未降低。

结论

CCFES 可改善上肢运动功能,但与 NMES 相比,其治疗效果并不更好。与 NMES 相比,CCFES 可显著增强瘫痪的桡侧腕伸肌的 sEMG 反应,但不会降低拮抗肌的协同收缩。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/700c/8716238/a48fed1ae738/NP2021-1987662.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/700c/8716238/a48fed1ae738/NP2021-1987662.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/700c/8716238/a48fed1ae738/NP2021-1987662.001.jpg

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