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林子玲,陈 玲,燕铁斌,黄裕桂.功能性电刺激改善脑卒中患者上肢功能的随机对照研究[J].中国康复医学杂志,2010,25(2):
功能性电刺激改善脑卒中患者上肢功能的随机对照研究    点此下载全文
林子玲  陈 玲  燕铁斌  黄裕桂
中山大学附属第五医院康复医学科, 珠海, 519000
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摘要:
      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300?滋s,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。 关键词 脑卒中;功能性电刺激;上肢;随机对照研究 中图分类号:R493,R741 文献标识码:A 文章编号:1001-1242(2010)-02-0152-04
关键词:脑卒中  功能性电刺激  上肢  随机对照研究
Effectiveness of functional electrical stimulation on functional recovery of the affected upper extremities in subjects with stroke:a randomized controlled trial    Download Fulltext
Fifth Affiliated Hospital,Sun Yat-sen University,Zhuhai, 519000
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Abstract:
      Abstract 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 300?滋s, 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 1st, 3rd, 6th 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 1st, 3rd month post-treatment(P<0.05);at the 6th 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.
Keywords:stroke  functional electrical stimulation  upper extremity  randomized controlled trial
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