Effect of functional electrical stimulation of interscapular muscles on trunk performance and balance in post-stroke elderly patients

Mohammed Youssef Elhamrawy, Wafik Said Bahnasy, Sabah Mohamed Elkady, Mohamed Taha Said
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Abstract

Disability in the upper limb in post-stroke survivors may have a variety of effects, particularly in the elderly, that require planning therapeutic actions to restore function. Thirty-four patients were randomly assigned to the control group (CON) and the Functional Electrical Stimulation (FES) group. For 12 weeks, the CON group received core stabilization exercises (CSEs). The FES group received (FES) for the interscapular muscles with CSEs for the first six weeks and completed the following six weeks with only CSEs. Patients were assessed at baseline, 6 and 12 weeks post-intervention. The trunk impairment scale (TIS) and the Postural Assessment Scale for Stroke (PASS) were used to assess trunk performance. A palpation meter was used to measure the scapular horizontal position (SP). Balance was assessed by the Berg Balance Scale (BBS), and the Timed Up-and-Go test (TUG). Function was assessed with Barthel Index (BI). Both groups improved significantly (P < 0.001 for both groups, d = 1.1–3.7 for control group and d = 1.9–6.1 for FES group) post-treatment (at 6 and 12 weeks) in all outcomes except SP in the control group (P < 0.05 at both times, d = 0.6 at 6 weeks and 0.8 at 12 weeks). FES for interscapular muscles may have positive effects on trunk performance, scapular position, balance, and function in stroke patients. Also, additional improvements were observed post-intervention compared to baseline. FES is recommended to be part of the rehabilitation program of elderly post-stroke patients.
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肩胛间肌肉功能性电刺激对中风后老年患者躯干表现和平衡能力的影响
中风后幸存者的上肢残疾可能会产生多种影响,尤其是对老年人而言,需要规划治疗行动以恢复功能。34 名患者被随机分配到对照组(CON)和功能性电刺激组(FES)。对照组接受为期 12 周的核心稳定运动(CSE)。功能性电刺激组在前六周接受肩胛间肌肉的功能性电刺激(FES),同时进行核心稳定训练,随后六周仅进行核心稳定训练。患者在基线、干预后 6 周和 12 周接受评估。躯干功能障碍量表(TIS)和卒中姿势评估量表(PASS)用于评估躯干功能。使用触诊计测量肩胛骨水平位置(SP)。平衡能力通过伯格平衡量表(BBS)和定时起立行走测试(TUG)进行评估。功能评估采用巴特尔指数(BI)。两组患者在治疗后(6 周和 12 周)的所有结果均有明显改善(两组的 P 均小于 0.001,对照组的 d = 1.1-3.7,FES 组的 d = 1.9-6.1),但对照组的 SP 除外(两组的 P 均小于 0.05,6 周时的 d = 0.6,12 周时的 d = 0.8)。肩胛间肌肉电刺激疗法可能会对中风患者的躯干表现、肩胛位置、平衡和功能产生积极影响。此外,与基线相比,干预后还观察到了额外的改善。建议将 FES 作为老年中风后患者康复计划的一部分。
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