Yıl: 2018 Cilt: 21 Sayı: 2 Sayfa Aralığı: 67 - 70 Metin Dili: İngilizce DOI: 10.31609/jpmrs.2018-60000 İndeks Tarihi: 04-02-2020

The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial

Öz:
Objective: To investigate the effect of upper extremity functional electrical stimulation(FES) on functional recovery in stroke patients. Material and Methods: The study was a randomizedcontrolledprospective trial, and approved by the local ethics committee. Stroke patients met criteriaand accepted to be in study were randomly allocated to routine physiotherapy (control group) or routinephysiotherapy + FES (FES group). Primary [Fugl-Meyer and Modified Ashworth Scale (MAS)] andsecondary measures [range of motion, Motor Activity Log-28 (MAL-28), Jebsen-Taylor test, handgripstrength, Short Form-36] were assessed before treatment (t0), at the second week of therapy (t1) andafter treatment (t2). Results: Seventeen patients were included in the study (control n: 8, FES n: 9).There were no significant differences between the groups for all outcomes at t0, t1 and t2 assessments.Significantly better results were detected in terms of elbow flexor muscles MAS score (p:0.014), upperextremity Fugl-Meyer score (p:0.011), grip strength (p:0.015) and MAL-28 score (p:0.012) within theFES group. The upper extremity Fugl-Meyer score of the control group was found to be significantlyhigher at repeated measures within the group (p:0.012). Conclusion: Upper extremity FES can be preferredas an additional method in upper limb rehabilitation to improve spasticity, motor functions,handgrip strength and level of independence in performing activities of daily living in stroke patients.
Anahtar Kelime:

Konular: Genel ve Dahili Tıp Rehabilitasyon

Fonksiyonel Elektrik Stimülasyonunun İnme İyileşmesi Üzerindeki Etkisi: Randomize Kontrollü Çalışma

Öz:
Amaç: Üst ekstremite fonksiyonel elektrik stimülasyonunun (FES) inmeli hastalarda fonksiyonel iyileşme üzerine etkisini araştırmak. Gereç ve Yöntemler: Randomize-kontrollü prospektif çalışmamız için etik kurul onayı alındı. Kriterleri karşılayan ve çalışmaya katılmak için onam veren inmeli hastalar rutin fizyoterapi (kontrol grubu) ve rutin fizyoterapi+FES (FES grubu) olarak 2 gruba randomize edildi. Hastalartedavi öncesinde (t0), tedavinin ikinci haftasında (t1) ve tedavi bitiminde (t2) primer [Fugl-Meyer ve Modifiye Ashworth skalası (MAS)] ve sekonder ölçütler [eklem hareket açıklığı, Motor Aktivite İzlemi-28 (MAİ 28), Jebsen-Taylor testi, el kavram gücü, Kısa form-36] ile değerlendirildi. Bulgular: Çalışmaya 17 hasta dahil edildi (8 kontrol, 9 FES grubu). Her iki grup arasında t0, t1 ve t2 ölçümlerinde tüm ölçütlerde istatistiksel anlamlı fark gözlenmedi. FES tedavisi alan grupta tekrarlayan ölçümlerde dirsek fleksör spastisitesi (p:0.014), üst ekstremite Fugl-Meyer skoru (p:0.011), kavrama gücü (p:0.015) ve MAİ-28 skorlarında (p:0.012) istatistiksel anlamlı iyileşme saptandı. Kontrol grubunda üst ekstremite Fugl-Meyer skorunda istatistiksel anlamlı düzelme tespit edildi (p:0.011). Sonuç: Üst ekstremite FES, inmeli hastalarda spastisite, motor fonksiyon, el kavrama gücü ve günlük yaşam aktivitelerinde iyileşme için standart fizyoterapiye ilave bir teknik olarak tercih edilebilir.
Anahtar Kelime:

Konular: Genel ve Dahili Tıp Rehabilitasyon
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Feys HM, De Weerdt WJ, Selz BE, et al. Effect of a therapeutic intervention for the hemiplegic upper limb in the acute phase after stroke: a single-blind, randomised, controlled multicentre trial. Stroke. 1998;29:785-92.
  • Heller A, Wade DT, Wood VA, et al. Arm function after stroke: measurement and recovery over the first three months. J Neurol Neurosurg Psychiatry. 1987;50:714-9.
  • Nakayama H, Jørgensen H, Raaschou H, et al. Recovery of upper extremity function in stroke patients: the Copenhagen Stroke Study. Arch Phys Med Rehabil. 1994;75:394-8.
  • Gowland C. Recovery of motor function following stroke: profile and predictions. Physiother Can. 1984;34:77-84.
  • Koyuncu E, Nakipoğlu-Yüzer GF, Doğan A ve ark. The effectiveness of functional electrical stimulation for the treatment of shoulder subluxation and shoulder pain in hemiplegic patients: a randomized controlled trial. Disabil Rehabil. 2010;32:560-6.
  • Church C, Price C, Pandyan AD, et al. Randomized controlled trial to evaluate the effect of surface neuromuscular electrical stimulation to the shoulder after acute stroke. Stroke. 2006;37:2995-3001.
  • Feys HM, De Weerdt WJ, Selz BE, et al. Effect of a therapeutic intervention for the hemiplegic upper limb in the acute phase after stroke: a single-blind, randomized, controlled multicenter trial. Stroke. 1998;29:785-92.
  • 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. Syst Rev. 2017;6:40.
  • Kwakkel G, Kollen BJ, van der Grond J, et al. Probability of regaining dexterity in the flaccid upper limb: impact of severity of paresis and time since onset in acute stroke. Stroke. 2003;34:2181-6.
  • Hara Y. Rehabilitation with functional electrical stimulation in stroke patients. Int J Phys Med Rehabil. 2013;1:147.
  • Howlett OA, Lannin NA, Ada L, et al. Functional electrical stimulation improves activity after stroke: a systematic review with metaanalysis. Arch Phys Med Rehabil. 2015;96: 934-43.
  • Pollock A, Farmer SE, Brady MC, et al. Interventions for improving upper limb function after stroke. Cochrane Database Syst Rev. 2014;12:CD010820.
  • Fugl-Meyer AR, Jääskö L, Leyman I, et al. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med. 1975;7:13-31.
  • Gregson JM, Leathley M, Moore AP, et al. Reliability of the Tone Assessment Scale and the modified Ashworth scale as clinical tools for assessing poststroke spasticity. Arch Phys Med Rehabil. 1999;80:1013-6.
  • Cakar E, Dinçer Ü, Kıralp MZ ve ark. Turkish adaptation of motor activity log-28. Turk J Phys Med Rehab. 2010;56:1-5.
  • Jebsen RH, Taylor N, Trieschmann RB, et al. An objective and standardized test of hand function. Arch Phys Med Rehabil. 1969;50: 311-9.
  • Higgins J, Mayo NE, Desrosiers J, et al. Upper-limb function and recovery in the acute phase poststroke. J Rehabil Res Dev. 2005; 42:65-76.
  • Kimberley TJ, Lewis SM, Auerbach EJ, et al. Electrical stimulation driving functional improvements and cortical changes in subjects with stroke. Exp Brain Res. 2004;154:450-60.
  • Ring H, Rosenthal N. Controlled study of neuroprosthetic functional electrical stimulation in sub-acute post-stroke rehabilitation. J Rehabil Med. 2005;37:32-6.
  • Sasaki K, Matsunaga T, Tomite T, et al. Effect of electrical stimulation therapy on upper extremity functional recovery and cerebral cortical changes in patients with chronic hemiplegia. Biomed Res. 2012;33:89-96.
