《中国康复理论与实践》

中国康复理论与实践 >

2020 , Vol. 26 >Issue 3: 295 - 300

DOI: https://doi.org/10.3969/j.issn.1006-9771.2020.03.006

功能性电刺激改善脑卒中偏瘫患者上肢功能的Meta分析

  • 张悦琪 ,
  • 赵梦娟 ,
  • 赵春善
展开
  • 北华大学护理学院,吉林吉林市 132000
张悦琪(1995-),女,汉族,辽宁海城市人,硕士研究生,主要研究方向：社区护理。|赵春善(1980-),女,朝鲜族,吉林吉林市人,博士,副教授,主要研究方向：老年慢性病研究。

收稿日期: 2019-07-29

  修回日期: 2019-08-27

  网络出版日期: 2020-04-01

基金资助

吉林省科技厅项目(20130624003JC)

收起

Effect of Functional Electrical Stimulation on Upper-limb Function in Stroke Patients with Hemiplegia: A Meta-analysis

  • Yue-qi ZHANG ,
  • Meng-juan ZHAO ,
  • Chun-shan ZHAO
Expand
  • Nursing School, Beihua University, Jilin, Jilin 132000, China

Received date: 2019-07-29

  Revised date: 2019-08-27

  Online published: 2020-04-01

Supported by

Jilin Science and Technology Department Project(20130624003JC)

Fold

摘要

目的 评价功能性电刺激改善脑卒中偏瘫患者上肢功能的效果。 方法 计算机检索PubMed、EMBASE、Web of Science、Cochrane临床试验数据库、中国知网、万方数据库、CBM、维普数据库,收集功能性电刺激改善脑卒中偏瘫患者上肢功能的随机对照试验,对纳入的研究进行质量评价并提取相关数据,采用RevMan5.3软件进行Meta分析。 结果 共纳入13个随机对照试验,共744例患者。功能性电刺激组改善脑卒中偏瘫患者上肢的运动功能显著优于常规组(MD = 9.77, 95%CI 6.36~13.17, P < 0.001)。亚组分析显示,干预4周以上(MD = 13.42, 95%CI 8.43~18.41, P < 0.001)或以下(MD = 5.82, 95%CI 2.58~9.06, P < 0.001),干预30 min以下(MD = 9.78, 95%CI 6.26~13.29, P < 0.001)或45 min以上(MD = 14.20, 95%CI 0.99~27.40, P < 0.05),均可改善患者上肢运动功能。功能性电刺激组提高脑卒中偏瘫患者日常生活活动能力的效果显著优于常规组(MD = 13.72, 95%CI 11.60~15.84, P < 0.001)。 结论 对脑卒中偏瘫患者上肢进行功能性电刺激干预,有助于进一步提高患者上肢运动功能和日常生活活动能力,建议临床推广使用。

关键词： 脑卒中; 偏瘫; 功能性电刺激; 上肢; Meta分析

本文引用格式

张悦琪 , 赵梦娟 , 赵春善 . 功能性电刺激改善脑卒中偏瘫患者上肢功能的Meta分析[J]. 中国康复理论与实践, 2020 , 26(3) : 295 -300 . DOI: 10.3969/j.issn.1006-9771.2020.03.006

Abstract

Objective To investigate the effect of functional electrical stimulation on upper-limb function in stroke patients with hemiplegia. Methods Randomized controlled trials about functional electrical stimulation on upper-limb function in stroke patients with hemiplegia were recalled from databases of PubMed, EMBASE, Web of Science, Cochrane, CNKI, Wanfang data, CBM and VIP. The quality of the trials was evaluated and the data were extracted. Data were analyzed with RevMan 5.3. Results A total of 13 trials involving 744 patients were included. Functional electrical stimulation group could improve upper-limb motor function more compared with routine rehabilitation group (MD = 9.77, 95%CI 6.36 to 13.17, P < 0.001), whatever less than 30 minutes a time (MD = 9.78, 95%CI 6.26 to 13.29, P < 0.001) or more than 45 minutes a time (MD = 14.20, 95%CI 0.99 to 27.40, P < 0.05), for less than four weeks (MD = 5.82, 95%CI 2.58 to 9.06, P < 0.001) or more (MD = 13.42, 95%CI 8.43 to 18.41, P < 0.001). Functional electrical stimulation group also improved the activities of daily living for stroke patients (MD = 13.72, 95%CI 11.60 to 15.84, P < 0.001). Conclusion Functional electrical stimulation is effective on upper-limb motor function and activities of daily living for stroke patients with hemiplegia, which could be widely applied in clinic.

