电刺激力量训练对脊髓损伤患者非常虚弱的肌肉没有或几乎没有影响：随机试验。

IF 9.7 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy Pub Date : 2025-01-01 DOI:10.1016/j.jphys.2024.11.012

Lydia W Chen , Md. Shofiqul Islam , Lisa A Harvey , Nicole Whitehead , Mohammad Sohrab Hossain , Ehsanur Rahman , Farjana Taoheed , Nadia Afrin Urme , Joanne V Glinsky

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引用次数: 0

摘要

问题在增强近期脊髓损伤（SCI）患者非常薄弱的肌肉力量方面，电刺激（ES）与力量训练和常规护理相结合是否比单纯的常规护理更有效？随机对照试验，采用隐蔽分配、意向治疗分析和盲法结果评估：从澳大利亚和孟加拉国的三家 SCI 单位招募了 60 名近期 SCI 患者：干预措施：参与者被随机分配到治疗组或对照组。干预措施：参与者被随机分为治疗组和对照组，治疗组选择上肢或下肢的一个主要肌群，该肌群在标准的6点徒手肌肉测试中达到1级或2级强度。实验组的参与者接受为期 8 周的力量训练、ES 和针对目标肌肉群的常规护理。对照组参与者只接受常规护理：由盲人评估员在基线和 8 周时进行评估。主要结果为改良的 13 点手动肌肉测试中的自主肌力。三个次要结果是参与者对力量、功能和实现自选目标能力的看法：结果：8 周时，自主肌力的组间平均差异为 13 分中的 0.7 分（95% CI -0.7-2.1），临床上有价值的治疗效果被认为是 1 分。没有一项次要结果显示出具有临床意义的效果：结论：为期 8 周的力量训练结合 ES 对 SCI 患者非常薄弱的肌肉力量的影响微乎其微：ACTRN12621000197831。

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Strength training with electrical stimulation has no or little effect on the very weak muscles of patients with spinal cord injury: a randomised trial

Question

Is electrical stimulation (ES) combined with strength training and usual care more effective than usual care alone in increasing the strength of very weak muscles in people with recent spinal cord injury (SCI)?

Design

A randomised controlled trial with concealed allocation, intention-to-treat analysis and blinded outcome assessors.

Participants

Sixty participants with recent SCI were recruited from three SCI units in Australia and Bangladesh.

Interventions

Participants were randomised to either a treatment or control group. A major muscle group of the upper or lower limb with Grade 1 or Grade 2 strength on a standard 6-point manual muscle test was selected. Participants in the experimental group received strength training combined with ES and usual care for the target muscle group over 8 weeks. Participants in the control group received only usual care.

Outcome measures

Assessments were undertaken by a blinded assessor at baseline and 8 weeks. The primary outcome was voluntary muscle strength on a modified 13-point manual muscle test. The three secondary outcomes were participants’ perceptions of strength, function and ability to perform self-selected goals.

Results

The mean between-group difference for voluntary strength at 8 weeks was 0.7 out of 13 points (95% CI –0.7 to 2.1), where the clinically worthwhile treatment effect was deemed a priori as 1 point. None of the secondary outcomes demonstrated a clinically important effect.

Conclusion

Strength training combined with ES over 8 weeks has a negligible effect on the strength of very weak muscles in people with SCI.

Registration

ACTRN12621000197831.

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来源期刊

Journal of Physiotherapy ORTHOPEDICS-REHABILITATION

CiteScore

11.40

自引率

7.40%

发文量

审稿时长

72 days

期刊介绍： The Journal of Physiotherapy is the official journal of the Australian Physiotherapy Association. It aims to publish high-quality research with a significant impact on global physiotherapy practice. The journal's vision is to lead the field in supporting clinicians to access, understand, and implement research evidence that will enhance person-centred care. In January 2008, the Journal of Physiotherapy became the first physiotherapy journal to adhere to the ICMJE requirement of registering randomized trials with a recognized Trial Registry. The journal prioritizes systematic reviews, clinical trials, economic analyses, experimental studies, qualitative studies, epidemiological studies, and observational studies. In January 2014, it also became the first core physiotherapy/physical therapy journal to provide free access to editorials and peer-reviewed original research. The Australian Physiotherapy Association extended their support for excellence in physiotherapy practice by sponsoring open access publication of all Journal of Physiotherapy content in 2016. As a result, all past, present, and future journal articles are freely accessible, and there are no author fees for publication.