随意運動介助型電気刺激を用いた筋力トレーニングと歩行練習が軽症急性期脳卒中患者の運動麻痺や歩行機能に及ぼす影響：準ランダム化比較試験での検討
〔目的〕本研究は随意運動介助型電気刺激の使用が及ぼす軽症急性期脳卒中患者の運動麻痺や歩行機能への効果を検討することである．〔対象と方法〕対象者は初発脳卒中患者24名とし，通常リハ群（13名）と機能的電気刺激（FES）リハ群（11名）に割付け，FESリハ群は通常リハ群と同様の治療内容に加えて電気刺激を併用して実施し た．身体機能や歩行機能を各群の初期評価，介入後1週間，退院時にて測定し，反復測定2元配置分散分析と多重比較検定（Dunnett）にて検討した．〔結果〕Stroke Impairment Assessment Set （SIAS）足背屈，麻痺側股関節屈曲筋力・足関節背屈筋力，歩行速度，...
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| Published in | 理学療法科学 Vol. 35; no. 6; pp. 885 - 891 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
理学療法科学学会
2020
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1341-1667 2434-2807 |
| DOI | 10.1589/rika.35.885 |
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| Abstract | 〔目的〕本研究は随意運動介助型電気刺激の使用が及ぼす軽症急性期脳卒中患者の運動麻痺や歩行機能への効果を検討することである．〔対象と方法〕対象者は初発脳卒中患者24名とし，通常リハ群（13名）と機能的電気刺激（FES）リハ群（11名）に割付け，FESリハ群は通常リハ群と同様の治療内容に加えて電気刺激を併用して実施し た．身体機能や歩行機能を各群の初期評価，介入後1週間，退院時にて測定し，反復測定2元配置分散分析と多重比較検定（Dunnett）にて検討した．〔結果〕Stroke Impairment Assessment Set （SIAS）足背屈，麻痺側股関節屈曲筋力・足関節背屈筋力，歩行速度，2分間歩行距離において通常リハ群よりもFESリハ群の退院時に有意な改善を示した．〔結語〕軽症急性期脳卒中患者において通常リハに随意運動介助型電気装置を併用することで運動麻痺や歩行機能が向上する可能性が示唆された． |
|---|---|
| AbstractList | 要旨: 〔目的〕本研究は随意運動介助型電気刺激の使用が及ぼす軽症急性期脳卒中患者の運動麻痺や歩行機能への効果を検討することである. 〔対象と方法〕対象者は初発脳卒中患者24名とし, 通常リハ群(13名)と機能的電気刺激(FES)リハ群(11名)に割付け, FESリハ群は通常リハ群と同様の治療内容に加えて電気刺激を併用して実施した. 身体機能や歩行機能を各群の初期評価, 介入後1週間, 退院時にて測定し, 反復測定2元配置分散分析と多重比較検定(Dunnett)にて検討した. 〔結果〕Stroke Impairment Assessment Set (SIAS)足背屈, 麻痺側股関節屈曲筋力・足関節背屈筋力, 歩行速度, 2分間歩行距離において通常リハ群よりもFESリハ群の退院時に有意な改善を示した. 〔結語〕軽症急性期脳卒中患者において通常リハに随意運動介助型電気装置を併用することで運動麻痺や歩行機能が向上する可能性が示唆された. 〔目的〕本研究は随意運動介助型電気刺激の使用が及ぼす軽症急性期脳卒中患者の運動麻痺や歩行機能への効果を検討することである．〔対象と方法〕対象者は初発脳卒中患者24名とし，通常リハ群（13名）と機能的電気刺激（FES）リハ群（11名）に割付け，FESリハ群は通常リハ群と同様の治療内容に加えて電気刺激を併用して実施し た．身体機能や歩行機能を各群の初期評価，介入後1週間，退院時にて測定し，反復測定2元配置分散分析と多重比較検定（Dunnett）にて検討した．〔結果〕Stroke Impairment Assessment Set （SIAS）足背屈，麻痺側股関節屈曲筋力・足関節背屈筋力，歩行速度，2分間歩行距離において通常リハ群よりもFESリハ群の退院時に有意な改善を示した．〔結語〕軽症急性期脳卒中患者において通常リハに随意運動介助型電気装置を併用することで運動麻痺や歩行機能が向上する可能性が示唆された． |
| Author | 井上, 和樹 五十嵐, 達也 林, 翔太 高橋, 直哉 川口, 亮太 大熊, 彩 臼田, 滋 |
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| References | 21) Miller M, Flansbjer UB, Downham D, et al.: Superimposed electrical stimulation: assessment of voluntary activation and perceived discomfort in healthy, moderately active older and younger women and men. Am J Phys Med Rehabil, 2006, 85: 945-950. 27) Fulk GD, He Y, Boyne P, et al.: Predicting home and community walking activity poststroke. Stroke, 2017, 48: 406-411. 13) Yan T, Hui-Chan CW, Li LS: Functional electrical stimulation improves motor recovery of the lower extremity and walking ability of subjects with first acute stroke: a randomized placebo-controlled trial. Stroke, 2005, 36: 80-85. 26) Hsiao H, Knarr BA, Pohlig RT, et al.: Mechanisms used to increase peak propulsive force following 12-weeks of gait training in individuals poststroke. J Biomech, 2016, 49: 388-395. 7) Prenton S, Hollands KL, Kenney LP, et al.: Functional electrical stimulation and ankle foot orthoses provide equivalent therapeutic effects on foot drop: a meta-analysis providing direction for future research. J Rehabil Med, 2018, 50: 129-139. 5) Robbins SM, Houghton PE, Woodbury MG, et al.: The therapeutic effect of functional and transcutaneous electric stimulation on improving gait speed in stroke patients: a meta-analysis. Arch Phys Med Rehabil, 2006, 87: 853-859. 3) 原 行弘：機能的電気刺激を用いた脳可塑性を生かす ニューロリハビリテーション．Jpn J Rehabil Med, 2016, 53: 452-458. 16) 網本 和，菅原憲一（編）：標準理学療法学 専門分野 物理療法学．