| Objective: Most of the patients with stroke have upper limb motor dysfunction.The characteristics of slow recovery of upper limb motor function seriously affect the ability of daily life and quality of life of patients,which is the difficulty of stroke rehabilitation research at present.Neuromuscular electrical stimulation(NMES)is one of the commonly used physical therapy,which can significantly improve the recovery of hemiplegic patients with stroke;contralateral controlled functional electrical stimulation(CCFES)is a new type of neuromuscular electrical stimulation treatment,and related research has proved that contralateral controlled functional electrical stimulation has a better effect on the improvement of upper limb function than neuromuscular electrical stimulation.But most evaluation methods are subjective.In this study,we will add enhanced therapies and more objective evaluation methods,and the effect of CCFES on the recovery of upper extremity motor function in patients with subacute stroke will be observed.Methods: According to the inclusion criteria and exclusion criteria of this study,43 patients with subacute stroke within 3 months were randomly divided into routine CCFES group(14 cases,group A),CCFES strengthened group(14 cases,group B)and NMES group(15 cases,group C).In addition to the intervention treatment in this study,the three groups will also received the same other conventional rehabilitation training.In addition,group A was treated with conventional dose of contralateral controlled functional electrical stimulation(current frequency: 60 Hz,pulse width: 200 ? s,wave rise: wave drop ratio is 1s: 1s,stimulation time: rest time = 10s: 10s),group B was treated with enhanced dose of contralateral controlled functional electrical stimulation,group C was treated with conventional dose of neuromuscular electrical stimulation(current frequency: 60 Hz,pulse width: 200 ?s,wave rise: wave drop ratio is 1s: 1s,stimulation time: rest time = 10s: 10s).All the three groups were given corresponding electrical stimulation treatment for 20 minutes,group B: twice a day,group A and group C: once a day,all groups will do five times a week for three weeks.Before treatment and 3 weeks after treatment,four evaluation methods were used to evaluate the function of the upper limb: Fugl Meyer score of the upper limb,modified Barthel index,active joint activity of wrist dorsiflexion and sEMG.Results:There was no significant difference between the three groups before treatment(P >0.05).After treatment,all evaluations of the three groups were significantly improved than before(P < 0.05).There was significant difference in the improvement of each index between group A and group B after treatment compared with group C(P < 0.05).There was no significant difference in FMA [(17.71±7.00)vs(16.21±8.44)]and Barthel index scores[(22.79±7.49)vs(18.43±7.29)]of upper limbs between group A and group B aftertreatment(P > 0.05),however,comparison with group A,active ROM for wrist dorsiflexion[(22.79±6.74)°vs(15.36±8.24)°] and the ratio of the affected wrist dorsiflexion RMS to the healthy wrist dorsiflexion RMS [(0.09±0.03)vs(0.06±0.02)]of group B were higher than those of group A after treatment(P < 0.05).Conclusion: The results of this study show that CCFES regular training and CCFES intensive training have significant advantages over NMES regular training in promoting the recovery of upper limb function in patients with subacute stroke,and CCFES intensive training is better than CCFES regular training in enhancing the muscle strength of the affected limb and improving joint activity,which is worth clinical application.However,the optimal therapeutic dose of contralateral controlled functional electrical stimulation intensive training needs more large sample related research to explore. |
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