Key words： stroke; hemiplegia; functional electrical stimulation; upper limb; meta analysis

参考文献

[1] Guan T, Ma J, Li M, et al. Rapid transitions in the epidemiology of stroke and its risk factors in China from 2002 to 2013[J]. Neurology, 2017, 89(1):53-61.
[2] 中华医学会神经病学分会神经康复学组, 中华医学会神经病学分会脑血管病学组, 卫生部脑卒中筛查与防治工程委员会办公室. 中国脑卒中康复治疗指南(2011完全版)[J]. 中国康复理论与实践, 2012, 18(4):301-318.
[3] 燕铁斌, 窦祖林. 实用瘫痪康复[M]. 北京: 人民卫生出版社, 1999: 397-398.
[4] Thrasher T A, Zivanovic V, Mcilroy W, et al. Rehabilitation of reaching and grasping function in severe hemiplegic patients using functional electrical stimulation therapy[J]. Neurorehabil Neural Repair, 2008, 22(6):706-714.
[5] Francisco R D, Barrio J D. Effectiveness of functional electrical stimulation in stroke patients: a systematic review[J]. Rev Neurol, 2016, 63(3):109-118.
[6] Rushton D N. Functional electrical stimulation[J]. Physiol Meas, 1997, 18(4):241-275.
[7] 桑德春, 纪树荣, 张缨, 等. Fugl-Meyer量表在社区脑卒中康复疗效评定中的应用[J]. 中国康复医学杂志, 2007, 22(3):264-265.
[8] 闵瑜, 吴媛媛, 燕铁斌. 改良Barthel指数(简体中文版)量表评定脑卒中患者日常生活活动能力的效度和信度研究[J]. 中华物理医学与康复杂志, 2008, 30(3):185-188.
[9] Khan F, Rathore C, Kate M, et al. The comparative efficacy of theta burst stimulation or functional electrical stimulation when combined with physical therapy after stroke: a randomized controlled trial[J]. Clin Rehabil, 2019, 33(4):693-703.
[10] Josdottir J, Thorsen R, Aprile I, et al. Arm rehabilitation in post stroke subjects: a randomized controlled trial on the efficacy of myoelectrically driven FES applied in a task-oriented approach[J]. PLoS One, 2017, 12(12):1-16.
[11] Marquez-Chin C, Bagher S, Zivanovic V, et al. Functional electrical stimulation therapy for severe hemiplegia: randomized control trial revisited[J]. Can J Occup Ther, 2017, 84(2):87-97.
[12] 翟凤娟. 对侧控制型功能性电刺激护理干预对脑卒中患者上肢功能影响研究[J]. 世界中医药, 2015(A01):650-651.
[13] 任海, 何永红. 脑卒中偏瘫患者功能性电刺激后上肢功能的远期恢复[J]. 中外医学研究, 2014, 12(12):129-131.
[14] 耿尚勇, 李月春, 李峰. 功能性电刺激结合智能运动对脑卒中偏瘫患者运动功能的影响[J]. 中国实用神经疾病杂志, 2014, 17(8):14-16.
[15] 罗金维. 功能性电刺激对偏瘫侧肢体功能恢复的影响[J]. 医学信息:中旬刊, 2011, 24(9):4695-4696.
[16] 林子玲, 陈玲, 燕铁斌, 等. 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):152-155.
[17] Chan M K, Tong R K, Chung K Y. Bilateral upper limb training with functional electric stimulation in patients with chronic stroke[J]. Neurorehabil Neural Repair, 2009, 23(4):357-365.
[18] Alon G, Levitt A F, Mccarthy P A. Functional electrical stimulation enhancement of upper extremity functional recovery during stroke rehabilitation: a pilot study[J]. Neurorehabil Neural Repair, 2007, 21(3):207-215.
[19] 刘忠良, 宋琳, 关爽, 等. 功能性电刺激对脑卒中偏瘫患者上肢运动功能恢复的影响[J]. 中国康复, 2005, 20(1):52-53.
[20] 方华, 周志贤, 刘桂芬. 功能性电刺激辅助干预脑卒中患者运动功能恢复的作用[J]. 中国临床康复, 2004, 8(16):3004-3005.
[21] Eraifej J, Clark W, France B, et al. Effectiveness of upper limb functional electrical stimulation after stroke for the improvement of activities of daily living and motor function: a systematic review and meta-analysis[J]. Syst Rev, 2017, 6(1):40-61.
[22] Arya K N, Pandian S, Puri V. Rehabilitation methods for reducing shoulder subluxation in post-stroke hemiparesis: a systematic review[J]. Top Stroke Rehabi, 2018, 25(1):68-81.
[23] 王国宝, 鲍勇, 丁旭, 等. 功能性电刺激对脑卒中肢体运动功能康复的作用及进展[J]. 中国康复, 2012, 27(5):372-375.
[24] 安立鹏. 基于功能性电刺激的上肢镜像康复运动控制研究[D]. 沈阳:东北大学, 2014.
[25] Veerbeek J M, Kwakkel G, van Wegen E E, et al. Early prediction of outcome of activities of daily living after stroke: a systematic review[J]. Stroke, 2011, 42(5):1482-1488.
[26] Kimberley T J, Lewis S M, Auerbach E J, et al. Electrical stimulation driving functional improvements and cortical changes in subjects with stroke[J]. Exp Brain Res, 2004, 154(4):450-460.
Options
文章导航

/

〈 〉