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针对一名脑瘫患儿臀肌的功能性重复神经肌肉磁刺激(frNMS)的可行性:病例报告

Feasibility of Functional Repetitive Neuromuscular Magnetic Stimulation (frNMS) Targeting the Gluteal Muscle in a Child with Cerebral Palsy: A Case Report.

作者信息

Bonfert Michaela V, Meuche Anne, Urban Giada, Börner Corinna, Breuer Ute, Warken Birgit, Wimmer Christine, Strattner Henriette, Müller Tessa, Hösl Matthias, Heinen Florian, Berweck Steffen, Schröder Sebastian A

机构信息

Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine & LMU Center for Children with Medical Complexity - iSPZ Hauner, LMU Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.

Specialist Centre for Paediatric Neurology, Neurorehabilitation and Epileptology, Schoen Clinic Vogtareuth, Vogtareuth, Germany.

出版信息

Phys Occup Ther Pediatr. 2023;43(3):338-350. doi: 10.1080/01942638.2022.2138732. Epub 2022 Nov 21.

Abstract

BACKGROUND

Motor impairment due to spasticity, weakness, and insufficient selective motor control is a key feature of cerebral palsy (CP). For standing and walking, the gluteal muscles play an important role. Physical therapy represents an evidence-based treatment to promote strength and endurance but may be limited to address selective motor control. Treatment incorporating neurostimulating techniques may increase the therapeutic benefits in these situations.

PURPOSE

The aim of this case report was to evaluate the feasibility, safety and clinical effects of a customized protocol of functional repetitive neuromuscular magnetic stimulation (frNMS).

METHODS

This case report describes a frNMS protocol applied to the gluteal muscles in an 8-year old boy with bilateral spastic CP. The protocol combines 12 sessions of customized physiotherapeutic exercises with simultaneous electromagnetic stimulation.

RESULTS

frNMS protocol was adhered to as planned, no relevant adverse events were observed. At day fourafter the intervention the patient reported clinical benefits and improvements of standing and walking assessed by Gross Motor Function Measure dimensions D (+5.1%) and E (+4.2%) were documented. Body sway as measured by center of pressure displacement during posturography decreased.

CONCLUSION

Clinical studies are warranted to assess effects of frNMS and its mechanisms of action in a controlled setting.

摘要

背景

由于痉挛、肌无力和选择性运动控制不足导致的运动障碍是脑瘫(CP)的关键特征。对于站立和行走,臀肌起着重要作用。物理治疗是一种基于证据的促进力量和耐力的治疗方法,但可能在解决选择性运动控制方面存在局限性。结合神经刺激技术的治疗可能会在这些情况下增加治疗效果。

目的

本病例报告的目的是评估定制的功能性重复神经肌肉磁刺激(frNMS)方案的可行性、安全性和临床效果。

方法

本病例报告描述了一种应用于一名8岁双侧痉挛性脑瘫男孩臀肌的frNMS方案。该方案将12次定制的物理治疗练习与同步电磁刺激相结合。

结果

frNMS方案按计划实施,未观察到相关不良事件。干预后第4天,患者报告有临床获益,通过粗大运动功能测量维度D(提高5.1%)和E(提高4.2%)评估的站立和行走能力得到改善。姿势描记术中通过压力中心位移测量的身体摇摆减少。

结论

有必要进行临床研究,以在对照环境中评估frNMS的效果及其作用机制。

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