Chasiotis Athanasios, Giannopapas Vasileios, Papadopoulou Marianna, Chondrogianni Maria, Stasinopoulos Dimitrios, Giannopoulos Sotirios, Bakalidou Daphne
Department of Physiotherapy, University of West Attica, Athens, GRC.
Department of Physical Therapy, University of West Attica, Athens, GRC.
Cureus. 2022 Nov 29;14(11):e32001. doi: 10.7759/cureus.32001. eCollection 2022 Nov.
Stroke is a cerebrovascular disorder characterized by the sudden onset of symptoms and clinical signs caused by either vascular infraction or hemorrhage. One of the main symptoms in the majority of post-stroke patients is spasticity. The main therapeutic options of spasticity in post-stroke patients include pharmacological interventions, rehabilitation techniques, and surgery. This review aims to explore the effectiveness of Neuromuscular Electrical Stimulation (NMES) for post-stroke spastic hemiparetic limb (upper and lower). Thorough research of the PubMed Medline database was performed. Records were limited to clinical studies published between 01/01/2010 and 01/01/2022. The results were screened by the authors in pairs. The search identified 26 records. After screening, nine records met the inclusion-exclusion criteria and were assessed. There were seven studies for spastic upper limbs and two for spastic lower limbs. The approaches investigated the effectiveness of electrical stimulation on post-stroke spastic upper or lower limb. Spasticity was measured through the modified Ashworth scale (MAS) and electromyographic recordings (EMG). In most cases, spasticity was decreased for at least two weeks post-intervention. In conclusion, NMES can be used either solo or in combination with different physical therapy modalities in order to produce optimal results, taking into consideration the specific needs and limitations of each individual patient. Based on the existing literature, as well as the limitations of the included studies, the authors believe that future studies on the subject of NMES in the management of post-stroke spasticity should focus on carefully examining each electrical parameter.
中风是一种脑血管疾病，其特征是由血管梗死或出血引起的症状和临床体征突然发作。大多数中风后患者的主要症状之一是痉挛。中风后患者痉挛的主要治疗选择包括药物干预、康复技术和手术。本综述旨在探讨神经肌肉电刺激（NMES）对中风后痉挛性偏瘫肢体（上肢和下肢）的有效性。对PubMed Medline数据库进行了全面检索。记录限于2010年1月1日至2022年1月1日期间发表的临床研究。作者对结果进行了双人筛选。检索到26条记录。筛选后，9条记录符合纳入排除标准并进行了评估。其中7项研究针对痉挛性上肢，2项针对痉挛性下肢。这些研究探讨了电刺激对中风后痉挛性上肢或下肢的有效性。通过改良Ashworth量表（MAS）和肌电图记录（EMG）来测量痉挛程度。在大多数情况下，干预后至少两周痉挛程度有所降低。总之，考虑到每个患者的具体需求和限制，NMES可以单独使用或与不同的物理治疗方式联合使用，以产生最佳效果。基于现有文献以及纳入研究的局限性，作者认为未来关于NMES在中风后痉挛管理方面的研究应侧重于仔细检查每个电参数。
