Article

OBJECTIVE: To investigate the therapeutic effects of combining electric
stimulation (ES) with active ankle dorsiflexion while standing on a rocker board
in subjects with plantarflexor spasticity after stroke. DESIGN: Randomized
controlled trial. SETTING: A rehabilitation medical center. PARTICIPANTS:
Subjects (N=15) with spastic foot after stroke. INTERVENTIONS: Subjects were
randomly assigned to an experimental or a control group. The experimental group
received ES of ankle dorsiflexors in concert with a motor training paradigm that
required the subject to dorsiflex the ankles in response to a cue while standing
on a rocker board. After 30 minutes of this exercise, subjects received
ambulation training focusing on ankle control for 15 minutes. The control group
received general range of motion and strength exercises for 30 minutes, followed
by 15 minutes of ambulation training focusing on ankle control. Sessions occurred
3 times a week for 4 weeks. MAIN OUTCOME MEASURES: Dynamic spasticity of
plantarflexors, dorsiflexor muscle strength, balance performance, gait
kinematics, and functional gait performance as assessed by the Emory Functional
Ambulation Profile (EFAP) were used as outcome measurements. RESULTS: The
experimental group demonstrated a greater decrease in dynamic ankle spasticity at
a comfortable gait speed (P=.049), a greater improvement in spatial gait symmetry
(P=.015), and a greater improvement in functional gait ability as indicated by
the EFAP (P=.015) than the control group. CONCLUSIONS: Our results suggest that
repeated ES with volitional ankle movements can decrease dynamic ankle spasticity
in subjects with stroke. Furthermore, such improvement parallels better gait
symmetry and functional gait performance.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS