功能性電刺激於脊髓損傷病人之應用

The Application of Functional Electrical Stimulation in Spinal Cord Injured Patients

傳麗蘭(Li-Lan Fu)

《物理治療》 25卷2期 (2000/03) Pp. 96-103

摘要

脊髓損傷後，由於癱瘓的肌肉無法自主性地收縮運動，而導效肌肉逐漸萎縮，進而失去彈性、關節僵化、骨質疏鬆等常見之症狀，間接導致了心臟血管方面的問題，如血栓形成、高血壓、冠狀動脈疾病等併發症，而且也造成了整個心肺功能(cardiopulmonary fitness)的下降。其它如痙攣、褥瘡、便秘造成的腸道過度擴張、膀胱輸尿管不正常的逆向回流等現象都嚴重的影響了患者的健康情況。除了生理方面的影響外，也常造成患者自我形象的低落、憂鬱等心理方面的問題。
脊髓損傷以交通事故引起的為最多，且患者大多為年輕的男性，所以脊髓損傷患者的復健更顯得重要。如何加強剩餘的功能、如何達到獨立生活或具有謀生的技能子都是相當重要的。功能性電刺激應用於脊髓損患者的主要目的就是功能的改善。功能性電刺激是利用外加的電流來刺激骨骼肌肉神經系統，使之產生功能性動作。本文將分別介紹功能性電刺激控制方法、功能性電刺激之臨床應用及病患之選取標準及注意事項。

關鍵字

脊髓損傷 ； 電刺激 ； 運動治療

並列摘要

The possible complications following spinal cord injury (SCI) include muscle weakness, joint contracture, osteoporesis, pressure sore, urinary disease and cardiovascular diseases from lack of activity. Beside these physical problems, spinal cord injured patients often have lower self-image, and feel depressed with his own physical condition.
SCI are caused mostly by traffic accident, and mainly in young male population. The goals of rehabilitation are to improve their residual function and help them to live with an independent life physically and economically. Functional electrical stimulation (FES) uses electrical current on skeletal muscle to induce functional movements. The purpose of FES application is to improve their daily function such as standing and walking. This report is divided to (1) the theory of FES control mechanism; (2) clinical application of FES in SCI; and (3) patient selection criteria and precaution.

並列關鍵字

Functional electrical stimulation ； Spinal cord injury ； Exercise