Chae J, Bethoux F, Bohine T, Dobos L, Davis T, Friedl A
Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio 44109-1998, USA.
Stroke. 1998 May;29(5):975-9. doi: 10.1161/01.str.29.5.975.
The purpose of this study was to assess the efficacy of neuromuscular stimulation in enhancing the upper extremity motor and functional recovery of acute stroke survivors.
Forty-six stroke survivors admitted to an inpatient rehabilitation unit were randomly assigned to receive either neuromuscular stimulation or placebo. Twenty-eight subjects completed the study. The treatment group received surface neuromuscular stimulation to produce wrist and finger extension exercises. The control group received placebo stimulation over the paretic forearm. All subjects were treated 1 hour per day, for a total of 15 sessions. Outcomes were assessed in a blinded manner with the upper extremity component of the Fugl-Meyer Motor Assessment and the self-care component of the Functional Independence Measure at pretreatment, after treatment, and at 4 and 12 weeks after treatment.
The treatment subjects and control subjects had comparable baseline characteristics. Parametric analyses revealed significantly greater gains in Fugl-Meyer scores for the treatment group after treatment (13.1 versus 6.5; P=0.05), at 4 weeks after treatment (17.9 versus 9.7; P=0.05), and at 12 weeks after treatment (20.6 versus 11.2; P=0.06). Functional Independence Measure scores were not different between groups at any of the time periods (P>0.10).
Data suggest that neuromuscular stimulation enhances the upper extremity motor recovery of acute stroke survivors. However, the sample size in this study was too small to detect any significant effect of neuromuscular stimulation on self-care function.
本研究旨在评估神经肌肉刺激对促进急性中风幸存者上肢运动和功能恢复的疗效。
46名入住住院康复单元的中风幸存者被随机分配接受神经肌肉刺激或安慰剂治疗。28名受试者完成了研究。治疗组接受表面神经肌肉刺激以进行手腕和手指伸展运动。对照组在前臂麻痹部位接受安慰剂刺激。所有受试者每天接受1小时治疗，共15次治疗。在治疗前、治疗后以及治疗后4周和12周，采用Fugl-Meyer运动评估的上肢部分和功能独立性测量的自我护理部分以盲法评估结果。
治疗组和对照组的基线特征具有可比性。参数分析显示，治疗组在治疗后（13.1对6.5；P=0.05）、治疗后4周（17.9对9.7；P=0.05）和治疗后12周（20.6对11.2；P=0.06）的Fugl-Meyer评分有显著更大的提高。在任何时间段，两组之间的功能独立性测量评分均无差异（P>0.10）。
数据表明神经肌肉刺激可促进急性中风幸存者的上肢运动恢复。然而，本研究的样本量太小，无法检测到神经肌肉刺激对自我护理功能的任何显著影响。
