| Objective:To compare the effects of contralaterally mirror movement controlled functional electrical stimulation (CMMCFES) vs. conventional functional electrical stimulation(FES) on upper extremity impairment and activity limitation in patients after stroke; To investigate the therapeutic effect of mirror movements combined with functional electrical stimulation on motor reconstructions.Methods:65 post-stroke patients classified and stratified according to Brunnstrom stages were randomized to conventional CMMCFES or FES group.30 cases for each group completed the treatment phase,meanwhile,4 cases were suspended and lease withdrewed. Treatments for both groups consisted of daily CMMCFES or FES(binary channels stimulation on extensors carpi and extensor digitorum) based on the conventional rehabilitation treatments for 4 weeks. Assessments were made at pretreatment and in the 2ed weekend,4th weekend and 8th weekend including FMA-U(total score, wrist score and hand score), MSS(the total score, wrist score and hand score), MAS of upper limb and hand(flexor muscle and extensor muscle), AROM of shoulder(anteflexion, abduction, rear protraction), elbow(flexion and extension), wrist(dorsiflexion and palmar flexion).Results:The FMA-U and MSS score(the total score, wrist score and hand score) of CMMCFES group was increased apparently in the 2ed weekend and 4th weekend compared with the conventional FES group (P<0.05). Adjacent time difference of the wrist AROM covered from the 2ed weekend to 4th weekend in the CMMCFES group was increased much more apparently than that in the conventional FES group(P<0.05). There was no statistical significance between the two groups in the AROM of shoulder and elbow in the 2ed weekend,4th weekend and 8th weekend (P>0.05) and also no remarkable difference referring to every adjacent time difference (P>0.05). The difference between the two groups showed in the 2ed weekend (P<0.05), which was remarkable 2 weeks later (P<0.01) and persisted steadily for another 4 weeks even without any FES. There was no statistical significance between the two groups in the MAS of neither upper limb nor hand in the 2ed weekend,4th weekend and 8th weekend (P>0.05).Conclusion:CMMCFES instrument plays an important role in the recovery of the motor function of wrist and hand without excessive muscle tension appeared in hand, which might be better than the conventional FES. But there is no evidence shows preferable effect in recovery of the motor function of shoulder and elbow by CMMCFES instrument. |
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