fes治疗脑卒中的临床应用及其机制(讲义).pptVIP

功能性电刺激治疗脑卒中及其机制探讨;内容;脑损伤后 运动障碍表现;脑卒中后运动控制障碍表现;上运动神经元综合症表现;治疗脑卒中后运动障碍的方法;内容;功能性电刺激;FES的特点;Dr.Yan@126.com ;非植入式 功能性电刺激;临床随机对照研究;入选标准 大脑中动脉系统初发脑卒中 发病后２周内 年龄45～84 岁 发病前ADL自理;技术路线：偏瘫下肢;治疗组模拟正常的步态周期 ２台双通道FES通过转换器连接 电极位置 胫前肌、腓肠肌、股四头肌、腘伸肌 参数 30 Hz，脉宽 0.3 ms, 强度 20-30mA 时间 入院后３天内开始 30 min/ 天,5 天/周 x 3 周 ;评定;结果;*;3周FES 治疗可以 延缓偏瘫下肢痉挛的发生及其发展 增加拮抗肌的收缩，降低痉挛肌的协同收缩 FES组较安慰刺激组和对照组早 2~4天恢复独立步行，FES组患者治疗 3周后均能行走 回归家庭 FES组84.6%，安慰组56.3%，对照组 41.7%;NEW YORK (Reuters Health) - Adding functional electrical stimulation (FES) to standard rehabilitation improves lower extremity function and walking ability in patients with a first acute stroke, new research shows. FES, which has been in use since the 1960s, involves the use of mild electric currents designed to stimulate the muscles. Previous reports have suggested an advantage for electric stimulation therapy over standard rehabilitation, but most studies investigating the issue have not been properly designed, Dr. Christina W. Y. Hui-Chan, from The Hong Kong Polytechnic University, and colleagues note. To address this issue, the researchers assessed the outcomes of 46 patients who were randomly treated with standard rehabilitation alone or in combination with either FES or fake placebo stimulation. Stimulation began a few days after the stroke and was given five days per week for three weeks. The researchers findings appear in the American Heart Associations journal Stroke. Compared with the other two interventions, FES plus standard rehabilitation?improved several measures of lower limb function. As noted, treatment with FES also improved walking ability. After treatment, all patients in the FES group were able to walk and 85 percent returned home. In contrast, the percentage of patients returning home in the other groups hovered around just 50 percent. While the results are encouraging, it is not clear that they can be generalized to all stroke patients because the study did not include all stroke categories or patients outside the