Department of Physical Medicine and Rehabilitation, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara Turkey.
Malawi Med J. 2021 Sep;33(3):144-152. doi: 10.4314/mmj.v33i3.1.
The purpose of this study was to evaluate the effects of functional electrical stimulation (FES) bicycle therapy system on motor function, gait pattern, spasticity, daily living activities, and aerobic capacity in children with cerebral palsy (CP) and to compare the results with sham stimulation and standard treatment.
Patients with cerebral palsy who received botulinum toxin type-A injections to lower extremities and those with Gross Motor Function Measure Classification System (GMFCS) levels I - III, were included in the study. Twenty-five patients were randomly assigned into three treatment groups for 4-weeks: Group 1, FES-cycling and standard treatment; Group 2, Sham stimulus FES-cycling and standard treatment; Group 3, Standard treatment. Clinical assessment tools included the Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS), Pediatric Functional Independence Measure (WeeFIM), GMFCS, Gross Motor Function Measure-88 (GMFM-88), selective motor control tests, 6-minute walk test, and Visual Gait Analysis (VGA).
In all groups, there were significant improvements in MAS, MTS, WeeFIM, GMFM-88, 6-minute walk test, and VGA scores. No changes in GMFCS levels were observed in any group. At the end of the study, there was no significant difference among the groups in terms of any clinical assessment parameter.
All groups showed statistically significant improvements in motor function, walking pattern, spasticity, daily living activities, and aerobic capacity in patients with CP following the rehabilitation period. Although FES-cycling demonstrated no superiority over the other approaches and provided no additional benefit to the results, FES appears to be safe and well-tolerated in children with CP, at least as much as standard exercise treatment.
本研究旨在评估功能性电刺激(FES)自行车治疗系统对脑瘫患儿运动功能、步态模式、痉挛、日常生活活动和有氧能力的影响,并将结果与假刺激和标准治疗进行比较。
本研究纳入了接受下肢肉毒毒素 A 注射且粗大运动功能分级系统(GMFCS)水平为 I - III 的脑瘫患儿。25 名患者被随机分为 3 个治疗组,进行 4 周的治疗:第 1 组,FES 自行车和标准治疗;第 2 组,假刺激 FES 自行车和标准治疗;第 3 组,标准治疗。临床评估工具包括改良 Ashworth 量表(MAS)、改良 Tardieu 量表(MTS)、儿科功能性独立测量(WeeFIM)、GMFCS、粗大运动功能测量-88 量表(GMFM-88)、选择性运动控制测试、6 分钟步行测试和视觉步态分析(VGA)。
在所有组中,MAS、MTS、WeeFIM、GMFM-88、6 分钟步行测试和 VGA 评分均有显著改善。在任何组中,GMFCS 水平均无变化。研究结束时,各组在任何临床评估参数方面均无显著差异。
在康复期间,所有组的脑瘫患儿的运动功能、步行模式、痉挛、日常生活活动和有氧能力均有显著改善。尽管 FES 自行车治疗在其他方法中没有表现出优势,也没有为结果提供额外的益处,但 FES 似乎对脑瘫患儿是安全且耐受良好的,至少与标准运动治疗一样。