不同频率神经肌肉电刺激对脑卒中吞咽障碍的疗效观察

目的:观察不同频率神经肌肉电刺激对脑卒中吞咽障碍的疗效.方法:选取脑卒中后急性期吞咽障碍患者80例,随机分为2组(低频电刺激治疗组和高频频率电刺激治疗组),各组均采用常规药物治疗和吞咽功能训练,在此基础上分别加用30 Hz和80 Hz频率的神经肌肉电刺激治疗,为期3周.治疗前后,采用日本洼田饮水实验对入组患者吞咽功能进行评价.结果:高频治疗(80Hz)治疗效果阳性率明显高于低频(30Hz)治疗效果(P＜0.001).结论:高频率神经肌肉电刺激对脑卒中后吞咽障碍治疗效果显著优于低频率治疗.     

电刺激训练前后肌肉力量交叉迁移效果的实验观察

采用T90 - 1型电刺激肌肉力量训练仪对 10名 19～ 2 1岁男性二级运动员左腿股前肌群进行电刺激训练 ,测定等长状态时伸膝与屈膝肌肉力量。结果 :受试者左腿股前肌群 (主动肌群 )伸膝力量提高 4 7± 3 5kg(P <0 0 1) ,对抗肌群 (股后肌群 )屈膝力量提高 2 1± 2 8kg(P <0 0 1)。右腿股前肌群 (主动肌群 )伸膝力量提高 2 6± 0 5 5kg(P <0 0 1) ,对抗肌群 (股后肌群 )屈膝力量提高 1 0± 0 71kg(P <0 0 5 )。表明电刺激左腿股前肌群明显提高股后肌群的力量的同时 ,亦可有效地提高右腿股前、股后肌群的力量。     

PHENIX电刺激联合生物反馈治疗女性盆底功能障碍性疾病疗效Meta分析

目的:系统评价PHENIX电刺激联合生物反馈治疗女性盆底功能障碍性疾病(PFD)的疗效.方法:采用计算机配合手工方法检索2010年1月-2015年12月,在中国知网(CNKI)、维普中文科技期刊数据库、万方数字知识服务平台等数据库已发表的文献、学位论文,以及中国学术会议论文数据库会议论文,选择PHENIX神经肌肉刺激治...     

低频电刺激对急性脑卒中后偏瘫患者运动功能的随机对照研究

目的:探讨低频神经肌肉电刺激对急性脑卒中偏瘫患者运动功能的影响.方法:80例急性脑卒中患者按前瞻性随机化原则分为电刺激组40例和对照组40例.两组常规治疗相同,电刺激组加用低频神经肌肉电刺激仪进行治疗,电极片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30Hz,脉宽200μs,电流以患者最大耐受强度为限.每天治疗1次,每次30min,共2周(14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组患者在治疗2周后,电刺激组与对照组的FMA评分及MB1总分比较,差异均有统计学意义(P＜0.05).结论:低频神经肌肉电刺激治疗能提高急性脑卒中后偏瘫患者运动功能.     

可编程式经皮神经肌肉电刺激系统的设计及初步实验研究

目的 研究可用于中长期失重环境下肌肉萎缩对抗的可编程式经皮神经肌肉电刺激系统的设计及其应用.方法 由可控恒流脉冲发生器、导线、皮肤电极组成系统,针对刺激处方筛选的要求,刺激脉冲参数独立可调且能实现不同刺激阶段的组合输出.结果 系统样机工作正常,输出信号精确;不同波形的脉冲电流都能引起股四头肌的感觉、收缩、强直及疼痛,但所需幅度阖值不同,相同幅度刺激引起的主观感受也存在差异.结论 研制的系统输出信号准确、可编程功能强大,便于进行刺激处方的筛选和验证.可作为失重环境下肌肉萎缩的电刺激对抗研究的仪器平台;人体试用实验验证了刺激系统的功能性,为刺激参数的优化提供了初步依据.     

经皮肌肉电刺激对尾部悬吊大鼠骨丢失防护的初步研究

目的 进一步评估经皮肌肉电刺激(PMES)对尾部悬吊大鼠骨丢失的防护作用.方法 17只雄性SD大鼠随机分为3组:自由对照组(Con)4只,尾吊组(TS)7只,尾吊且PMES组(TS PMES)6只.用频率50 Hz且幅度3 mA的电流对右侧臀中肌进行刺激,1 h/d,共26 d.实验结束后测量所有大鼠股骨近端、中段和远端的骨密度(BMD).结果 对于右侧股骨近端BMD,3组之间均无显著性差别.对于右侧股骨中段BMD,Con组与其它组都存在显著性差别(P＜0.05),而其它2组无显著性差别.对于右侧股骨远端BMD,TS组与其它组都存在非常显著的差别(P＜0.01),而其它2组无显著性差别.结论 尾部悬吊大鼠股骨骨丢失发生在中段和远端,PMES可以对抗股骨远端的骨质疏松,保持正常的BMD.     

