CAJ | 학술논문

目的探讨低频电刺激(LES)对脑卒中偏瘫患者日常生活活动(ADL)能力的影响.方法 37例早期脑卒中患者经minimize软件分层后随机分为电刺激组19例和对照组18例.2组常规治疗相同,对照组不行电刺激治疗,电刺激组采用LES治疗,电极置于偏瘫侧胫前肌及腓骨长、短肌的运动点上,刺激参数为频率30 Hz,脉宽200μs,通电/断电比5 s/5s,波升/波降为1s/1s,电流以患者最大耐受强度为限.每天治疗1次,每次30 min,共3周(15次).用Fugl-Meyer运动功能评定量表(FMA)中下肢部分评定下肢运动功能,用改良Barthel指数(MBI)评定ADL能力.结果 2组患者一般资料及治疗前各项评定结果差异无统计学意义(P>0.05).治疗2周和3周后,电刺激组与对照组的FMA评分及MBI总分比较,差异均有统计学意义(P<0.05),电刺激组与对照组在MBI各项中的床椅转移、平地行走及上下楼梯等评分比较,差异有统计学意义(P<0.05).结论 LES能提高早期脑卒中偏瘫患者下肢运动能力及ADL能力.
목적 탐토저빈전자격(LES)대뇌졸중편탄환자일상생활활동(ADL)능력적영향.방법 37례조기뇌졸중환자경minimize연건분층후수궤분위전자격조19례화대조조18례.2조상규치료상동,대조조불행전자격치료,전자격조채용LES치료,전겁치우편탄측경전기급비골장、단기적운동점상,자격삼수위빈솔30 Hz,맥관200μs,통전/단전비5 s/5s,파승/파강위1s/1s,전류이환자최대내수강도위한.매천치료1차,매차30 min,공3주(15차).용Fugl-Meyer운동공능평정량표(FMA)중하지부분평정하지운동공능,용개량Barthel지수(MBI)평정ADL능력.결과 2조환자일반자료급치료전각항평정결과차이무통계학의의(P>0.05).치료2주화3주후,전자격조여대조조적FMA평분급MBI총분비교,차이균유통계학의의(P<0.05),전자격조여대조조재MBI각항중적상의전이、평지행주급상하루제등평분비교,차이유통계학의의(P<0.05).결론 LES능제고조기뇌졸중편탄환자하지운동능력급ADL능력.
Objective To assess the efficacy of low-frequency electrical stimulation (LES) in improving ability in the activities of daily living (ADL) of subjects after a recent stroke. Methods In a randomized controlled trial, 37 subjects with a first stroke were randomly divided into an electrical stimulation (ES) group and a control group. In the ES group (n = 19 ) electrodes were applied on the motor points of the tibialis anterior, the peroneal longus and the peroneus brevis muscles. Stimulation current was applied at an intensity set to cause full ankle extension. The stimulus pulse was a symmetric biphasic wave with frequency of 30 Hz, a pulse width of 200 μs, a duty cycle of 5 s on and 5 s off ramped up and down for 1 s each and amplitude up to 90 mA. The current amplitude was adjusted according to each subject's comfort. Stimulation lasted for 30 min/d, 5 d/week for 3 weeks. All subjects in the 2 groups also received a standard rehabilitation program. Evaluations included the Fugl-Meyer motor assessment (FMA) for the lower extremity and the modified Barthel index (MBI) for ADL ability. Measurements were recorded before treatment and after 2 and 3 weeks of treatment. Results Before treatment there was no significant difference between the two groups in terms of age, time post-stroke, stroke severity or the baseline measurements. After 2 and 3 weeks of treatment, the FMA scores in the ES group were significantly higher than those of the control group. The MBI scores in the ES group were also significantly higher than in the control group. The average MBI transferring, walking and stair climbing scores in the ES group were all significantly higher than those in the control group after either 2 or 3 weeks. Conclusion Three weeks of LES can improve ADL ability soon after stroke.