DOI QR코드

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The Effects of TENS Applied to Affected Lower Extremities on Balance in Stroke Patients

  • Lee, Kyu-Ri (Department of Physical Therapy, Gimcheon University) ;
  • Jang, Sang-Hun (Department of Physical Therapy, Gimcheon University)
  • 투고 : 2014.06.24
  • 심사 : 2014.08.08
  • 발행 : 2014.08.31

초록

PURPOSE: This study was to investigate the effectiveness of TENS on balance in stroke patients by analyzing some components such as foot pressure, limit of stability and velocity sway after providing somatosensroy input using TENS. METHODS: Twenty five subjects participated and were randomly divided into two groups, TENS group (n=13) and control group (n=12) by the computer program. Interventions were given to subjects 5 days a week for four weeks. TENS group were treated with TENS for 60 minutes in addition to the conventional therapy which included 30-minute exercise and rehabilitation ergometer training for 15 minutes. Control group performed only conventional therapy. TENS was applied on the skin of soleus, tibialis anterior, tensor fascia latae and vastus medialis in affected side. Foot pressure, limit of stability and velocity sway for balance test were measured using Biorescue. RESULTS: TENS group was significantly increased limit of stability and foot pressure in affected side more than control group. And in eye closed condition, TENS group was significantly decreased velocity sway more than control group. CONCLUSION: The application of TENS is effective to improve the somatosensory input of affected side and to increase the motor function and balance ability.