神经肌肉电刺激对前交叉韧带重建术后腘绳肌功能的影响

目的:观察神经肌肉电刺激(NMES)对前交叉韧带(ACL)重建术后腘绳肌功能的影响,为预防自体腘绳肌腱重建ACL术后患侧腘绳肌肌力的下降、及早促进膝关节功能恢复提供依据。方法:选取自体腘绳肌重建ACL男性患者30名为对象,随机分为常规康复组、等长收缩组、神经肌肉电刺激(NMES)组,采用BIODEX等速肌力测试仪测试双侧腘绳肌等长肌力,采用Tensiomyography肌肉状态测试分析仪测试电机械延迟(EMD)和收缩持续时间;行IKDC膝关节主观功能评分。结果:术后3个月患侧腘绳肌等长肌力常规组较术前有所下降,而等长收缩组和NMES组则较术前有所增加,且与常规组均有显著性差异(P<0.05)。半腱肌EMD:术后NMES组较常规康复组和等长收缩组增加较少,均有显著差异性(P<0.05,P<0.01)。股二头肌EMD:术后三组受试对象EMD患侧均较健侧增加,等长收缩组较常规康复组有显著差异性(P<0.05)。半腱肌和股二头肌收缩持续时间:三组患者术前和术后无论是健侧还是患侧股二头肌收缩持续时间均无显著差异性。IKDC评分:三组患者术后3个月与术前差值,常规康复组较等长收缩组差异显著(P<0.05)。结论:术后早期应用NMES可以有效地预防自体腘绳肌腱重建ACL术后腘绳肌肌力的下降以及电机械延迟的延长。     

经颅磁及电刺激运动诱发电位监测大鼠脊髓功能

 目的 检测大鼠磁刺激运动诱发电位(MEP)与电刺激MEP信号的正常值,比较两者在刺激方式、信号特征和临床意义等方面的异同.方法 20只雄性SD大鼠经静脉麻醉后采用Mag 2型磁刺激仪和Cantada型肌电图仪分别进行单次经颅磁及电刺激,观察不同刺激强度下,在T<,12>硬膜外和双侧前肢伸肌和后肢腓肠肌记录的MEP变化特征.结果 磁刺激ScMEP先正后负,以P<,1>和N<,1>波最显著,波形不够稳定,个体间差异较大,随着刺激强度增大,MEP潜伏期缩短,波幅增大.近阈值电刺激MEP与相应的超强磁刺激MEP潜伏期相近,波幅也相差不大.结论 采用单次磁或电震刺激MEP仍能客观反映脊髓运动传导束的功能状态,电和磁刺激MEP之间存在一定程度的同源成份,可以作为临床与动物实验比较研究的依据.     

神经肌肉电刺激在全脑血管造影术后患者中的应用

【摘要】 目的 探索神经肌肉电刺激在经股动脉穿刺全脑血管造影术后患者中的应用效果。方法 按照住院时间顺序将2019年的982例全脑血管造影术后患者分为观察组与对照组,每组491例。两组患者均运用常规术后护理干预方案,观察组在常规护理的基础上,于术后3 d实施神经肌肉电刺激干预方案,比较两组患者下肢深静脉血栓的发生率,术后即刻、6 h、12 h、24 h和术后第3天的舒适度得分。结果 观察组患者下肢深静脉血栓发生率显著低于对照组（P＜0.05）,观察组全脑血管造影术后不同时间点舒适度评分均显著高于对照组（P＜0.05）。结论 神经肌肉电刺激可显著降低全脑血管造影术患者术后深静脉血栓的发生率,提高术后患者的舒适度,值得在临床上推广使用。     

99mTc-sestamibi muscle scintigraphy to assess the response to neuromuscular electrical stimulation of normal quadriceps femoris muscle

