功能性電刺激對腦卒中足下垂患者步行矯正效果的系統評價_《中國循證醫學雜志》

作者：

徐旭東 ¹ ,  金奕 ² , 趙媛 ¹ , 鄔聞文 ¹ , 王秀東 ²

1.天津中醫藥大學（天津 300193）； 2.天津市環湖醫院（天津 300060）;

關鍵詞：

功能性電刺激腦卒中足下垂系統評價 Meta分析隨機對照試驗

DOI：

10.7507/1672-2531.20130130

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　系統評價功能性電刺激對腦卒中足下垂患者步行的矯正效果。
方法　計算機檢索PubMed、Web of Science、The Cochrane Library（2013年第1期）、EMbase、CBM、CNKI、VIP和WanFang Data等數據庫，收集功能性電刺激對腦卒中患者足下垂矯正效果的隨機對照試驗（RCT），檢索時限均為2000年1月～2013年1月，并追溯納入研究的參考文獻。由2位研究者按照納入與排除標準獨立篩選文獻、提取資料和評價質量后，采用RevMan 5.1軟件進行Meta分析。
結果　共納入8個RCT，255例患者。4個RCT的合并分析結果顯示，與常規治療相比，功能性電刺激能提高腦卒中足下垂患者的步行速度，兩組差異有統計學意義［MD=0.09，95%CI（0.00，0.18），P=0.04］，其余指標因數據不全僅作相應的描述性分析。
結論　功能性電刺激能提高腦卒中足下垂患者步行速度，但其他指標療效尚不能確定，尚需更多高質量、大樣本、多中心的RCT結果證實。

引用本文： 徐旭東,金奕,趙媛,鄔聞文,王秀東. 功能性電刺激對腦卒中足下垂患者步行矯正效果的系統評價. 中國循證醫學雜志, 2013, 13(6): 735-740. doi: 10.7507/1672-2531.20130130 復制