키워드

참고문헌

  1. Bonan IV, Colle FM, Guichard JP, et al. Reliance on Visual Information after Stroke. Part I: Balance on Dynamic Posturography. Arch Phys Med Rehabil. 2004; 85(2):268-73. https://doi.org/10.1016/j.apmr.2003.06.017
  2. Braun SM, Beurskens AJ, van Kroonenburgh SM, et al. Effects of Mental Practice Embedded in Daily Therapy Compared to Therapy as Usual in Adult Stroke Patients in Dutch Nursing Homes: Design of a Randomised Controlled Trial. BMC Neurol. 2007;7(1):34. https://doi.org/10.1186/1471-2377-7-34
  3. Cheng PT, Wu SH, Liaw MY, et al. Symmetrical Body-weight Distribution Training in Stroke Patients and Its Effect on Fall Prevention. Arch Phys Med Rehabil. 2001;82(12):1650-4. https://doi.org/10.1053/apmr.2001.26256
  4. Cho HY, Sung IT, Cho KH, et al. A Single Trial of Transcutaneous Electrical Nerve Stimulation (TENS) Improves Spasticity and Balance in Patients with Chronic Stroke. Tohoku J Exp Med. 2013;229(3): 187-93. https://doi.org/10.1620/tjem.229.187
  5. Cohen H, Blatchly CA, Gombash LL.. A Study of the Clinical Test of Sensory Interaction and Balance. Phys Ther. 1993;73(6):346-51. https://doi.org/10.1093/ptj/73.6.346
  6. Cunha BP, Alouche SR, Araujo IMG, et al. Individuals with Post-stroke Hemiparesis are able to Use Additional Sensory Information to Reduce Postural Sway. Neurosci Lett. 2012;513(1):6-11. https://doi.org/10.1016/j.neulet.2012.01.053
  7. Dean CM, Richards CL, Malouin F. Task-related Circuit Training Improves Performance of Locomotor Tasks in Chronic Stroke: A Randomized, Controlled Pilot Trial. Arch Phys Med Rehabil. 2000;81(4):409-17. https://doi.org/10.1053/mr.2000.3839
  8. DeSantana JM, Da Silva LFS, De Resende MA, et al. Transcutaneous Electrical Nerve Stimulation at both High and Low Frequencies Activates Ventrolateral Periaqueductal Grey to Decrease Mechanical Hyperalgesia in Arthritic Rats. Neuroscience. 2009;163(4):1233-41. https://doi.org/10.1016/j.neuroscience.2009.06.056
  9. Dickstein R, Laufer Y, Katz M. TENS to the Posterior Aspect of the Legs Decreases Postural Sway during Stance. Neurosci Lett. 2006;393(1):51-5. https://doi.org/10.1016/j.neulet.2005.09.039
  10. Golaszewski S, Kremser C, Wagner M, et al. Functional Magnetic Resonance Imaging of Human Motor Cortex before and after Whole-hand Afferent Electrical Stimulation. Scand J Rehabil Med. 1999;31(3):165-73. https://doi.org/10.1080/003655099444506
  11. Gravelle, DC, Laughton CA, Dhruv NT, et al. Noise-enhanced Balance Control in Older Adults. Neuroreport. 2002;13(15):1853-6. https://doi.org/10.1097/00001756-200210280-00004
  12. Kalra A, Urban MO, Sluka KA. Blockade of Opioid Receptors in Rostral Ventral Medulla Prevents Antihyperalgesia Produced by Transcutaneous Electrical Nerve Stimulation (TENS). J Pharmacol Exp Ther. 2001; 298(1):257-63.
  13. Katz-Leurer M, Sender I, Keren O, et al. The Influence of Early Cycling Training on Balance in Stroke Patients at the Subacute Stage. Results of a Preliminary Trial. Clin Rehabil. 2006;20(5):398-405. https://doi.org/10.1191/0269215505cr960oa
  14. Laufer Y, Elboim-Gabyzon M. Does Sensory Transcutaneous Electrical Stimulation Enhance Motor Recovery Following a Stroke? A Systematic Review. Neurorehabil Neural Repair 2011;25(9):799-809.
  15. Mergner T, Rosemeier T. Interaction of Vestibular, Somatosensory and Visual Signals for Postural Control and Motion Perception under Terrestrial and Microgravity Conditions-a Conceptual Model. Brain Res Rev. 1998;28(1-2):118-135. https://doi.org/10.1016/S0165-0173(98)00032-0
  16. Ng SS, Hui-Chan CW. Does the Use of TENS Increase the Effectiveness of Exercise for Improving Walking after Stroke? A Randomized Controlled Clinical Trial. Clin Rehabil. 2009;23(12):1093-103. https://doi.org/10.1177/0269215509342327
  17. Pavol MJ. Detecting and Understanding Differences in Postural Sway. Focus on "A New Interpretation of Spontaneous Sway Measures Based on a Simple Model of Human Postural Control". J Neurophysiol. 2005;93(1):20-1. https://doi.org/10.1152/jn.00864.2004
  18. Perennou DA, Leblond C, Amblard B, et al. Transcutaneous Electric Nerve Stimulation Reduces Neglect-related Postural Instability after Stroke. Arch Phys Med Rehabil. 2001;82(4):440-448. https://doi.org/10.1053/apmr.2001.21986
  19. Priplata A, Niemi J, Salen M, et al. Noise-Enhanced Human Balance Control. Phys Rev Lett. 2002;89(23):238101. https://doi.org/10.1103/PhysRevLett.89.238101
  20. Schmid AA, Van Puymbroeck M, Altenburger PA, et al. Balance and Balance Self-Efficacy Are Associated With Activity and Participation After Stroke: A Cross-Sectional Study in People With Chronic Stroke. Arch Phys Med Rehabil. 2012;93(6):1101-7. https://doi.org/10.1016/j.apmr.2012.01.020
  21. Smania N, Picelli A, Gandolfi M, et al. Rehabilitation of Sensorimotor Integration Deficits in Balance Impairment of Patients with Stroke Hemiparesis: a Before/After Pilot Study. Neurol Sci. 2008;29(5):313-9. https://doi.org/10.1007/s10072-008-0988-0
  22. Tong RK, Ng MF, Li LS. Effectiveness of Gait Training Using an Electromechanical Gait Trainer, With and Without Functional Electric Stimulation, in Subacute Stroke: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2006;87(10):1298-304. https://doi.org/10.1016/j.apmr.2006.06.016
  23. Tyson SF, Sadeghi-Demneh E, Nester CJ. The Effects of Transcutaneous Electrical Nerve Stimulation on Strength, Proprioception, Balance and Mobility in People with Stroke: a Randomized Controlled Cross-over Trial. Clin Rehabil. 2013;27(9):785-91. https://doi.org/10.1177/0269215513478227
  24. Worms G, Gollee ZMH, Cikajlo I, et al. Sensory Electrical Nerve Stimulation for Training Dynamic Balance Responses in a Chronic Stroke Patient. J Med Biol Eng. 2011;31(1):19-29. https://doi.org/10.5405/jmbe.666
  25. Yang YR, Chen YC, Lee CS, et al. Dual-task-related Gait Changes in Individuals with Stroke. Gait Posture. 2007;25(2):185-90. https://doi.org/10.1016/j.gaitpost.2006.03.007

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