OBJECTIVES: Neuromuscular electrical stimulation (NMES) is widely used for improving muscle strength by simultaneous contraction in the prevention of muscle atrophy. Although there exist many clinical methods for evaluating the therapeutic response of muscles, 99mTc-sestamibi which is a skeletal muscle perfusion and metabolism agent has not previously been used for this purpose. The aim of our work was to ascertain whether 99Tc-sestamibi muscle scintigraphy is useful in the monitoring of therapeutic response to NMES in healthy women. METHODS: The study included 16 women aged between 21 and 45, with a mean age of 32.7 +/- 6.4. Both quadriceps femoris muscles (QFM) of each patient were studied. After randomization to remove the effect of the dominant side, one QFM of each patient was subjected to the NMES procedure for a period of 20 days. NMES was performed with an alternating biphasic rectangular current, from a computed electrical stimulator daily for 23 minutes. After measurement of skinfold thickness over the thigh, pre- and post-NMES girth measurements were assessed in centimeters. Sixty minutes after injections of 555 MBq 99mTc-sestamibi, static images of the thigh were obtained for 5 minutes. The thigh-to-knee uptake ratio was calculated by semiquantitative analysis and normalized to body surface area (NUR = normalized uptake ratio). RESULTS: The difference between the pre and post NMES NUR values was significant (1.76 +/- 0.31 versus 2.25 +/- 0.38, p = 0.0000). The percentage (%) increase in NUR values also well correlated with the % increase in thigh girth measurements (r = 0.89, p = 0.0000). CONCLUSION: These results indicated that 99mTc-sestamibi muscle scintigraphy as a new tool may be useful in evaluating therapeutic response to NMES.     

偏瘫后肩手综合征关节松动术疗效观察

 目的 通过观察关节松动术治疗偏瘫后肩手综合征(RSD)的疗效,并对其原理进行分析探讨.方法 脑卒中偏瘫患者38例,均出现肩痛等症状,符合RSD诊断,所有患者随机分为2组,每组19例,实验组除进行常规理疗外,还接受关节松动术治疗,对照组只进行常规理疗.所有病例均接受整体感知疗效(global perceived effect, GPE)、视觉模拟量表(visual Analog Scale, VAS)和肩关节被动活动度(ROM)评定.结果 实验组VAS、GPE和ROM改善优于对照组,有统计学差异;2组组内治疗后症状有改善,有统计学差异.结论 疼痛和交感神经系统失调可能是RSD形成的关键因素,通过关节松动术可以缓解疼痛,调节交感神经,综合其他常规理疗,从而打破这种恶性循环,最终达到治疗目的 .     

右正中神经电刺激早期干预对颅脑损伤昏迷患者的临床疗效观察

目的 观察右正中神经电刺激对颅脑损伤早期昏迷患者的临床疗效. 方法 对2005 - 2011年间颅脑损伤昏迷患者(昏迷时间＞2周)按照随机数字表法分为常规治疗组(对照组)和右正中神经电刺激+常规治疗(治疗组),治疗时间＞2周.观察患者对右正中神经电刺激的治疗依从性以及伤后6个月意识恢复情况. 结果 共纳入465例患者,完成治疗疗程437例,其中治疗组221例,对照组216例,治疗期间无电刺激相关并发症出现.脑血流灌注及脑干诱发电位检测提示治疗组出现明显改善.386例患者获得伤后6个月随访,治疗组患者(204例)意识清醒122例,微意识状态46例,植物状态36例;对照组(182例)意识清醒84例,微意识状态40例,植物状态58例.与对照组比较,治疗组患者意识恢复清醒比例明显高于对照组,植物状态比例明显低于对照组,微意识状态比例与对照组比较差异无统计学意义. 结论 右正中神经电刺激是适宜在颅脑损伤早期昏迷阶段应用的昏迷促醒手段.     

An exploration of the function of the triceps surae during normal gait using functional electrical stimulation

Gastrocnemius and soleus have a common tendon and both are active during stance phase, where they are thought to arrest and control tibial advance. Soleus is associated with the production of an extending moment at the knee. The two-joint gastrocnemius, which crosses the knee joint, will have an additional contribution to the knee flexors.

Recent work using induced acceleration analysis (IAA) has demonstrated distinct differences between the actions of gastrocnemius and soleus. This study aims to use gait analysis to provide in vivo examination of these theoretical predictions.

Functional electrical stimulation (FES) was chosen to provide a perturbation in muscle force, a close physical analogue to the theoretical predictions of IAA. Five adult male subjects, with no gait problems, participated. Each had gastrocnemius and soleus stimulated at three different timings during normal gait, while 3D gait data were collected. The order of testing was randomised and unstimulated trials were randomly interspersed to act as a control.