1.	Loyd-Jones D, Adams R, Carnethon M, et al. Heart disease and stroke statistics update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation, 2009, 11(3): 480-486.
2.	Warlow C, Sudlow C, Dennis M. Stroke. Lancet, 2003, 362(9391): 1211-1224.
3.	Laufer Y, Hausdorff JM, Ring H. Effects of a foot drop neuroprosthesis on functional abilities,social participation and gait velocity. American Journal of Physical Medicine and Rehabilitation, 2009, 88(1): 14-20.
4.	Rushton D. Functional electrical stimulation. Physiological Measure, 1997, 18(4): 241-275.
5.	Asplund K, Tuomilehto J, Stegmayr B, et al. Diagnosticcriteriaand quality control of the registration of stroke events in the MONICA project. Acta Med Scand Suppl, 1988, 728: 26-39.
6.	Higgins PT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
7.	Salisbury L, Shiels J, Todd I, et al. A feasibility study to investigate the clinical application of functional electrical stimulation (FES), for dropped foot, during the sub-acute phase of stroke-A randomized controlled trial. Physiother Theory Pract, 2013, 29(1): 31-40.
8.	Kottink AI, Tenniglo MJ, de Vries WH, et al. Effects of an implantable two-channel peroneal nerve stimulator versus conventional walking device on spatiotemporal parameters and kinematics of hemiparetic gait. J Rehabil Med, 2012, 44(1): 51-57.
9.	Solopova IA, Tihonova DY, Grishin AA, et al. Assisted leg displacements and progressive loading by a tilt table combined with FES promote gait recovery in acute stroke. NeuroRehabilitation, 2011, 29(1): 67-77.
10.	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(4): 393-400.
11.	Daly JJ, Zimbelman J, Roenigk KL, et al. Recovery of coordinated gait: randomized controlled stroke trial of functional electrical stimulation (FES) versus no FES, with weight-supported treadmill and over-ground training. Neurorehabil and Neural Repair, 2011, 25(7): 588-596.
12.	Sabut SK, Sikdar C, Mondal R, et al. Restoration of gait and motor recovery by functional electrical stimulation therapy in persons with stroke. Disabil Rehabil, 2010, 32(19): 1594-1603.
13.	Kottink AI, Hermens HJ, Nene AV. Therapeutic effect of an implantable peroneal nerve stimulator in subjects with chronic stroke and footdrop: A randomized controlled trial. Phys Ther, 2008, 88(4): 437-448.
14.	Ng MF, Tong RK, Li LS. A pilot study of randomized clinical controlled trial of gait training in subacute stroke patients with partial body-weight support electromechanical gait trainer and functional electrical stimulation: six-month follow-up. Stroke, 2008, 39(1): 154-160.
15.	Kottink AI, Hermens HJ, Nene AV, et al. A randomized controlled trial of an implantable 2-channel peroneal nerve stimulator on walking speed and activity in poststroke hemiplegia. Arch Phys Med Rehabil, 2007, 88(8): 971-978.
16.	Fredrickson E, Ruff RL, Dally JJ. Physiological cost index as a proxy measure for the oxygen cost of gait in stroke patients. Neurorehabil Neural Repair, 2007, 21(5): 429-434.
17.	Grant M, Ryan C, Tigbe W, et al. Validation of the activPAL activity monitor in measuring free-living physical activity. Biomechanics of the lower limb in health, disease and rehabilitation. Presented to: Salford, 3rd Intetnational Conference; 2005, Sept5-7; Slaford(UK).p196-197.
18.	Peckham PH, Mortimer JT, Marsolais EB. Alteration in the force and fatigability of skelteal muscle in quadriplegic humans following exercise induced by chronic electrical stimulation. Clin Orthop Relat Res, 1976, 46(114): 326-333.
19.	Kimberley TJ, Lewis SM, Auerbach EJ, et al. Electrical stimulation driving functional inprovements and cortical changes in subjects with stroke. Exp Brain Res, 2004, 154(4): 450-460.
20.	Hara Y. Neurorehabilitation with new functional electrical stimulation for hemiparetic upper extremity in stroke patients. J Nippon Med Sch, 2008, 75(1): 4-14.
21.	Kottink AI, Oostendorp LJ, Buurke JH, et al. The orthotic effect of functional electrical stimulation on the improvement of walking in stroke patients with a dropped foot: A systematic review. Artif Organs, 2004, 28(6): 577-86.
22.	Matsunaga T, Shimada Y, Sato M, et al. The akita heel sensor system (AHSS) for the correction of dropped foot gait in hemiplegic patients. Proceedings of the 5th Annual Conference of IFESS, Aalborg, Denmark, 2000: 394-395.
23.	Moher D. The consort guidelines: Improving the quality of research consolidated standards of reporting trials interview by bonnie horrigan. Altern Ther Health Med, 2002, 8(3): 103-108.

