アブストラクト
| Title | 痙縮に対する電気刺激療法 |
|---|---|
| Subtitle | 特集 痙縮の治療戦略 |
| Authors | 中村潤二*1, 庄本康治*2 |
| Authors (kana) | なかむらじゅんじ |
| Organization | *1西大和リハビリテーション病院 リハビリテーション部, 主任 / 畿央大学大学院健康科学研究科, 客員研究員, *2畿央大学大学院健康科学研究科, 教授 |
| Journal | MB Medical Rehabilitation |
| Volume | |
| Number | 261 |
| Page | 19-25 |
| Year/Month | 2021 / 5 |
| Article | 報告 |
| Publisher | 全日本病院出版会 |
| Abstract | 「Abstract」痙縮に対する物理療法には, 電気刺激療法, 温熱療法, 振動刺激療法, 体外衝撃波療法などがある. 中でも電気刺激療法は多くの研究が進められている分野であり, エビデンスレベルの高い研究が数多く報告され, 臨床でも多く使用されるようになってきている. 電気刺激療法の適応となる疾患は, 脳卒中, 脊髄損傷, 脳性麻痺や多発性硬化症など多岐にわたり, 痙縮抑制の効果が報告されている. また単に痙縮を抑制するだけでなく, 痙縮運動障害を改善させるために, 電気刺激療法と運動療法を併用し, 新たな動作戦略を獲得することが重要であると考えられる. そこで本稿では痙縮に対する電気刺激療法について解説し, 効果的に痙縮抑制のための適切な刺激方法について検討するとともに, 運動療法との併用について紹介する. |
| Practice | 医療技術 |
| Keywords | 物理療法 (biophysical agents), 電気刺激療法 (electrical stimulation therapy), 痙縮 (spasticity), 痙縮運動障害 (spastic movement disorders) |
- 全文ダウンロード： 従量制、基本料金制の方共に968円(税込) です。
参考文献
- 1) Winstein CJ, et al : Guidelines for Adult Stroke Rehabilitation and Recovery : A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke, 47 : e98-e169, 2016.
- 2) Bekhet AH, et al : The Effects of Electrical Stimulation Parameters in Managing Spasticity after Spinal Cord Injury : A Systematic Review. Am J Phys Med Rehabil, 98 : 484-499, 2019.
- 3) Yildizgoren MT, et al : Effects of neuromuscular electrical stimulation on the wrist and finger flexor spasticity and hand functions in cerebral palsy. Pediatr Neurol, 51 : 360-364, 2014.
- 4) 齊藤 慧, 山口智史 : 電気刺激の応用. 正門由久(編), リハビリテーションのための臨床神経生理学, pp.51-59, 中外医学社, 2015.
- 5) Stein C, et al : Effects of Electrical Stimulation in Spastic Muscles After Stroke : Systematic Rev-iew and Meta-Analysis of Randomized Contro-lled Trials. Stroke, 46 : 2197-2205, 2015.
残りの21件を表示する
- 6) Gracies JM : Pathophysiology of spastic paresis. II : Emergency of muscle overactivity. Muscle Nerve, 31 : 552-571, 2005.
- 7) Mahmood, A et al : Effect of Transcutaneous Electrical Nerve Stimulation on Spasticity in Adults With Stroke : A Systematic Review and Meta-analysis. Arch Phys Med Rehabil, 100 : 751-768, 2019.
- 8) Laddha D, et al : Effect of Transcutaneous Elec-trical Nerve Stimulation on Plantar Flexor Mus-cle Spasticity and Walking Speed iln Stroke Patients. Physiother Res Int. 21 : 247-256, 2016.
- 9) Wang YH, et al : Full-movement neuromuscular electrical stimulation improves plantar flexor spasticity and ankle active dorsiflexion in stroke patients : A randomized controlled study. Clin Rehabil, 30 : 577-586, 2016.
- 10) Peres ASC, et al : Can somatosensory electrical stimulation relieve spasticity in post-stroke pat-ients? A TMS pilot study. Biomed Tech, 63 : 501-506, 2018.
- 11) Koyama S, et al : Modulation of spinal inhibitory reflexes depends on the frequency of transcuta-neous electrical nerve stimulation in spastic stroke survivors. Somatosens Mot Res, 33 : 8-15, 2016.
- 12) Marcolino MAZ, et al : Effects of transcutaneous electrical nerve stimulation alone or as addi-tional therapy on chronic post-stroke spastic-ity : systematic review and meta-analysis of randomized controlled trials. Disabil Rehabil, 42 : 623-635, 2020.
- 13) Aydin G, et al : Transcutaneous electrical nerve stimulation versus baclofen in spasticity : clinical and electromyophysiologic comparison. Am J Med Rehabil, 84 : 584-592, 2005.
- 14) Mills PB, et al : Transcutaneous Electrical Nerve Stimulation for Management of Limb Spastic-ity : A Systematic Review. J Phys Med Rehabil, 95 : 309-318, 2016.
- 15) Yamaguchi T, et al : Real-time changes in corti-cospinal excitability during voluntary contrac-tion with concurrent electrical stimulation. PLoS One, 7 : e46122, 2012.
- 16) Ng SM, et al : Transcutaneous electrical nerve stimulation combined with task-related training improves lower limb functions in subjects with chronic stroke. Stroke, 38 : 2953-2959, 2007.
- 17) Jung KS, et al : Effects of sit-to-stand training combined with transcutaneous electrical stimu-lation on spasticity, muscle strength and balance ability in patients with stroke : A randomized controlled study. Gait Posture, 54 : 183-187, 2017.
- 18) Qi YC, et al : Therapeutic Effect Evaluation of Neuromuscular Electrical Stimulation With or Without Strengthening Exercise on Spastic Cerebral Palsy. Clin Pediatr(Phila), 57 : 580-583, 2018.
- 19) Pool D, et al : The orthotic and therapeutic effects following daily community applied func-tional electrical stimulation in children with uni-lateral spastic cerebral palsy : A randomised controlled trial. BMC Pediatr, 15 : 1-10, 2015.
- 20) Freeha S, et al : Effectiveness of Functional Elec-trical Stimulation(FES) versus Conventional Ele-ctrical Stimulation in Gait Rehabilitation of Pat-ients with Stroke. J Coll Physicians Surg Pak, 27 : 703-706, 2017.
- 21) Nielsen JB, et al : Spastic movement disorder : should we forget hyperexcitable stretch reflexes and start talking about inappropriate prediction of sensory consequences of movement? Exp Brain Res, 238 : 1627-1636, 2020.
- 22) Al-Abdulwahab SS, et al : Neuromuscular elec-trical stimulation of the gluteus medius improves the gait of children with cerebral palsy. Neuro-Rehabilitation, 24 : 209-217, 2009.
- 23) 中村潤二ほか : 脳卒中片麻痺患者の痙縮に対するストレッチングと電気刺激の併用治療の効果の検討 : 予備的研究. 奈良理学療法学, 5 : 11-14, 2013.
- 24) Thomaz SR, et al : Effect of electrical stimulation on muscle atrophy and spasticity in patients with spinal cord injury-a systematic review with meta-analysis. Spinal Cord, 57 : 258-266, 2019.
- 25) 生野公貴ほか : 脳卒中後の屈筋群優位な上肢緊張肢位を改善させる新たな電気刺激方法の考案. LIFE 講演概要集(CD-ROM), 2016 : 136-137, 2016.
- 26) Knikou M : The H-reflex as a probe : Pathways and pitfalls. J Neurosci Methods, 171 : 1-12, 2008.