The results show very different actions for soleus (ankle plantarflexing/knee extending) and gastrocnemius (ankle dorsiflexing/knee flexing) in stance phase. The counterintuitive nature of the action of gastrocnemius suggests that further clinical and biomechanical investigation into this muscle's function is required. The actions of both muscles at the knee confirm published IAA predictions. In vivo evidence such as this gives greater confidence when using model predictions. The approach adopted in this study could eventually be extended to other muscles and patient populations.     

Clinical and radiological outcomes of corrective exercises and neuromuscular electrical stimulation in children with flexible flatfeet: A randomized controlled trial

BackgroundFlexible flatfeet are common among children being scarcely symptomatic requires no specific treatment and resolves spontaneously. However, flexible flatfoot tends to advance and deteriorate overtime and eventually resulting in significant impairments such as plantar fasciitis and patellofemoral pain syndrome. Research question: What is the effect of corrective exercises and neuromuscular electrical stimulation in children with flexible flatfeet?MethodThis is a randomized controlled trial with 72 children, seven to twelve yearsold, randomly assigned to either intervention or control group (36 children for each group) and engaged in a four months (3 sessions/week) of corrective exercise and neuromuscular electrical stimulation or corrective exercise and sham neuromuscular electrical stimulation respectively. Assessments of Staheli’s arch index (through foot print), navicular drop (through navicular drop test) and radiographic indexes (through anterior-posterior and medio-lateral X-ray) of both feet were performed before and after the intervention programs.ResultsStudy groups were comparable with respect to all outcome measures at entry (P > 0.05). Within group comparison showed significant improvements in all measured variables. Further, between groups comparison revealed significant higher improvements (P < 0.05) in right and left feet Staheli’s arch index, navicular drop as well as the radiographic indexes in favor of the intervention group.SignificanceIntegration of corrective exercises and neuromuscular electrical stimulation is more effective than exercises alone for providing clinical and radiological improvements in children with flexible flatfeet.     

Therapeutic effect of functional electrical stimulation-triggered gait training corresponding gait cycle for stroke

The purpose of this study was to determine the therapeutic effects of functional electrical stimulation (FES) applied to the gluteus medius and tibialis anterior muscles during the gait cycle in individuals with hemiparetic stroke. Eighteen patients who had suffered a stroke were enrolled in this study. The participants were divided into either the gluteus medius and tibialis anterior (GM + TA) training group (n = 9) or the control group (n = 9). The GM + TA group received FES-triggered gait training to the gluteus medius (GM) in the stance phase and the tibialis anterior (TA) in the swing phase for 30 min, 5 session a week over a 6-week period, and control group who received only gait training without FES-triggered for the same duration of time. A foot-switch sensor was used to trigger the device in the stance (GM) and swing (TA) phases of the gait cycle reciprocally. This study measured three types of outcome measures, including spatiotemporal gait parameters, muscles activities, and balance function. After 6 weeks training, there was a significant improvement in gait velocity, cadence, stride length, and gait symmetry in the GM + TA training group compared to the control group. Dynamic balance function was significantly improved in the GM + TA training group compared to the control group. The mean changeable values of the GM was significantly greater strength in the GM + TA training group than the control group. These findings suggest that FES-triggered gait training of the GM in the stance phase and TA in the swing phase may improve the spatiotemporal parameters of gait in persons with hemiparetic stroke.     

反复海马CA1区惊厥阈下电刺激致实验大鼠持续性临床下痫样放电研究

目的：通过海马CA1区惊厥阈下电刺激建立可持续较长时间、无明显惊厥行为的临床下痫样放电动物模型。方法：选用雄性SD大鼠25只，通过反复大鼠海马CA1区惊厥阈下电刺激，观察大鼠惊厥行为，纪录电刺激停止后1、3、7、14、30d时大鼠皮层脑电图改变。结果：采用刺激频率30Hz，波宽1ms，串长10S，刺激强度0．1mA，串隔5min，10次／d，连续刺激4d，最后一次电刺激后30d内，均可在大鼠皮层记录到稳定发放的散在或阵发性高幅尖波、棘波、棘慢波，而实验动物并无明显的惊厥行为表现（Racine0级）。结论：反复海马CA1区惊厥阈下电刺激可较长时间诱发实验动物出现无明显惊厥行为的临床下痫样放电。