Ni Lingmei, Yao Zhao, Zhao Yifan, Zhang Tianfang, Wang Jie, Li Siyue, Chen Zuobing
Infection Prevention and Control Department, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China.
Front Neurol. 2023 Feb 24;14:1081458. doi: 10.3389/fneur.2023.1081458. eCollection 2023.
Peripheral nerve injury is common and frequently occurs in extremity trauma patients. The motor and sensory impairment caused by the injury will affect patients' daily life and social work. Surgical therapeutic approaches don't assure functional recovery, which may lead to neuronal atrophy and hinder accelerated regeneration. Rehabilitation is a necessary stage for patients to recover better. A meaningful role in non-pharmacological intervention is played by rehabilitation, through individualized electrical stimulation therapy. Clinical studies have shown that electrical stimulation enhances axon growth during nerve repair and accelerates sensorimotor recovery. According to different effects and parameters, electrical stimulation can be divided into neuromuscular, transcutaneous, and functional electrical stimulation. The therapeutic mechanism of electrical stimulation may be to reduce muscle atrophy and promote muscle reinnervation by increasing the expression of structural protective proteins and neurotrophic factors. Meanwhile, it can modulate sensory feedback and reduce neuralgia by inhibiting the descending pathway. However, there are not many summary clinical application parameters of electrical stimulation, and the long-term effectiveness and safety also need to be further explored. This article aims to explore application methodologies for effective electrical stimulation in the rehabilitation of peripheral nerve injury, with simultaneous consideration for fundamental principles of electrical stimulation and the latest technology. The highlight of this paper is to identify the most appropriate stimulation parameters (frequency, intensity, duration) to achieve efficacious electrical stimulation in the rehabilitation of peripheral nerve injury.
周围神经损伤很常见,在四肢创伤患者中经常发生。损伤引起的运动和感觉障碍会影响患者的日常生活和社会工作。手术治疗方法并不能保证功能恢复,这可能导致神经元萎缩并阻碍加速再生。康复是患者更好恢复的必要阶段。康复通过个体化电刺激疗法在非药物干预中发挥着重要作用。临床研究表明,电刺激可促进神经修复过程中的轴突生长并加速感觉运动恢复。根据不同的作用和参数,电刺激可分为神经肌肉电刺激、经皮电刺激和功能性电刺激。电刺激的治疗机制可能是通过增加结构保护蛋白和神经营养因子的表达来减少肌肉萎缩并促进肌肉再支配。同时,它可以调节感觉反馈并通过抑制下行通路来减轻神经痛。然而,电刺激的临床应用参数总结并不多,其长期有效性和安全性也有待进一步探索。本文旨在探索有效电刺激在周围神经损伤康复中的应用方法,同时考虑电刺激的基本原理和最新技术。本文的亮点是确定最适合的刺激参数(频率、强度、持续时间),以在周围神经损伤康复中实现有效的电刺激。