ABSTRACT

Objectives: To investigate the effects of transcutaneous electrical stimulation (tES) on upper limb functional rehabilitation in a patient with traumatic brain injury (TBI), and to identify the optimum stimulation parameters of tES.

Design: A preliminary case study.

Methods: Two successive interventions: Phase I–voluntary physical training (vPT) and Phase II – tES along with vPT (tES+vPT). tES was delivered at C3 and C6 cervical regions. Clinical assessments presented the variation of muscle tone and motor functions, before and after each training phase, and evaluated at 1-month follow up after the last intervention.

Results: Our results indicate that vPT alone contributed to a release of muscle spasticity of both arms of the patient with no significant improvement of hand function, while tES+vPT further reduced the spasticity of the left arm, and improved the voluntary motor function of both arms. The grip forces were also increased after the tES+vPT treatment. We found that 1 ms biphasic tES at 30 Hz produced optimum motor outputs.

Conclusion: The study demonstrates, for the first time, the potential benefits of cervical tES in regard to improving upper limb motor functions in a patient with chronic TBI.

摘要

目的：探讨经皮电刺激（tES）对颅脑损伤（TBI）患者上肢功能康复的影响，并确定tES的最佳刺激参数。

设计：初步案例研究。

方法：两项连续干预：第一阶段–自愿体育锻炼（vPT）和第二阶段– tES以及vPT（tES + vPT）。tES在C3和C6宫颈区域递送。临床评估显示了每个训练阶段前后的肌肉张力和运动功能的变化，并在最后一次干预后的1个月随访中进行了评估。

结果：我们的结果表明，仅vPT有助于释放患者双臂的肌肉痉挛，而手功能没有明显改善，而tES + vPT进一步减轻了左臂的痉挛，并改善了双方的自主运动功能武器。tES + vPT处理后，抓地力也增加了。我们发现，在30 Hz处1 ms双相tES产生了最佳的电机输出。

结论：这项研究首次证明了宫颈tES在改善慢性TBI患者上肢运动功能方面的潜在益处。