RESUMO
Background: Shoulder subluxation in stroke is one of the most common and challenging squeals. Shoulder subluxation limits the patient’s daily activities, and it may lead to permanent disability. NMES (NeuroMuscular Electrical Stimulation) had been studied widely on shoulder subluxation with controversial results, but no evidence is reported of its effectiveness in shoulder subluxation. As NMES helps in producing strong contraction and thereby helps in improving the strength of the muscles and as it also helps in learning to contract appropriate muscles, this study was made to examine the Effectiveness of Electrical Stimulations in reducing Subluxation of the Shoulder after Stroke. Method: Study design, A Randomized control experimental design of 30 subjects. Subjects were randomly assigned into two groups, experimental (NMES group) and control (Non-NMES group) with 15 subjects in each group. Outcome measures were taken before and after the intervention on both the groups by using ‘Pain Estimation Scale’ (PES), 'Subluxation Grading’ by X-rays (AP view) and upper arm section of ‘Motor Assessment Scale’(MAS). Experimental group electrodes were placed over posterior deltoid and supraspinatus. Treatment time was 30 mints two times a day for five days in a week and six weeks. Results: Comparison of electrical stimulation with non-electrical stimulation was done by considering the differences of pre and post treatments in both groups and significance is observed by using independent sample t-test. Statistical analysis proved that there was significant (p<0.05) improvement using NMES compared to NON-NMES in all the three parameters. Conclusion: Electrical stimulation has shown significant improvement in reducing shoulder subluxation, pain and increased motor recovery of the arm in stroke patients compared to the patient's given non-electrical stimulation training.
RESUMO
Objective To examine the psychometric characteristics of the Neonatal Oral-motor Assessment Scale (NOMAS) and the influence of evaluation time on assessment results of oral motor skills for preterm infants,and to provide advice for the application of oral-motor assessment in clinic practice.Methods Following Palmer's method,a video recording was made for the preterm infants at different age during the first 2 min of nutritive sucking(NS).We stored the recordings on a digital videodisc and two NOMAS assessors assessed each recording.Results The NOMAS had acceptable internal consistency for less than 35 weeks' PMA (postmenstrual age).Moderate correlation were found between scores on the NOMAS and feeding performance for less than 35 weeks' PMA (normal sucking r=0.58,sucking disorder r=-0.61).The NOMAS demonstrated low responsiveness to changes in oral-motor skill in a week period,ranging from 33 to 36 weeks' PMA (SRM=0.02～0.49).The NOMAS scores for evaluating 30 seconds and 2 minutes were not consistent,the former scores was higher.Conclusions The reliability and validity of NOMAS were acceptable in assessing the oral-motor function of preterm infants for less than 35 weeks' PMA.The evaluation time of NOMAS was suitable for 2 min.