E. N. Shchurova, Oxana G. Prudnikova, A. A. Kachesova, M. Saifutdinov, M.S. Tertyshnaya
{"title":"硬膜外电刺激对脊髓损伤后患者功能状态的改善:前瞻性研究","authors":"E. N. Shchurova, Oxana G. Prudnikova, A. A. Kachesova, M. Saifutdinov, M.S. Tertyshnaya","doi":"10.38025/2078-1962-2023-22-6-28-41","DOIUrl":null,"url":null,"abstract":"the lack of convincing evidence of a therapeutic effect. \nAIM. To evaluate the effect of complex rehabilitation using EPS and activation of the proprioceptive apparatus on the indicators of the functional state of patients with long-term consequences of spinal cord injury with partial spinal cord injury. \nMATERIALS AND METHODS. A prospective study was conducted with the participation of 29 patients with long-term consequences of spinal cord injury with partial spinal cord injury. The catamnesis of the disease was 3.7 ± 0.5 years. Comprehensive rehabilitation included epidural electrical stimulation by implantable electrode and activation of the proprioceptive apparatus. The neurological (ASIA scale) and functional (CSIM III scale) status of the patient was analyzed. Motor function was evaluated using 10-meter Walk test; M-responses of limb muscles — using electromyography, temperature and pain sensitivity — using esthesiometry. \nRESULTS. An increase in muscle strength and M-response of the muscles of the extremities, normalization of the motor deficit index, reduction of the walking test time, increase in movement speed and the patient’s independence index were revealed. There is an improvement in temperature and pain sensitivity at the level of damage and in the dermatomes located distally. The effect decreases in dermatomes far from the level of the electrode installation; but with increase in the number of courses the effect increases. \nDISCUSSION. The results obtained indicate that this rehabilitation complex, including UES, has a positive effect on the functioning of both the motor and sensitive spheres. \nCONCLUSION. Application of EES and activation of the proprioceptive apparatus improves the functional condition of sensorimotor sphere in the long-term consequences of spinal cord injury with partial spinal cord damage. Repeated rehabilitation courses have cumulative effect.","PeriodicalId":397121,"journal":{"name":"Bulletin of Rehabilitation Medicine","volume":"149 2","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Improvement of Functional State of Patients after Spinal Cord Injury During Epidural Electrical Stimulation: Prospective Study\",\"authors\":\"E. N. Shchurova, Oxana G. Prudnikova, A. A. Kachesova, M. Saifutdinov, M.S. Tertyshnaya\",\"doi\":\"10.38025/2078-1962-2023-22-6-28-41\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"the lack of convincing evidence of a therapeutic effect. \\nAIM. To evaluate the effect of complex rehabilitation using EPS and activation of the proprioceptive apparatus on the indicators of the functional state of patients with long-term consequences of spinal cord injury with partial spinal cord injury. \\nMATERIALS AND METHODS. A prospective study was conducted with the participation of 29 patients with long-term consequences of spinal cord injury with partial spinal cord injury. The catamnesis of the disease was 3.7 ± 0.5 years. Comprehensive rehabilitation included epidural electrical stimulation by implantable electrode and activation of the proprioceptive apparatus. The neurological (ASIA scale) and functional (CSIM III scale) status of the patient was analyzed. Motor function was evaluated using 10-meter Walk test; M-responses of limb muscles — using electromyography, temperature and pain sensitivity — using esthesiometry. \\nRESULTS. An increase in muscle strength and M-response of the muscles of the extremities, normalization of the motor deficit index, reduction of the walking test time, increase in movement speed and the patient’s independence index were revealed. There is an improvement in temperature and pain sensitivity at the level of damage and in the dermatomes located distally. The effect decreases in dermatomes far from the level of the electrode installation; but with increase in the number of courses the effect increases. \\nDISCUSSION. The results obtained indicate that this rehabilitation complex, including UES, has a positive effect on the functioning of both the motor and sensitive spheres. \\nCONCLUSION. Application of EES and activation of the proprioceptive apparatus improves the functional condition of sensorimotor sphere in the long-term consequences of spinal cord injury with partial spinal cord damage. 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引用次数: 0
摘要
缺乏令人信服的治疗效果证据。目的评估使用 EPS 和本体感觉器官激活综合康复治疗对部分脊髓损伤长期后遗症患者功能状态指标的影响。材料和方法:对 29 名脊髓损伤长期后遗症(部分脊髓损伤)患者进行了前瞻性研究。病程为 3.7 ± 0.5 年。综合康复包括通过植入电极进行硬膜外电刺激和激活本体感觉器官。对患者的神经(ASIA量表)和功能(CSIM III量表)状况进行了分析。运动功能通过 10 米步行测试进行评估;四肢肌肉的 M 反应通过肌电图进行评估;温度和疼痛敏感度通过雌激素测定法进行评估。结果如下结果显示,四肢肌肉的肌力和M反应增强,运动障碍指数恢复正常,步行测试时间缩短,运动速度提高,患者的独立性指数提高。受损部位和远端皮节的温度和疼痛敏感性有所改善。在距离电极安装位置较远的皮节,效果有所减弱;但随着疗程数的增加,效果会有所增强。讨论。研究结果表明,包括 UES 在内的康复综合疗法对运动和敏感领域的功能都有积极影响。结论。在部分脊髓损伤的长期后果中,应用 EES 和激活本体感觉器可改善感觉运动领域的功能状况。重复康复疗程具有累积效应。
Improvement of Functional State of Patients after Spinal Cord Injury During Epidural Electrical Stimulation: Prospective Study
the lack of convincing evidence of a therapeutic effect.
AIM. To evaluate the effect of complex rehabilitation using EPS and activation of the proprioceptive apparatus on the indicators of the functional state of patients with long-term consequences of spinal cord injury with partial spinal cord injury.
MATERIALS AND METHODS. A prospective study was conducted with the participation of 29 patients with long-term consequences of spinal cord injury with partial spinal cord injury. The catamnesis of the disease was 3.7 ± 0.5 years. Comprehensive rehabilitation included epidural electrical stimulation by implantable electrode and activation of the proprioceptive apparatus. The neurological (ASIA scale) and functional (CSIM III scale) status of the patient was analyzed. Motor function was evaluated using 10-meter Walk test; M-responses of limb muscles — using electromyography, temperature and pain sensitivity — using esthesiometry.
RESULTS. An increase in muscle strength and M-response of the muscles of the extremities, normalization of the motor deficit index, reduction of the walking test time, increase in movement speed and the patient’s independence index were revealed. There is an improvement in temperature and pain sensitivity at the level of damage and in the dermatomes located distally. The effect decreases in dermatomes far from the level of the electrode installation; but with increase in the number of courses the effect increases.
DISCUSSION. The results obtained indicate that this rehabilitation complex, including UES, has a positive effect on the functioning of both the motor and sensitive spheres.
CONCLUSION. Application of EES and activation of the proprioceptive apparatus improves the functional condition of sensorimotor sphere in the long-term consequences of spinal cord injury with partial spinal cord damage. Repeated rehabilitation courses have cumulative effect.