THERAPEUTIC ELECTRICAL STIMULATION TO THE LOWER EXTREMITIES OF STROKE PATIENTS
M. Ichie (Akita University, Akita, Japan) and Y. Handa (Tohoku University, Sendai, Japan)
Therapeutic electrical stimulation (TES) by using percutaneous intramuscular electrode was applied to the lower extremities of 50 hemiparetic patients due to stroke. Profile of the patients was as follows; 18 to 72 years old (ave. 52.9 y), 28 males and 22 females, 5 to 252 months (ave. 47.8 m) passed from onset. The classification of the patients in Brunnstrom's stages was the third to fifth grades. The electrodes were implanted to the gluteus maximus, gluteus medius, hamstrings, femoral nerve and common peroneal nerve in each patient. Fifteen minutes session of cyclic electrical stimulation between the flexors and extensors was done six times per day. The assessments of Brunnstrom's stages of paresis, ROM of the ankle joint, walking speed on a ten meter truck were done. Improvement of Brunnstrom's stages was found in 18 % of the patients. Especially the 60% of the third stage patients graded up to the fourth stage. ROM of the ankle joint was improved about 5 to 20 degrees in 76 % of the patients. More than 50 % of the patient showed improvement of the walking speed. These results showed that TES to the lower extremities is effective even in the chronic stage of stroke.
A SIMPLE FUNCTIONAL EVALUATION OF HEMIPLEGIC SHOULDER
Yoshio Taketomi, Toshiaki Muraki (Kobe University, Kobe, Japan)
Abstract: The purpose of this study was, by using a modified goniometer, to examine the relationship between Brunnstrom's Motor Recovery Stage and angle of shoulder shrugging movement (scapular elevation). Subjects consisted of 275 stroke patients with hemiplegia (141 males and 134 females aged 38 to 93 years (68.9±11.2). One-way factorial analysis of variance (ANOVA) showed a significant difference (p<0.0001), followed by post-hoc comparison of Scheffe's F test between the two stages. All pairs differed significantly (p<0.05〜p<0.0001) except between Stages 4 and 5. Moreover, Spearman's correlation by rank between Stage and angle in the affected upper extremity was statistically significant (Rho value= 0.70, p<0.0001). This study suggested that the evaluation of shoulder shrugging movement with the modified goniometer would be a simple, reliable and easy-to-manage method for the development of the motor recovery stage of the hemiplegic arms in a clinical setting.