1. Loyd-Jones D, Adams R, Carnethon M, et al. Heart disease and stroke statistics update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation, 2009, 11(3): 480-486.
2. Warlow C, Sudlow C, Dennis M. Stroke. Lancet, 2003, 362(9391): 1211-1224.
3. Laufer Y, Hausdorff JM, Ring H. Effects of a foot drop neuroprosthesis on functional abilities,social participation and gait velocity. American Journal of Physical Medicine and Rehabilitation, 2009, 88(1): 14-20.
4. Rushton D. Functional electrical stimulation. Physiological Measure, 1997, 18(4): 241-275.
5. Asplund K, Tuomilehto J, Stegmayr B, et al. Diagnosticcriteriaand quality control of the registration of stroke events in the MONICA project. Acta Med Scand Suppl, 1988, 728: 26-39.
6. Higgins PT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
7. Salisbury L, Shiels J, Todd I, et al. A feasibility study to investigate the clinical application of functional electrical stimulation (FES), for dropped foot, during the sub-acute phase of stroke-A randomized controlled trial. Physiother Theory Pract, 2013, 29(1): 31-40.
8. Kottink AI, Tenniglo MJ, de Vries WH, et al. Effects of an implantable two-channel peroneal nerve stimulator versus conventional walking device on spatiotemporal parameters and kinematics of hemiparetic gait. J Rehabil Med, 2012, 44(1): 51-57.
9. Solopova IA, Tihonova DY, Grishin AA, et al. Assisted leg displacements and progressive loading by a tilt table combined with FES promote gait recovery in acute stroke. NeuroRehabilitation, 2011, 29(1): 67-77.
10. 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(4): 393-400.
11. Daly JJ, Zimbelman J, Roenigk KL, et al. Recovery of coordinated gait: randomized controlled stroke trial of functional electrical stimulation (FES) versus no FES, with weight-supported treadmill and over-ground training. Neurorehabil and Neural Repair, 2011, 25(7): 588-596.
12. Sabut SK, Sikdar C, Mondal R, et al. Restoration of gait and motor recovery by functional electrical stimulation therapy in persons with stroke. Disabil Rehabil, 2010, 32(19): 1594-1603.
13. Kottink AI, Hermens HJ, Nene AV. Therapeutic effect of an implantable peroneal nerve stimulator in subjects with chronic stroke and footdrop: A randomized controlled trial. Phys Ther, 2008, 88(4): 437-448.
14. Ng MF, Tong RK, Li LS. A pilot study of randomized clinical controlled trial of gait training in subacute stroke patients with partial body-weight support electromechanical gait trainer and functional electrical stimulation: six-month follow-up. Stroke, 2008, 39(1): 154-160.
15. Kottink AI, Hermens HJ, Nene AV, et al. A randomized controlled trial of an implantable 2-channel peroneal nerve stimulator on walking speed and activity in poststroke hemiplegia. Arch Phys Med Rehabil, 2007, 88(8): 971-978.
16. Fredrickson E, Ruff RL, Dally JJ. Physiological cost index as a proxy measure for the oxygen cost of gait in stroke patients. Neurorehabil Neural Repair, 2007, 21(5): 429-434.
17. Grant M, Ryan C, Tigbe W, et al. Validation of the activPAL activity monitor in measuring free-living physical activity. Biomechanics of the lower limb in health, disease and rehabilitation. Presented to: Salford, 3rd Intetnational Conference; 2005, Sept5-7; Slaford(UK).p196-197.
18. Peckham PH, Mortimer JT, Marsolais EB. Alteration in the force and fatigability of skelteal muscle in quadriplegic humans following exercise induced by chronic electrical stimulation. Clin Orthop Relat Res, 1976, 46(114): 326-333.
19. Kimberley TJ, Lewis SM, Auerbach EJ, et al. Electrical stimulation driving functional inprovements and cortical changes in subjects with stroke. Exp Brain Res, 2004, 154(4): 450-460.
20. Hara Y. Neurorehabilitation with new functional electrical stimulation for hemiparetic upper extremity in stroke patients. J Nippon Med Sch, 2008, 75(1): 4-14.
21. Kottink AI, Oostendorp LJ, Buurke JH, et al. The orthotic effect of functional electrical stimulation on the improvement of walking in stroke patients with a dropped foot: A systematic review. Artif Organs, 2004, 28(6): 577-86.
22. Matsunaga T, Shimada Y, Sato M, et al. The akita heel sensor system (AHSS) for the correction of dropped foot gait in hemiplegic patients. Proceedings of the 5th Annual Conference of IFESS, Aalborg, Denmark, 2000: 394-395.
23. Moher D. The consort guidelines: Improving the quality of research consolidated standards of reporting trials interview by bonnie horrigan. Altern Ther Health Med, 2002, 8(3): 103-108.

《中國循證醫學雜志》

功能性電刺激對腦卒中足下垂患者步行矯正效果的系統評價

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《中國循證醫學雜志》

功能性電刺激對腦卒中足下垂患者步行矯正效果的系統評價

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