高频外周磁刺激治疗36例脑卒中患者足内翻的疗效观察
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摘要
目的观察高频外周磁刺激腓骨长短肌治疗脑卒中足内翻的临床疗效。方法选取2017年6月—2018年1月在郑州大学第二附属医院神经康复科脑卒中足内翻患者36例,按照随机数字表法分为观察组(n=18)和对照组(n=18),连续高频外周磁刺激腓骨长短肌治疗四周,观察患者足主动背屈外翻的角度及外翻的疗效。结果治疗后两组患者足主动外翻的角度及外翻的疗效判定与治疗前相比均有所提高,但观察组的主动背曲外翻的主动关节活动范围及疗效判定显著高于对照组。结论采用高频外周重复磁刺激腓骨长短肌治疗脑卒中后足下垂内翻,有利于改善其下垂内翻情况,改善患者步行的稳定性,提高其生活质量,无不良反应,安全性好。
Objective To observe the clinical effect of high frequency peripheral magnetic stimulation of humerus Peroneus longus and Peroneus brevis in the treatment of stroke foot varus. Methods Totally 36 cases of stroke varus in the Department of Neurorehabilitation of the Second Affiliated Hospital of Zhengzhou University from June 2017 to January 2018. According to the random number table method, it was divided into observation group(n=18) and control group(n=18). Continuous high-frequency peripheral magnetic stimulation of the humerus long and short muscles for four weeks, observe the patient's foot active dorsiflexion angle and the effect of eversion. Results After treatment, the angle of active valgus and the effect of eversion in both groups were improved compared with those before treatment. However, the active joint range and effect of active orthostatic valgus in the observation group were significantly higher than those in the control group.(P<0.05). Conclusion The use of high-frequency peripheral repetitive magnetic stimulation of the humerus long and short muscles to treat the ptosis of the foot after stroke is beneficial to improve the sagging varus, improve the stability of the patient's walking, improve their quality of life, no adverse reactions, good safety, can be promoted application.
Objective To observe the clinical effect of high frequency peripheral magnetic stimulation of humerus Peroneus longus and Peroneus brevis in the treatment of stroke foot varus. Methods Totally 36 cases of stroke varus in the Department of Neurorehabilitation of the Second Affiliated Hospital of Zhengzhou University from June 2017 to January 2018. According to the random number table method, it was divided into observation group(n=18) and control group(n=18). Continuous high-frequency peripheral magnetic stimulation of the humerus long and short muscles for four weeks, observe the patient's foot active dorsiflexion angle and the effect of eversion. Results After treatment, the angle of active valgus and the effect of eversion in both groups were improved compared with those before treatment. However, the active joint range and effect of active orthostatic valgus in the observation group were significantly higher than those in the control group.(P<0.05). Conclusion The use of high-frequency peripheral repetitive magnetic stimulation of the humerus long and short muscles to treat the ptosis of the foot after stroke is beneficial to improve the sagging varus, improve the stability of the patient's walking, improve their quality of life, no adverse reactions, good safety, can be promoted application.
引文
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[14] 李志斌,冯尚武,黄顺仪,等.肌电生物反馈疗法对脑卒中偏瘫患者下肢运动功能的效果[J].中国康复理论与实践,2013,19(11):1046-1048.
[15] 刘智岚,贾杰,谢臻,等.足下垂刺激仪对脑卒中足下垂患者下肢运动功能的影响[J].中华物理医学与康复杂志,2015,37(6):416-420.
[16] 吴玉玲,孙晓敏,吴立红,等.表面肌电生物反馈在脑卒中康复中的应用[J].中国康复理论与实践,2012,18(11):1024-1025.
[17] 陆蓉蓉,吴倍华,白玉龙.脑卒中后偏瘫患者足下垂和内翻的康复治疗[J].上海医药,2017,38(1):7-10.
[2] Lin VW,Kim KH,Hsiao I,et al.Functional magnetic stimulation facilitates gastric emptying [J].Arch Phys Med Rehabil,2002,83(6):806-810.
[3] Momosaki R,Abo M,Watanabe S,et al.Functional magnetic stimulation using a parabolic coil for dysphagia after stroke [J].Neuromodulation,2014,17(7):637-641.
[4] Tsai PY,Wang CP,Chiu FY,et al.Efficacy of functional magnetic stimulation in neurogenic bowel dysfunction after spinal cord injury [J].J Rehabil Med,2009,41(1):41-47.
[5] Lin VW,Hsiao IN,Zhu E,et al.Functional magnetic stimulation for conditioning of expiratory muscles in patients with spinal cord injury [J].Arch Phys Med Rehabil,2001,82(2):162-166.
[6] 中华神经科学会.中华神经外科学会.脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379.
[7] Yang C,Chen P,Du W,et al.Musculoskeletal ultrasonography assessment of functional magnetic stimulation on the effect of glenohumeral subluxation in acute poststroke hemiplegic patients [J].Biomed Res Int,2018:608-616.
[8] Krewer C,Hartl S,Müller F,et al.Effects of repetitive peripheral magnetic stimulation on upper-limb spasticity and impairment in patients with spastic hemiparesis:a randomized,double-blind,sham-controlled study [J].Arch Phys Med Rehabil,2014,95(6):1039-1047.
[9] Beaulieu LD,Schneider C.Repetitive peripheral magnetic stimulation to reduce pain or improve sensorimotor impairments:a literature review on parameters of application and afferents recruitment [J].Neurophysiol Clin,2015,45(3):223-237.
[10] Marzloose H,Siemes H.Repetitive peripheral magnetic stimulation.Treatment option for spasticity [J].Nervenarzt,2009,80(12):1489-1495.
[11] Pimentel LHC,Alencar FJ,Rodrigues L R S,et al.Effects of botulinum toxin type A for spastic foot in post-stroke patients enrolled in a rehabilitation program[J].Arquivos de neuro-psiquiatria,2014,72(1):28-32.
[12] Manca M,Ferraresi G,Cosma M,et al.Gait patterns in hemiplegic patients with equinus foot deformity[J].BioMed research international,2014(93):16.
[13] 马建强.肌电生物反馈联合运动疗法对脑卒中跖屈肌痉挛的疗效观察[J].中国康复,2014,29( 3) :212-213.
[14] 李志斌,冯尚武,黄顺仪,等.肌电生物反馈疗法对脑卒中偏瘫患者下肢运动功能的效果[J].中国康复理论与实践,2013,19(11):1046-1048.
[15] 刘智岚,贾杰,谢臻,等.足下垂刺激仪对脑卒中足下垂患者下肢运动功能的影响[J].中华物理医学与康复杂志,2015,37(6):416-420.
[16] 吴玉玲,孙晓敏,吴立红,等.表面肌电生物反馈在脑卒中康复中的应用[J].中国康复理论与实践,2012,18(11):1024-1025.
[17] 陆蓉蓉,吴倍华,白玉龙.脑卒中后偏瘫患者足下垂和内翻的康复治疗[J].上海医药,2017,38(1):7-10.