前交叉韧带重建后肌肉功能恢复中神经肌肉电刺激的应用

Effects of neuromuscular electrical stimulation on muscle strength after anterior cruciate ligament reconstruction

背景:神经肌肉电刺激疗法是应用低频脉冲电流刺激肌肉使其收缩,以恢复其运动功能的方法。已被证实能用于治疗受损肌肉,使用神经肌肉电刺激治疗可保持肌肉蛋白合成。对前交叉韧带重建后肌肉康复起着积极的作用,但其参数选择及临床评价存在争议。目的:从临床应用评价神经肌肉电刺激对前交叉韧带重建后肌力康复的效果。方法:第一作者应用计算机检索2000年1月至2015年1月Pub Med数据库、中国期刊全文数据库有关不同电刺激对前交叉韧带术后肌力恢复的文章,英文检索词"ACL,neuromuscular electrical stimulation";中文检索词"前交叉韧带,神经肌肉电刺激"。共检索到92篇相关文献,根据纳入标准保留30篇进行分析探讨。结果与结论:神经肌肉电刺激可提高肌力、增加运动范围、减轻水肿、减缓萎缩、促进组织愈合以及缓解疼痛,对肌肉酶活性也能产生积极影响,亦可提高患者等速肌力。神经肌肉电刺激在前交叉韧带重建后使用神经肌肉电刺激辅助肌力康复的参数设置差异较大,需选择合理的治疗方案。

BACKGROUND：Neuromuscular electrical stimulation is a method for promoting motor function recovery by muscle contraction induced by low-frequency pulse current stimulation. It has been verified that neuromuscular electrical stimulation can be used to treat damaged muscle, which can maintain muscle protein synthesis. Conflicting evidence exists regarding the effectiveness of neuromuscular electrical stimulation fol owing anterior cruciate ligament reconstruction. OBJECTIVE：To evaluation the clinical efficacy of neuromuscular electrical stimulation on the recovery of muscle strength after anterior cruciate ligament reconstruction. METHODS：PubMed database and China National Knowledge Infrastructure were searched by the first author by computer for articles about the effects of different electrical stimulations on muscle strength after anterior cruciate ligament reconstruction published from January 2000 to January 2015. The keywords were“ACL, neuromuscular electrical stimulation”in English and Chinese, respectively. Total y 92 articles were retrieved, but 30 articles met the inclusion criteria.RESULTS AND CONCLUSION：Neuromuscular electrical stimulation can improve muscle strength, increase range of motion, reduce edema, reduce muscle atrophy, promote tissue healing and relieve pain, which can also have a positive impact on enzymatic activity in the muscle and can improve patient’s isokinetic muscle strength. The neuromuscular electrical stimulation is preferred after anterior cruciate ligament reconstruction, but its parameter settings for muscle strength recovery are quite different and to choose the right treatment is necessary.