功能性电刺激对偏瘫足下垂患者步行能力的影响
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摘要
目的观察功能性电刺激对脑卒中偏瘫足下垂患者步行能力的影响。方法选择脑卒中偏瘫足下垂患者60例,随机分为治疗组(30例)、对照组(30例)。其中对照组30例,采用常规运动疗法治疗;治疗组30例,在对照组基础上配合功能性电刺激治疗。采用偏瘫侧主动踝背伸角度和功能性步行量表(functional ambulation category scale,FAC)进行评定。观察两组治疗前与治疗两周后偏瘫侧主动踝背伸角度和FAC分级的变化。结果治疗前两组的偏瘫侧主动踝背伸角度和FAC分级均差异无统计学意义(P> 0.05)。治疗后两组的偏瘫侧主动踝背伸角度和FAC分级均有明显提高(P <0.05),且治疗组改善程度优于对照组(P <0.05)。结论功能性电刺激可显著提高脑卒中偏瘫足下垂患者偏瘫侧主动踝背伸角度和FAC分级。
Objective To observe the effects of functional electrical stimulation on walking function of stroke patients with hemiplegia and foot droop. Methods 60 patients were randomly divided into two groups:observation group(n =30) and control group(n =30). Both received conventional exercise therapy. The patients in observation group received functional electrical stimulation. Measurements included angle of ankle back extension and functional ambulation category scale(FAC). Both were observed and compared before and after two weeks. Results There was no significant difference in the angle of active ankle extension and FAC classification between the two groups before treatment(P > 0.05).After treatment, the active ankle extension angle and FAC grade of the hemiplegic side in both groups were significantly improved(P < 0.05).The improvement degree of the treatment group was better than that of the control group(P < 0.05). Conclusion Functional electrical stimulation can significantly improve the angle of ankle back extension and FAC classification.
Objective To observe the effects of functional electrical stimulation on walking function of stroke patients with hemiplegia and foot droop. Methods 60 patients were randomly divided into two groups:observation group(n =30) and control group(n =30). Both received conventional exercise therapy. The patients in observation group received functional electrical stimulation. Measurements included angle of ankle back extension and functional ambulation category scale(FAC). Both were observed and compared before and after two weeks. Results There was no significant difference in the angle of active ankle extension and FAC classification between the two groups before treatment(P > 0.05).After treatment, the active ankle extension angle and FAC grade of the hemiplegic side in both groups were significantly improved(P < 0.05).The improvement degree of the treatment group was better than that of the control group(P < 0.05). Conclusion Functional electrical stimulation can significantly improve the angle of ankle back extension and FAC classification.
引文
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[11]Michael Fauth,Florentin Worgotter,Christian Tetzlaff.The formation of multi-synaptic connections by the interaction of synaptic and structural plasticity and their functional consequences[J].PLoSComputational Biology,2015,11(1):1-29.
[12]Qu H,Xie Y,Liu X,et al.Development of network-based multichannel neuromuscular electrical stimulation system for stroke rehabilitation[J].J Rehabil Res Dev,2016,53(2):263-278.
[2]Chen JJ,Dashtipour K,Walker H,et al.Systematic literature review of abobotulinumtoxinA in clinical trials for lower limb spasticity[J].Movement Disorder,2015,30(1):S551.
[3]朱娟.MOTOmed智能运动训练系统结合躯干控制训练对脑卒中患者下肢功能的影响[J].中国康复医学杂志,2016,31(10):1144-1146.
[4]Chen CF,Lin YT,Chen WS,et al.Contribution of corticospinal modulation and total electrical energy for peripheral-nervestimulationinduced neuroplasticity as indexed by additional muscular force[J].Brain Stimul,2016,9(1):133-140.
[5]Mccrimmon CM,King CE,Wang PT,et al.Brain-controlled functional electrical stimulation therapy for gait rehabilitation after stroke:a safety study[J].J Neuroeng Rehabil,2015,12:57.
[6]中华医学会全国第四届脑血管病学术会议.各类脑血管疾病诊断要点[J].中华神经科杂志,1996(6):60-61.
[7]Brunnstrom S.Motor Behavior of Adult Patients with Hemiplegia:Movement therapy in hemiplegia[M].NY:Harper&Row,1970:76-77.
[8]Fernandez-Gonzalez P,Molina-Rueda F,Cuesta-Gomez A,et al.Instrumental gait analysis in stroke patients[J].Rev Neurol,2016,63(10):433-439.
[9]Wa n g YH,Me n g F,Z h a n g Y,e t a l.F u l l-m o v e m e n t neuromuscular electrical stimulation improves plantar flexor spasticity and ankle active dorsiflexion in stroke patients:a randomized controlled study[J].Clin Rehabil,2016,30(6):577-586.
[10]Ko EJ,Chun MH,Kim DY,et al.The additive effects of core muscle strengthening and trunk NMES on trunk balance in stroke patients[J].Ann Rehabil Med,2016,40(1):142-151.
[11]Michael Fauth,Florentin Worgotter,Christian Tetzlaff.The formation of multi-synaptic connections by the interaction of synaptic and structural plasticity and their functional consequences[J].PLoSComputational Biology,2015,11(1):1-29.
[12]Qu H,Xie Y,Liu X,et al.Development of network-based multichannel neuromuscular electrical stimulation system for stroke rehabilitation[J].J Rehabil Res Dev,2016,53(2):263-278.