功能性电刺激对脑卒中偏瘫患者下肢运动功能的影响
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摘要
目的:探讨功能性电刺激对脑卒中偏瘫患者下肢运动功能的影响。方法:选择脑卒中偏瘫患者60例,患侧下肢肌力均≥3级,按照随机数字表法分为治疗组和对照组,各30例。对照组采用常规运动疗法治疗,治疗组在对照组基础上配合功能性电刺激治疗。采用Fugl-Meyer评定量表(Fugl-Meyer assessment,FMA)、Berg平衡量表(BBS)和10米最大步行速度(10 maximum walking speed,10MWS)评定两组治疗前与治疗2周后下肢运动功能、平衡能力及步行速度的变化。结果:治疗前,两组的FMA、BBS和步行速度比较,差异均无统计学意义(P>0.05);治疗后,两组的各项评定结果均明显提高,且治疗组改善程度均优于对照组,差异均有统计学意义(P<0.05)。结论:功能性电刺激可显著提高脑卒中偏瘫患者下肢运动功能、平衡能力及步行速度。
Objective:To observe the effects of functional electrical stimulation on lower limb motor function of stroke patients with hemiplegia.Method:60 stroke patients with hemiplegia and strength of affected lower limbs≥3 level were selected,according to the random number table method,the patients were divided into treatment group and control group,30 cases in each group.The control group was treated with conventional exercise therapy,on this basis the observation group was treated with functional electrical stimulation.Fugl-Meyer assessment(FMA),Berg balance scale(BBS),10 maximum walking speed(10 MWS)were used to evaluate the lower limb motor function,balance ability and walking speed of two groups before and two weeks after treatment were observed and compared.Result:Before treatment,the FMA,BBS and walking speed of the two groups were compared,the differences were not statistically significant(P>0.05).After treatment,all evaluation of the results of the two groups were significantly improved,and the improvement degree of the observation group was better than the control group,the differences were statistically significant(P<0.05).Conclusion:Functional electrical stimulation can improve the parameters of stroke patients with hemiplegia such as lower limbs motor function,balance and walking speed significantly.
Objective:To observe the effects of functional electrical stimulation on lower limb motor function of stroke patients with hemiplegia.Method:60 stroke patients with hemiplegia and strength of affected lower limbs≥3 level were selected,according to the random number table method,the patients were divided into treatment group and control group,30 cases in each group.The control group was treated with conventional exercise therapy,on this basis the observation group was treated with functional electrical stimulation.Fugl-Meyer assessment(FMA),Berg balance scale(BBS),10 maximum walking speed(10 MWS)were used to evaluate the lower limb motor function,balance ability and walking speed of two groups before and two weeks after treatment were observed and compared.Result:Before treatment,the FMA,BBS and walking speed of the two groups were compared,the differences were not statistically significant(P>0.05).After treatment,all evaluation of the results of the two groups were significantly improved,and the improvement degree of the observation group was better than the control group,the differences were statistically significant(P<0.05).Conclusion:Functional electrical stimulation can improve the parameters of stroke patients with hemiplegia such as lower limbs motor function,balance and walking speed significantly.
引文
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[19]李菁,黄华尧,陈清法,等.功能性电刺激辅助步行设备配合减重训练对脑卒中患者下肢功能的影响[J].中国康复医学杂志,2015,30(8):786-789.
[20]Fauth M,W?rg?tter F,Tetzlaff C.The formation of multisynaptic connections by the interaction of synaptic and structural plasticity and their functional consequences[J].PLoSComputational Biology,2015,11(1):e1004031.
[2]陈红霞,杨志敬,潘锐焕,等.中西医结合康复方案对脑卒中后偏瘫患者运动功能日常生活活动能力和生活质量的影响[J].中国中西医结合杂志,2016,36(4):395-398.
[3]王建华,谢立娟,王飞,等.情志护理结合运动想像在脑卒中偏瘫患者康复中的应用[J].现代中西医结合杂志,2017,26(14):1587-1589.
[4]王丛笑,郄淑燕,张晓颖,等.上肢康复训练系统在脑卒中偏瘫患者上肢功能康复中的应用[J].中国康复,2016,31(1):5-7.
[5]Dashtipour K,Chen J J,Walker H W,et al.Systematic literature review of abobotulinumtoxinA in clinical trials for adult upper limb spasticity[J].American Journal of Physical Medicine&Rehabilitation,2015,94(3):229.
[6]许佳,胡世红,凌晴,等.功能性电刺激对偏瘫患者下肢功能及步态的影响[J].中国康复,2015,30(3):189-191.
[7]Amp L W,Wilkins.Correction to:Guidelines for Adult Stroke Rehabilitation and Recovery:A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association[J].Stroke,2017,48(2):e78.
[8]Menezes K K,Nascimento L R,Pinheiro M B,et al.Lower-limb motor coordination is significantly impaired in ambulatory people with chronic stroke:a cross-sectional study[J].J Rehabil Med,2017,49(4):322-326.
[9]Jang S H,Lee H D.Gait recovery by activation of the unaffected corticoreticulospinal tract in a stroke patient:a case report[J].Medicine(Baltimore),2017,96(50):e9123.
[10]Lewthwaite R,Winstein C J,Lane C J,et al.Accelerating stroke recovery:body structures and functions,activities,participation,and quality of life outcomes from a large rehabilitation trial[J].Neurorehabil Neural Repair,2018,32(2):150-165.
[11]Kringle E A,Terhorst L,Butters M A,et al.Clinical predictors of engagement in inpatient rehabilitation among stroke survivors with cognitive deficits:an exploratory study[J].J Int Neuropsychol Soc,2018,24(6):572-583.
[12]Montanaro V V A,Hora T F,da Silva C M,et al.Mortality and stroke recurrence in a rehabilitation cohort of patients with cerebral infarcts and Chagas disease[J].Eur Neurol,2018,79(3-4):177-184.
[13]McCrimmom C M,King C E,Wang P T,et al.BrainControlled functional electrical stimulation therapy for gait rehabilitation after stroke:a safety study[J].J Neuroeng Rehabil,2015,12:57.
[14]游国清,梁慧英.功能性电刺激在改善早期脑卒中患者日常生活活动能力中的应用[J].脑与神经疾病杂志,2017,25(5):290-293.
[15]马全胜,宋德军,郄淑燕.功能性电刺激四肢联动训练对脑卒中患者下肢功能及步行能力的影响[J].康复学报,2016,26(6):10-13.
[16]Xu B,Yan T,Yang Y,et al.Effect of normal-walkingpattern-based functional electrical stimulation on gait of the lower extremity in subjects with ischemic stroke:A self controlled study[J].Neuro Rehabilitation,2016,38(2):163-169.
[17]谭志梅,姜文文,燕铁斌,等.基于正常行走模式的功能性电刺激对脑卒中恢复期患者行走功能的影响[J].中华医学杂志,2016,96(29):2342-2346.
[18]陈迎春,李岩,李辉,等.功能性电刺激对早期脑卒中偏瘫患者步行功能的影响[J].中国康复理论与实践,2015(2):212-215.
[19]李菁,黄华尧,陈清法,等.功能性电刺激辅助步行设备配合减重训练对脑卒中患者下肢功能的影响[J].中国康复医学杂志,2015,30(8):786-789.
[20]Fauth M,W?rg?tter F,Tetzlaff C.The formation of multisynaptic connections by the interaction of synaptic and structural plasticity and their functional consequences[J].PLoSComputational Biology,2015,11(1):e1004031.