Wang R Y, Tsai M W, Chan R C
Faculty of Physical Therapy, National Yang-Ming University, Shih-Pai, Taipei, Taiwan, Republic of China.
Am J Phys Med Rehabil. 1998 Jul-Aug;77(4):282-7. doi: 10.1097/00002060-199807000-00003.
Spasticity after a stroke interferes with the normal function of a limb. Electric stimulation has been used in a variety of ways to decrease spasticity. The purposes of this study were (1) to quantify the effectiveness of electric stimulation on decreasing ankle spasticity and (2) to develop a quantitative assessment of muscle tone, which could be replicated in the clinic. Ten patients with hemiparesis resulting from ischemic stroke participated in the study according to the selection criteria. Their mean age was 57 yr, with a mean stroke interval of 12.5 months. Patients received electric stimulation for 45 min through surface electrodes applied to the skin in the 12th thoracic and 1st lumbar areas. All patients received five electric stimulation treatment sessions. The electrical pulses were amplitude modulated frequency beat with a carry frequency of 2500 Hz and a stimulation frequency of 20 Hz. The stimulation intensity was adjusted to each patient to produce a sensory stimulation. The pre- and posttreatment evaluation included surface electromyography activity during passive ankle dorsiflexion, passive ankle dorsiflexion resistance at different angular velocities, as measured by an isokinetic machine and the modified Ashworth scale. Our results indicate that the surface spinal cord stimulation with middle frequency modulated to low frequency for sensory stimulation on the skin of 12th thoracic and first lumbar area is effective in reducing calf muscle spasticity of hemiplegic patients. The isokinetic torque measures for spasticity are a sensitive tool to document the effects of the treatment.
中风后的痉挛会干扰肢体的正常功能。电刺激已被用于多种方式来减轻痉挛。本研究的目的是：（1）量化电刺激对减轻踝关节痉挛的有效性；（2）开发一种可在临床重复的肌肉张力定量评估方法。根据入选标准，10例缺血性中风导致偏瘫的患者参与了本研究。他们的平均年龄为57岁，平均中风间隔时间为12.5个月。患者通过将表面电极应用于第12胸椎和第1腰椎区域的皮肤接受45分钟的电刺激。所有患者均接受了5次电刺激治疗。电脉冲采用调幅频率拍，载波频率为2500Hz，刺激频率为20Hz。根据每位患者的情况调整刺激强度以产生感觉刺激。治疗前后的评估包括被动踝关节背屈时的表面肌电图活动、通过等速运动仪测量的不同角速度下的被动踝关节背屈阻力以及改良Ashworth量表。我们的结果表明，在第12胸椎和第1腰椎区域皮肤进行中频调制为低频的表面脊髓感觉刺激对减轻偏瘫患者小腿肌肉痉挛有效。用于痉挛的等速扭矩测量是记录治疗效果的敏感工具。
