摘要
目的探讨步态诱发功能性电刺激与减重平板训练同步治疗对脑卒中患者偏瘫下肢表面肌电信号的影响。方法选择90例脑卒中后偏瘫患者,随机分为同步组(A组)、分离组(B组)和减重平板组(C组),每组各30例患者。A组采用步态诱发功能性电刺激与减重平板训练同步进行治疗,B组采用步态诱发功能性电刺激与减重平板训练分离进行治疗,C组仅单纯采用减重平板治疗,共治疗3周,观察对比3组治疗前后患侧胫骨前肌和腓肠肌外侧头的积分肌电值(iEMG)及协同收缩率(CR)、步速、左右步幅差、踝关节活动度(AROM)、Fugl-Meyer运动功能量表(FMA)下肢部分、改良Barthel指数(MBI)和功能性步行分级(FAC)评分。结果治疗后,3组患者胫骨前肌和腓肠肌i EMG值、踝背伸及跖屈CR、步速、左右步幅差、踝关节活动度、FMA评分、MBI评分、FAC评分均较治疗前改善(P均<0.05),治疗后A、B组前述各项指标均优于C组(P均<0.05),A组胫骨前肌iEMG、踝关节背伸CR及AROM优于B组(P均<0.05)。结论诱发功能性电刺激与减重平板训练同步治疗可以调节脑卒中偏瘫患者患侧下肢表面肌电信号,两者同步治疗改善表面肌电信号的作用明显优于两者分离治疗及单用减重平板训练治疗。
Objective To evaluate the effect of gait-triggered functional electrical stimulation combined with weight loss treadmill exercise on the surface electromyography signal of the hemiplegic lower limbs in patients diagnosed with stroke. Methods Ninety hemiplegic patients after stroke were chosen and randomly divided into the synchronous (group A) , separate ( group B) and weight loss treadmill exercise groups ( groupC) ( n = 30 for each group). Patients in group A received gait evoked functional electrical stimulation combined with weight loss treadmill exercise simultaneously. Participants in group B underwent gait-triggered functionalelectrical stimulation, subsequently followed by weight loss treadmill exercise. Those in group C receivedweight loss treadmill exercise alone. All therapies endured for three weeks. The integrated electromyogram( iEMG) value and co-contraction ratio ( CR) of the anterior tibial muscle and the lateral head of the gastrocnemiusmuscle, walking speed, stride difference, ankle joint range of motion (AROM) , Fugl-Meyer movementfunction scale ( FMA) of lower extremity, modified Barthel index (M BI) and functional walking score (FAC)score before and after treatment among three groups were statistically compared. Results After correspondingtreatment, iEMG value of the anterior tibial muscle and the lateral head of the gastrocnemius muscle, CR of ankledorsiflexion and plantar flexion, walking speed, stride difference, AROM, FMA, MBI and FAC scoreswere all significantly improved among three groups ( all P < 0. 05 ). The parameters above in groups A and Bwere superior to those in group C following respective therapy ( all P < 0. 05 ). The iEMG of the anterior tibialmuscle, CR and AROM of the ankle dorsiflexion in group A were significantly improved compared with those ingroup B ( all P < 0. 05 ). Conclusions Synchronous application of gait-triggered functional electrical stimula-tion and weight loss treadmill exercise can regulate the surface electromyography signal of the hemiplegic lower limbs
作者
程华军
陈尚杰
许琼瑜
朱芬
焦睿
高文芳
黄石钊
刘恒
王单
Cheng Huajun;Chen Shangjie;Xu Qiongyu;Zhu Fen;Jiao Rui;Gao Wenfang;Huang Shizhao;LiuHeng;Wang dan(Shenzhen Baoan Hospital Affiliated to Southern Medical University, Shenzhen 518100, China)
出处
《新医学》
2016年第10期686-690,共5页
Journal of New Medicine
基金
2015年深圳市科技计划项目(医疗卫生类
JCYJ20150402152005637)
关键词
表面肌电信号
脑卒中
同步
诱发功能性电刺激
减重平板训练
Surface electromyography signal
Stroke
Synchronization
Evoked functional electrical stimulation
Weight loss treadmill exercise
