摘要
目的:探讨功能性电刺激(FES)对脑卒中偏瘫患者上肢功能的远期影响。方法:37例初发脑卒中患者分层后随机分为FES组(n=19)和对照组(n=18)。2组常规治疗相同,对照组不给任何电刺激,FES组给予功能性电刺激治疗,一组电极放在患侧前臂背侧远端1/3与1/2处,一组电极放在三角肌中部与冈上肌中部;刺激参数为频率30Hz,脉宽300μs,通电/断电比5s/5s,波升/波降1s/1s,强度0—90mA,并随患者感觉而定。治疗每天1次,每次30min,共3周(15次)。入选患者分别于治疗前、治疗后第1个月、3个月、6个月接受以下量表评定:Fugl-Meyer运动功能评定量表中上肢部分(FMA)、改良Barthel指数(MBI)、肩部肌群肌力(MMT)。2组患者一般资料及治疗前各项评定结果差异无显著性意义。结果:治疗后第1个月、3个月2组在MMT、FMA、MBI差异均有显著性意义(P<0.05);治疗后第6个月,2组在FMA、MBI差异有显著性意义(P<0.05),在MMT差异有近似显著性意义(P=0.052)。结论:FES可以改善初发早期脑卒中患者偏瘫上肢的运动功能,提高日常生活活动能力,疗效可以持续6个月以上。
Objective：To assess the long-dated efficacy of functional electrical stimulation （FES） in enhancing functional recovery of the affected upper extremities in subjects with stroke.Method：In a randomized controlled trial,37 subjects with first stroke were randomly assigned into 2 groups：FES group or control group.The FES group （n=19） received FES on the affected supraspinatus muscle,deltoid muscle and extensor of wrist （stimulation between 1/3 and 1/2 of distal end of dorso-forearm） through surface electrodes.The intensity of stimulation current was set to produce full shoulder abduction and wrist extension with a duty cycle of 5s on and 5s off.The stimulus pulse was a symmetric biphasic waveform with amplitude ranging between 0 to 90 mA,frequency 30 Hz,pulse width of 300μs,and ramp up and down time of 2s each.The current amplitude were adjusted to subject comfort.It lasted for 30min per d,5d per week for 3 weeks.In addition two groups received standard rehabilitation program.Measurements included Fugl-Meyer motor assessment （FMA） for upper extremity,manual muscle testing （MMT） for the shoulder myodynamia,as well as modified Barthel index（MBI） for activities of daily living.Measurements were recorded before treatment,at the 1 st,3 rd,6 th month post-treatment.Result：Before treatment,there was no significant difference between the two groups for age,stroke severity,and the baseline of measurements.Significant differences were found in the scores of FMA,MMT,MBI between two groups at the 1 st,3 rd month post-treatment（P〈0.05）;at the 6 th month post-treatment,the scores of MBI,FMA in FES group were also higher than that in control group with significant difference （P〈0.05）,the scores of MMT presented margined significant difference （P=0.052）.Conclusion：Three weeks of FES to the affected upper extremities of subjects with early stroke improved their motor function and the efficacy could last for 6 months at least.
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2010年第2期152-155,共4页
Chinese Journal of Rehabilitation Medicine
关键词
脑卒中
功能性电刺激
上肢
随机对照研究
stroke
functional electrical stimulation
upper extremity
randomized controlled trial