  • Hendricks HT, Ijzerman KJ, de Kroon JR, et al. Functional electrical stimulation by means of the ‘Ness Handmaster Orthosis’ in chronic stroke patients: an exploratory study. Clin Rehabil. 2001;15:217-20.
  • Alon G, McBride K, Ring H. Improving selected hand functions using a noninvasive neuroprosthesis in persons with chronic stroke. J Stroke Cerebrovasc Dis. 2002;11:99-106.
  • Wang RY, Yang YR, Tsai MW, et al. Effects of functional electric stimulation on upper limb motor function and shoulder range of motion in hemiplegic patients. Am J Phys Med Rehabil. 2002;81:283-90.
  • Kobayashi H, Onishi H, Ihashi K, et al. Reduction in subluxation and improved muscle function of the hemiplegic shoulder joint after therapeutic electrical stimulation. J Electromyogr Kinesiol. 1999;9:327-36.
  • Alon G, Levitt AF, McCarthy PA. Functional electrical stimulation (FES) may modify the poor prognosis of stroke survivors with severe motor loss of the upper extremity: a preliminary study. Am J Phys Med Rehabil. 2008;87:627-36.
APA DEMIR Y, ALACA R, YAZICIOĞLU K, Yasar E, TAN A (2018). The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial. , 67 - 70. 10.31609/jpmrs.2018-60000
Chicago DEMIR YASIN,ALACA RIDVAN,YAZICIOĞLU Kamil,Yasar Evren,TAN ARİF KENAN The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial. (2018): 67 - 70. 10.31609/jpmrs.2018-60000
MLA DEMIR YASIN,ALACA RIDVAN,YAZICIOĞLU Kamil,Yasar Evren,TAN ARİF KENAN The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial. , 2018, ss.67 - 70. 10.31609/jpmrs.2018-60000
AMA DEMIR Y,ALACA R,YAZICIOĞLU K,Yasar E,TAN A The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial. . 2018; 67 - 70. 10.31609/jpmrs.2018-60000
Vancouver DEMIR Y,ALACA R,YAZICIOĞLU K,Yasar E,TAN A The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial. . 2018; 67 - 70. 10.31609/jpmrs.2018-60000
IEEE DEMIR Y,ALACA R,YAZICIOĞLU K,Yasar E,TAN A "The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial." , ss.67 - 70, 2018. 10.31609/jpmrs.2018-60000
ISNAD DEMIR, YASIN vd. "The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial". (2018), 67-70. https://doi.org/10.31609/jpmrs.2018-60000
APA DEMIR Y, ALACA R, YAZICIOĞLU K, Yasar E, TAN A (2018). The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi, 21(2), 67 - 70. 10.31609/jpmrs.2018-60000
Chicago DEMIR YASIN,ALACA RIDVAN,YAZICIOĞLU Kamil,Yasar Evren,TAN ARİF KENAN The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi 21, no.2 (2018): 67 - 70. 10.31609/jpmrs.2018-60000
MLA DEMIR YASIN,ALACA RIDVAN,YAZICIOĞLU Kamil,Yasar Evren,TAN ARİF KENAN The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi, vol.21, no.2, 2018, ss.67 - 70. 10.31609/jpmrs.2018-60000
AMA DEMIR Y,ALACA R,YAZICIOĞLU K,Yasar E,TAN A The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi. 2018; 21(2): 67 - 70. 10.31609/jpmrs.2018-60000
Vancouver DEMIR Y,ALACA R,YAZICIOĞLU K,Yasar E,TAN A The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi. 2018; 21(2): 67 - 70. 10.31609/jpmrs.2018-60000
IEEE DEMIR Y,ALACA R,YAZICIOĞLU K,Yasar E,TAN A "The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial." Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi, 21, ss.67 - 70, 2018. 10.31609/jpmrs.2018-60000
ISNAD DEMIR, YASIN vd. "The Effect of Functional Electrical Stimulation on Stroke Recovery: A Randomized Controlled Trial". Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi 21/2 (2018), 67-70. https://doi.org/10.31609/jpmrs.2018-60000