EFFECTS OF SURFACE SPINAL CORD STIMULATION ON SPASTICITY AND QUANTITATIVE ASSESSMENT OF MUSCLE TONE IN HEMIPLEGIC PATIENTS1

痉挛 医学 肌肉张力 脚踝 肌电图 刺激 物理医学与康复 改良阿什沃思量表 腰椎 冲程(发动机) 脊髓 物理疗法 麻醉 外科 内科学 机械工程 精神科 工程类
作者
Ray-Yau Wang,Mei‐Wun Tsai,Rai‐Chi Chan
出处
期刊:American Journal of Physical Medicine & Rehabilitation [Lippincott Williams & Wilkins]
卷期号:77 (4): 282-287 被引量:39
标识
DOI:10.1097/00002060-199807000-00003
摘要

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.
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