The Effect of Upper Extremity Electrical Stimulation in Addition to Conventional Rehabilitation in Individuals with Chronic Stroke: Randomized Controlled Study.
Objective: To investigate the effect of electrical stimulation of wrist and finger extensor muscles applied in addition to the conventional rehabilitation program on wrist spasticity, hand motor function, and quality of life in individuals with chronic stroke. Material and Methods: Patients were ran...
| Publicado en: | Journal of Physical Medicine & Rehabilitation Sciences Vol. 20; no. 3; pp. 126 - 134 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Turkiye Klinikleri
2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=126616503&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 126616503 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13093843 B6K0 jtl: Journal of Physical Medicine & Rehabilitation Sciences issn: 13093843 maglogo: N pubinfo: dt: 2017 vid: 20 iid: 3 pid: 67298 pub: Turkiye Klinikleri artinfo: ui: 126616503 126616503 126616503 126616503 ppf: 126 ppct: 8 formats: fmt: @attributes: type: P tig: atl: The Effect of Upper Extremity Electrical Stimulation in Addition to Conventional Rehabilitation in Individuals with Chronic Stroke: Randomized Controlled Study. aug: au: TİLKİCİ, Mehmet ALEMDAROĞLU, Ebru MANDIROĞLU, Sibel ORDU GÖKKAYA, Nilüfer Kutay UÇAN, Halil AYKAN, Sanem Aslıhan affil: Clinic of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara sug: subj: Stroke Rehabilitation Chronic Disease Rehabilitation Hemiplegia Rehabilitation Upper Extremity Physiopathology Electrical Stimulation, Neuromuscular Physical Therapy Methods Combined Modality Therapy Range of Motion Treatment Outcomes Quality of Life Activities of Daily Living Clinical Assessment Tools Scales Questionnaires Randomized Controlled Trials P-Value Data Analysis Software Descriptive Statistics Wilcoxon Signed Rank Test Mann-Whitney U Test Chi Square Test Fisher's Exact Test Middle Age Aged Aged, 80 and Over Female Male Human Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Female Male ab: Objective: To investigate the effect of electrical stimulation of wrist and finger extensor muscles applied in addition to the conventional rehabilitation program on wrist spasticity, hand motor function, and quality of life in individuals with chronic stroke. Material and Methods: Patients were randomized into two groups as control (n=20) and treatment groups (n=20). Patients in the treatment group received surface neuromuscular electrical stimulation to the wrist and finger extensors of the hemiplegic upper extremity for 30 minutes, 5 days a week for 3 weeks in addition to conventional rehabilitation. The control group received only the conventional rehabilitation program. All subjects were evaluated before and after treatment. The hemiplegic upper extremity hand motor functions and spasticity were evaluated using Brunnstrom's Motor Stage Recovery, Fugl Meyer Assessment Scale(FMAS), Modified Ashworth Scale (MAS) respectively. The Duruöz Hand Index, Functional Independence Measure (FIM), and Nottinhgam Health Profile (NHP) were also applied. Results: When the pre- and post- treatment variances of values were compared between the treatment and control groups, the variance of wrist extension angle (p<0.001), MAS value of wrist (p=0.012), NHP sleep (p=0.036), and NHP physical activity scores (p=0.043) were significantly higher in the treatment group than in the control group. The difference of variances between the groups was not significant in respect of the Brunnstrom stage of upper extremity or hand, Fugl-Meyer of upper extremity, MAS of elbow, NPH pain, NPH emotional, NPH social isolation, Duruöz Hand Scale, FIM motor, FIM cognitive and FIM total scores. Conclusion: Even though most of the outcome measures improved significantly in both groups, electrical stimulation applied to the forearm in addition to a conventional rehabilitation program was more effective in decreasing the spasticity and increasing range of motion of the wrist in hemiplegic upper extremity rehabilitation due to stroke when compared to a conventional program only. Furthermore, the combined program had more favorable effects on physical activity and sleep. Amaç: Kronik inmeli hastalarda konvansiyonel rehabilitasyona ek olarak; el bileği ve parmak ekstensörlerine uygulanan elektrik stimülasyonunun, el bileğinde spastisite, el motor fonksiyonu, yaşam kalitesi üzerine etkisini araştırmaktır. Gereç ve Yöntemler: Hastalar tedavi (n=20) ve kontrol (n=20) grubu olmak üzere iki gruba randomize edildi. Tedavi grubundaki hastalar hemiplejik üst ekstremiteye yönelik konvansiyonel rehabilitasyon programına ek olarak; üç hafta, haftada beş gün, günde 30 dk yüzeyel nöromusküler elektrik stimülasyonu tedavisi aldı. Kontrol grubu yalnız konvansiyonel rehabilitasyon programına alındı. Tüm hastalar tedavi öncesi ve sonrası değerlendirildi. Hemiplejik üst ekstremite motor fonksiyonları ve spastisitesi sırasıyla Brunnstrom Motor Evrelemesi, Fugl Meyer Değerlendirme Skalası (FMDS) ve Modiye Ashworth Skalası (MAS), ile değerlendirildi. Aynı zamanda Duruöz El indeksi, Fonksiyonel Bağımsızlık Ölçeği (FBÖ) ve Nottinhgam Sağlık Profili (NSP) uygulandı. Bulgular: Tedavi ve kontrol gruplarında tedavi öncesi ve sonrası değerlerin farkları karşılaştırıldığında; el bilek ekstansiyonu açısı (p<0,001), el bileği MAS değeri (p=0,012), NSP uyku (p=0,036) ve NSP fiziksel aktivite skor farkı (p=0,043) tedavi grubunda anlamlı derecede yüksek idi. Üst ekstremite Brunnstrom Motor Evrelemesi, FMDS, dirsek MAS, NSP ağrı, emosyonel reaksiyonlar, sosyal izolasyon skorları, Duruöz El indeksi, FBÖ motor, FBÖ kognitif, FBÖ total değerleri farkı bakımından gruplar arasında anlamlı fark yoktu. Sonuç: Her iki grupta da son durum ölçeklerinin büyük bir kısmı istatistiksel olarak anlamlı düzelme göstermiş olsa da inmeye bağlı hemiplejik üst ekstremite rehabilitasyonunda konvansiyonel rehabilitasyon programına ek olarak uygulanan ön kol elektrik stimülasyonu tedavisi, yalnız konvansiyonel rehabilitasyon programı ile karşılaştırıldığında, el bileğinde spastisiteyi azaltmakta, eklem hareket açıklığını artırmakta daha etkindi. Ayrıca, kombine program fiziksel aktivite ve uyku üzerine daha fazla olumlu etkiye sahip idi. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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