The Effects of Functional Electrical Stimulation (FES) Cycling Training on Muscle Strength and Standing Balance of Stroke Patients

功能性電刺激輔助踩車訓練對於中風患者下肢肌肉力量與站立平衡之影響

許詠鈞(Yung-Chun Hsu) ； 葉純妤(Chun-Yu Yeh) ； 蔡昆宏(Kuen-Horng Tsai)

《童綜合醫學雜誌》 3卷2期 (2009/12) Pp. 84-90

https://doi.org/10.29838/TMJ.200912.0003

摘要

目的：評估中風患者使用功能性電刺激輔助踩車運動訓練前後，偏癱下肢肌肉力量及站立平衡反應，是否會有不同之變化。
方法：利用隨機分配方式將十六位受測者分為電刺激踩車實驗組（八位）與踩車訓練控制組（八位）。在進行踩車運動前，病患均先接受偏癱下肢肌肉力量與站立穩定極限平衡的評估（分別以手握肌力測試儀及電腦動態平衡反應測試儀來量化）；而當兩組受測者分別完成踩車運動後，再次評估其偏癱下肢肌肉力量與穩定極限平衡的變化。
結果：兩組受測者其兩側膝伸直肌肌力於踩車訓練前後並無明顯統計差異；但在往偏癱側的站立穩定極限平衡測試參數則發現：重心初次位移距離(P=.031)、重心最大位移距離(P=.000)與重心位移方向控制(P=.013)有明顯的增加改善趨勢。而兩組間的踩車運動訓練對於中風患者之膝伸直肌肌力，以及站立穩定極限平衡測試指標等皆無明顯之差異影響。
結論：本研究可以證實並觀察出，兩組受測者在進行踩車運動訓練後，皆明顯有助於改善增加偏癱側的站立穩定極限平衡反應表現，其中包含了重心初次位移距離、重心最大位移距離及重心位移方向控制等參數。但是在兩組間應變數的比較上，功能性電刺激針對於踩車實驗組而言，卻無法額外增加中風患者膝伸直肌肌力與站立穩定極限平衡反應表現。未來的臨床研究希望可以徵召較多的受試者，參與探討有關功能性電刺激輔助踩車訓練後，對於功能性動作回復與步態行走之長效性影響。

關鍵字

功能性電刺激 ； 踩車運動 ； 肌肉力量 ； 站立平衡 ； 腦中風

並列摘要

Objective: To investigate the possible beneficial effects of muscle strength and standing balance in subjects with stroke using the FES-cycling ergometer system.
Methods: Sixteen hemiplegic stroke patients were randomly assigned to perform leg cycling exercise (LCE), one with functional electrical stimulation (FES) evoking muscle contractions during a single bout cycling training and a control group received the same study protocol without FES. All subjects, blinded for group assignment, were measured at baseline and at post-test in the laboratory. Muscle strength was quantitatively measured by hand-held dynamometer (HHD), and furthermore the standing balance was evaluated by the limits of stability (LOS).
Results: There was no significant change in the muscle strength after cycling in both groups. In addition, significant improvement of the paretic-side stability was detected in endpoint excursion (P= .031), maximum excursion (P= .000), and directional control (P= .013). While training-induced temporal changes of all outcome measures were no significant difference between the two groups.
Conclusions: This experiment showed that a short cycling training program is a useful therapeutic intervention to improve the standing balance ability in patients with stroke. But the use of FES had no additional benefit in this experimental study. In the future studies, it will be of interest to use larger groups of subjects to investigate the long-term effects of this intervention on motor recovery and functional walking.

並列關鍵字

functional electrical stimulation ； leg cycling exercise ； muscle strength ； standing balance ； stroke