Comparison of the Benefits between the Application of Transcutaneous Nerve Stimulation (TENS) and Functional Electrical Stimulation (FES) on the Postural Control and Mobility Ability in Acute Stroke Patients

比較經皮及功能性電刺激應用於中風急性期在姿勢維持及活動能力的效益

嚴筱晴(Hsiao-Ching Yen) ； 潘冠碩(Guan-Shuo Pan) ； 李亞芸(Ya-Yun Lee) ； 陸哲駒(Jer-Junn Luh)

《物理治療》 42卷2期 (2017/06) Pp. 168-169

https://doi.org/10.6215/FJPT.2017.73.P21

摘要

Background and Purpose: Rehabilitation is recommended to start as early as possible after stroke onset. In the intensive care unit (ICU) of our facility, patients are generally prescribed bed rest within 3 days after stroke to reduce neurological complications. Additionally, the patients in stroke ICU may not have sufficient endurance, such as attention or alertness, for standard rehabilitation treatment. One potential rehabilitation approach for facilitation in stroke patients staying in ICU is electrical stimulation, such as transcutaneous nerve stimulation (TENS) and functional electrical stimulation (FES). Although some investigators have studied the benefits of FES in the early phase of recovery after stroke, limited studies have investigated the effects of TENS for motor recovery in stroke patients staying in stroke ICU. This study aims to investigate if TENS has similar effect on motor recovery as those who received FES. Methods: Forty-five stroke patients who were admitted in stroke ICU within 3 days after stroke onset were randomly allocated to standard rehabilitation (SR) group (n = 19), FES group (n = 13) and TENS group (n = 13). For the FES and TENS group, the interventions were applied at the tibialis anterior and quadriceps muscles over the paretic side for 30 min additional to standard rehabilitation. The measurements included whether the participants achieve three mobility milestones, which are sitting ≥ 5 mins, standing ≥ 1 min, and walking ≥ 50 m, within 14 days after stroke. We also measured the postural assessment scale for stroke patients (PASS) scores at the 2nd and 4th post-stroke weeks. Outcome measurements were analyzed with repeated measure analysis of variance and a χ2 test. Results: The rate of achieving the milestone of walking ≥ 50 m within 14 days after stroke in the FES and TENS groups were significantly higher than the SR group. The FES and TENS groups demonstrated significantly greater increase in the PASS scores at the 2nd post-stroke week than the SR group, but no significant differences were found between the FES and TENS groups. Conclusion and Clinical Relevance: Applying either TENS or FES on the paretic lower limb in stroke ICU improves the mobility and postural control in the acute stage. TENS and FES show similar effects on motor recovery in the acute phase.