医学書院，東京，2013，pp100-112 25) Hsiao H, Knarr BA, Higginson JS, et al.: The relative contribution of ankle moment and trailing limb angle to propulsive force during gait. Hum Mov Sci, 2015, 39: 212-221. 12) Alon G, Conroy VM, Donner TW: Intensive training of subjects with chronic hemiparesis on a motorized cycle combined with functional electrical stimulation (FES): a feasibility and safety study. Physiother Res Int, 2011, 16: 81-91. 20) Wu CW, Seo HJ, Cohen LG: Influence of electric somatosensory stimulation on paretic-hand function in chronic stroke. Arch Phys Med Rehabil, 2006, 87: 351-357. 30) Connelly DM, Thomas BK, Cliffe SJ, et al.: Clinical utility of the 2-minute walk test for older adults living in long-term care. Physiother Can, 2009, 61: 78-87. 22) Langeard A, Bigot L, Chastan N, et al.: Does neuromuscular electrical stimulation training of the lower limb have functional effects on the elderly?: a systematic review. Exp Gerontol, 2017, 91: 88-98. 31) Mirza FT, Jenkins S, Justine M, et al.: Regression equations to estimate the 2-min walk distance in an adult Asian population aged 40-75 years. Respirology, 2018, 23: 674-680. 2) French B, Thomas L, Leathley M, et al.: Does repetitive task training improve functional activity after stroke? A Cochrane systematic review and meta-analysis. J Rehabil Med, 2010, 42: 9-14. 8) Tan Z, Liu H, Yan T, et al.: The effectiveness of functional electrical stimulation based on a normal gait pattern on subjects with early stroke: a randomized controlled trial. BioMed Res Int, 2014, 2014: 545408. 11) Lee HJ, Cho KH, Lee WH: The effects of body weight support treadmill training with power-assisted functional electrical stimulation on functional movement and gait in stroke patients. Am J Phys Med Rehabil, 2013, 92: 1051-1059. 1) 日本脳卒中協会 脳卒中ガイドライン委員会：脳卒中治療ガイドライン2015．小川 彰・他（編），協和企画，東京，2015，pp291-292 17) Ohata K, Yasui T, Tsuboyama T, et al.: Effects of an ankle-foot orthosis with oil damper on muscle activity in adults after stroke. Gait Posture, 2011, 33: 102-107. 9) Kesar TM, Perumal R, Reisman DS, et al.: Functional electrical stimulation of ankle plantarflexor and dorsiflexor muscles: effects on poststroke gait. Stroke, 2009, 40: 3821-3827. 29) 山本 摂，宮崎貴明，近野一浩・他：脳卒中片麻痺患者の実用歩行耐久性の評価．理学療法科学，1995, 10: 7-10. 10) Embrey DG, Holtz SL, Alon G, et al.: Functional electrical stimulation to dorsiflexors and plantar flexors during gait to improve walking in adults with chronic hemiplegia. Arch Phys Med Rehabil, 2010, 91: 687-696. 15) 村岡慶裕：IVESの開発と今後の展望．Jpn J Rehabil Med, 2017, 54: 23-26. 24) Lin SI: Motor function and joint position sense in relation to gait performance in chronic stroke patients. Arch Phys Med Rehabil, 2005, 86: 197-203. 6) Kluding PM, Dunning K, O’Dell MW, et al.: Foot drop stimulation versus ankle foot orthosis after stroke: 30-week outcomes. Stroke, 2013, 44: 1660-1669. 19) de Kroon JR, Ijzerman MJ, Chae J, et al.: Relation between stimulation characteristics and clinical outcome in studies using electrical stimulation to improve motor control of the upper extremity in stroke. J Rehabil Med, 2005, 37: 65-74. 14) Sabut SK, Sikdar C, Kumar R, et al.: Functional electrical stimulation of dorsiflexor muscle: effects on dorsiflexor strength, plantarflexor spasticity, and motor recovery in stroke patients. NeuroRehabilitation, 2011, 29: 393-400. 4) Liberson WT, Holmquest HJ, Scot D, et al.: Functional electrotherapy: stimulation of the peroneal nerve synchronized with the swing phase of the gait of hemiplegic patients. Arch Phys Med Rehabil, 1961, 42: 101-105. 