背景：本研究的目的是评估在慢性中风后对痉挛型腓肠肌和股四头肌进行一次电容性和电阻性能量转移（TECAR）治疗后肌肉特性的变化。
方法：在一项双盲随机对照试验中，共纳入36名患有下肢高张力的慢性卒中幸存者。实验组（n=18）接受TECAR治疗30分钟，并结合腓肠肌和股四头肌的功能按摩（FM）。对照组(n=18)接受TECAR治疗(无电刺激)与真实FM的组合的假治疗。主要结果是用改良的Ashworth量表（MAS）评估下肢肌肉的肌张力。次要结果是MAS的测角度（测角器），腓肠肌/四头肌的神经肌肉特性（肌压计），和被动运动范围（倾角计）。所有测量均在基线（T0）进行，治疗后立即（T1），并在治疗后30分钟（T2）由盲法评估员进行。
结果：MAS评分踝关节背屈在T0-T1时显着降低（p=0.046），实验组的变化维持在T0-T2（p=0.019）。T2时膝关节屈曲（p=0.012）和踝关节背屈（p=0.034）的被动运动范围显着改善。此外,T1时膝关节屈曲改善(p=0.019)。
结论：在同时对腓肠肌和股直肌进行一次Tecar治疗，可立即降低慢性中风幸存者的肌张力并增加踝关节和膝关节的被动活动范围。用肌压计测量的神经肌肉特性没有显着变化。
BACKGROUND: The aim of this study was to assess changes in muscle properties after a single session of capacitive and resistive energetic transfer (TECAR) therapy on spastic gastrocnemius and quadriceps muscles in chronic post-stroke.
METHODS: A total of 36 chronic stroke survivors with lower limb hypertonia were enrolled in a double-blind randomized controlled trial. The experimental group (n = 18) received a single 30 min session of TECAR therapy in combination with functional massage (FM) on the gastrocnemius and quadriceps muscles. The control group (n = 18) received a sham treatment of TECAR therapy (without electrical stimulation) in combination with real FM. The primary outcome was muscle tone of the lower limb muscles assessed with the Modified Ashworth Scale (MAS). The secondary outcomes were goniometric degrees of the MAS (goniometer), neuromuscular properties of the gastrocnemius/quadriceps (myotonometer), and passive range of motion (inclinometer). All measurements were performed at baseline (T0), immediately after treatment (T1), and at 30 min post-treatment (T2) by a blinded assessor.
RESULTS: The MAS score ankle dorsiflexion significantly decreased at T0-T1 (p = 0.046), and the change was maintained at T0-T2 (p = 0.019) in the experimental group. Significant improvements were noted in the passive range of motion for knee flexion (p = 0.012) and ankle dorsiflexion (p = 0.034) at T2. In addition, knee flexion improved at T1 (p = 0.019).
CONCLUSIONS: A single session of Tecar therapy at the same time with FM on the gastrocnemius and rectus femoris immediately reduces muscle tone and increases the passive range of motion of both ankle and knee in chronic stroke survivors. There were no significant changes in the neuromuscular properties measured with myotonometer.
PDF(Pubmed)