28) Bethoux F, Rogers HL, Nolan KJ, et al.: Long-term follow-up to a randomized controlled trial comparing peroneal nerve functional electrical stimulation to an ankle foot orthosis for patients with chronic stroke. Neurorehabil Neural Repair, 2015, 29: 911-922. 18) 水本 篤，竹内 理：研究論文における効果量の報告のために─基礎的概念と注意点─．英語教育研究，2008, 31: 57-66. 23) 篠原英記，鶴見隆正（編）：理学療法MOOK 5 物理療法．三輪書店，東京，2000，pp88-131 32) Hiengkaew V, Jitaree K, Chaiyawat P: Minimal detectable changes of the Berg Balance Scale, Fugl-Meyer Assessment Scale, Timed “Up & Go” Test, gait speeds, and 2-minute walk test in individuals with chronic stroke with different degrees of ankle plantarflexor tone. Arch Phys Med Rehabil, 2012, 93: 1201-1208. |
| References_xml | – reference: 21) Miller M, Flansbjer UB, Downham D, et al.: Superimposed electrical stimulation: assessment of voluntary activation and perceived discomfort in healthy, moderately active older and younger women and men. Am J Phys Med Rehabil, 2006, 85: 945-950. – reference: 24) Lin SI: Motor function and joint position sense in relation to gait performance in chronic stroke patients. Arch Phys Med Rehabil, 2005, 86: 197-203. – reference: 11) Lee HJ, Cho KH, Lee WH: The effects of body weight support treadmill training with power-assisted functional electrical stimulation on functional movement and gait in stroke patients. Am J Phys Med Rehabil, 2013, 92: 1051-1059. – reference: 20) Wu CW, Seo HJ, Cohen LG: Influence of electric somatosensory stimulation on paretic-hand function in chronic stroke. Arch Phys Med Rehabil, 2006, 87: 351-357. – reference: 9) Kesar TM, Perumal R, Reisman DS, et al.: Functional electrical stimulation of ankle plantarflexor and dorsiflexor muscles: effects on poststroke gait. Stroke, 2009, 40: 3821-3827. – reference: 8) Tan Z, Liu H, Yan T, et al.: The effectiveness of functional electrical stimulation based on a normal gait pattern on subjects with early stroke: a randomized controlled trial. BioMed Res Int, 2014, 2014: 545408. – reference: 5) Robbins SM, Houghton PE, Woodbury MG, et al.: The therapeutic effect of functional and transcutaneous electric stimulation on improving gait speed in stroke patients: a meta-analysis. Arch Phys Med Rehabil, 2006, 87: 853-859. – reference: 22) Langeard A, Bigot L, Chastan N, et al.: Does neuromuscular electrical stimulation training of the lower limb have functional effects on the elderly?: a systematic review. Exp Gerontol, 2017, 91: 88-98. – reference: 19) de Kroon JR, Ijzerman MJ, Chae J, et al.: Relation between stimulation characteristics and clinical outcome in studies using electrical stimulation to improve motor control of the upper extremity in stroke. J Rehabil Med, 2005, 37: 65-74. – reference: 27) Fulk GD, He Y, Boyne P, et al.: Predicting home and community walking activity poststroke. Stroke, 2017, 48: 406-411. – reference: 13) Yan T, Hui-Chan CW, Li LS: Functional electrical stimulation improves motor recovery of the lower extremity and walking ability of subjects with first acute stroke: a randomized placebo-controlled trial. Stroke, 2005, 36: 80-85. – reference: 26) Hsiao H, Knarr BA, Pohlig RT, et al.: Mechanisms used to increase peak propulsive force following 12-weeks of gait training in individuals poststroke. J Biomech, 2016, 49: 388-395. – reference: 30) Connelly DM, Thomas BK, Cliffe SJ, et al.: Clinical utility of the 2-minute walk test for older adults living in long-term care. Physiother Can, 2009, 61: 78-87. – reference: 6) Kluding PM, Dunning K, O’Dell MW, et al.: Foot drop stimulation versus ankle foot orthosis after stroke: 30-week outcomes. Stroke, 2013, 44: 1660-1669. – reference: 12) Alon G, Conroy VM, Donner TW: Intensive training of subjects with chronic hemiparesis on a motorized cycle combined with functional electrical stimulation (FES): a feasibility and safety study. Physiother Res Int, 2011, 16: 81-91. – reference: 15) 村岡慶裕：IVESの開発と今後の展望．Jpn J Rehabil Med, 2017, 54: 23-26. – reference: 31) Mirza FT, Jenkins S, Justine M, et al.: Regression equations to estimate the 2-min walk distance in an adult Asian population aged 40-75 years. Respirology, 2018, 23: 674-680. – reference: 28) Bethoux F, Rogers HL, Nolan KJ, et al.: Long-term follow-up to a randomized controlled trial comparing peroneal nerve functional electrical stimulation to an ankle foot orthosis for patients with chronic stroke. Neurorehabil Neural Repair, 2015, 29: 911-922. – reference: 14) Sabut SK, Sikdar C, Kumar R, et al.: Functional electrical stimulation of dorsiflexor muscle: effects on dorsiflexor strength, plantarflexor spasticity, and motor recovery in stroke patients. NeuroRehabilitation, 2011, 29: 393-400. – reference: 18) 水本 篤，竹内 理：研究論文における効果量の報告のために─基礎的概念と注意点─．英語教育研究，2008, 31: 57-66. – reference: 1) 日本脳卒中協会 脳卒中ガイドライン委員会：脳卒中治療ガイドライン2015．小川 彰・他（編），協和企画，東京，2015，pp291-292． – reference: 3) 原 行弘：機能的電気刺激を用いた脳可塑性を生かす ニューロリハビリテーション．Jpn J Rehabil Med, 2016, 53: 452-458. – reference: 4) Liberson WT, Holmquest HJ, Scot D, et al.: Functional electrotherapy: stimulation of the peroneal nerve synchronized with the swing phase of the gait of hemiplegic patients. Arch Phys Med Rehabil, 1961, 42: 101-105. – reference: 2) French B, Thomas L, Leathley M, et al.: Does repetitive task training improve functional activity after stroke? A Cochrane systematic review and meta-analysis. J Rehabil Med, 2010, 42: 9-14. – reference: 10) Embrey DG, Holtz SL, Alon G, et al.: Functional electrical stimulation to dorsiflexors and plantar flexors during gait to improve walking in adults with chronic hemiplegia. Arch Phys Med Rehabil, 2010, 91: 687-696. – reference: 16) 網本 和，菅原憲一（編）：標準理学療法学 専門分野 物理療法学．医学書院，東京，2013，pp100-112． – reference: 32) Hiengkaew V, Jitaree K, Chaiyawat P: Minimal detectable changes of the Berg Balance Scale, Fugl-Meyer Assessment Scale, Timed “Up & Go” Test, gait speeds, and 2-minute walk test in individuals with chronic stroke with different degrees of ankle plantarflexor tone. Arch Phys Med Rehabil, 2012, 93: 1201-1208. – reference: 7) Prenton S, Hollands KL, Kenney LP, et al.: Functional electrical stimulation and ankle foot orthoses provide equivalent therapeutic effects on foot drop: a meta-analysis providing direction for future research. J Rehabil Med, 2018, 50: 129-139. – reference: 17) Ohata K, Yasui T, Tsuboyama T, et al.: Effects of an ankle-foot orthosis with oil damper on muscle activity in adults after stroke. Gait Posture, 2011, 33: 102-107. – reference: 25) Hsiao H, Knarr BA, Higginson JS, et al.: The relative contribution of ankle moment and trailing limb angle to propulsive force during gait. Hum Mov Sci, 2015, 39: 212-221. – reference: 29) 山本 摂，宮崎貴明，近野一浩・他：脳卒中片麻痺患者の実用歩行耐久性の評価．理学療法科学，1995, 10: 7-10. – reference: 23) 篠原英記，鶴見隆正（編）：理学療法MOOK 5 物理療法．三輪書店，東京，2000，pp88-131． |
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| Snippet | 〔目的〕本研究は随意運動介助型電気刺激の使用が及ぼす軽症急性期脳卒中患者の運動麻痺や歩行機能への効果を検討することである．〔対象と方法〕対象者は初発脳卒中患者24... 要旨: 〔目的〕本研究は随意運動介助型電気刺激の使用が及ぼす軽症急性期脳卒中患者の運動麻痺や歩行機能への効果を検討することである. 〔対象と方法〕対象者は初発脳卒中患... |
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| Title | 随意運動介助型電気刺激を用いた筋力トレーニングと歩行練習が軽症急性期脳卒中患者の運動麻痺や歩行機能に及ぼす影響：準ランダム化比較試験での検討 |
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| ispartofPNX | 理学療法科学, 2020, Vol.35(6), pp.885-891 |
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