摘要
目的观察反复促通疗法联合肌电反馈式助力电刺激治疗对亚急性期卒中偏瘫患者下肢运动功能障碍的影响。方法本研究为随机对照临床研究,连续纳入2019年5月至2020年12月于江苏省常州市德安医院康复中心住院的卒中偏瘫患者43例,按照随机数字表法将43例入组患者完全随机分为治疗组21例和对照组22例,2组均给予常规康复治疗和下肢反复促通疗法治疗,治疗组在反复促通疗法治疗的同时给予肌电反馈式助力电刺激治疗。治疗前和治疗3周后,测试2组患者Fugl-Meyer下肢运动功能(FMA-LE)评分、Berg平衡量表评分、胫骨前肌积分肌电值(iEMG)和伸膝位踝关节主动背屈活动度(AROM),并进行组间及组内治疗前后的比较。结果43例患者治疗过程中,因3例病情变化转院,使得治疗组脱落1例,对照组脱落2例,最终共40例患者入组,其中治疗组20例,对照组20例。治疗前治疗组与对照组患者FMA-LE评分、Berg平衡量表评分、iEMG、AROM差异均无统计学意义[分别为10.50(6.50,16.00)分比11.00(8.25,15.75)分、5.50(2.00,13.50)分比3.50(2.00,14.00)分、17.85(14.10,20.39)V·s比18.25(11.83,20.38)V·s、0.00°(0.00°,0.00°)比0.00°(0.00°,0.00°),均P>0.05]。治疗3周后,FMA-LE评分、Berg平衡量表评分、iEMG、AROM治疗组分别为23.00(21.25,25.00)分、37.50(27.00,42.00)分、62.00(54.65,64.88)V·s、5.00°(5.00°,10.00°),对照组分别为20.00(16.50,21.75)分、31.50(20.00,36.75)分、43.20(27.51,50.59)V·s、2.50°(0.00°,5.00°),2组患者治疗后FMA-LE评分、Berg平衡量表评分、iEMG、AROM均较治疗前明显改善,差异均有统计学意义(均P<0.01),且治疗后治疗组各项评分均优于对照组,差异均有统计学意义(均P<0.05)。结论反复促通疗法联合肌电反馈式助力电刺激治疗可明显提高亚急性期卒中偏瘫患者的下肢运动功能。
Objective To observe the effect of repetitive facilitative exercise combined with power-assisted electrical stimulation to the subacute stroke patients with lower extremity motor dysfunction.Methods This is a randomized controlled clinical study.A total of 43 stroke patients with hemiplegia in the Rehabilitation Center of Changzhou Dean Hospital from May 2019 to December 2020 were consecutively included.According to the randomized number table,43 patients were randomly divided into the experimental group(n=21)and control group(n=22).All the patients in two groups received the conventional rehabilitation and the repetitive facilitative exercise of lower extremity.Additionally,the experiment group was given power-assisted electrical stimulation simultaneously while receiving repetitive facilitative exercise.Fugl-Meyer assessment-lower extremity motor function(FMA-LE)score,Berg balance scale(BBS),active range of motion(AROM)of the hemiplegic ankle dorsiflexion as well as integrated electromyogram(iEMG)of hemiplegic tibialis anterior muscle were evaluated by the same rehabilitation therapist at the beginning and after 3-week intervention respectively.These outcomes were compared within groups and between groups.Results During the treatment,3 patients were transferred due to the changes of their condition,leading 1 case fall out of the experimental group and 2 cases fall out of the control group.A total of 40 patients were eventually enrolled,20 in the experimental group and 20 in the control group.There was no significant difference in FMA-LE,BBS,iEMG and AROM between two groups before the intervention(FMA-LE:10.50[6.50,16.00]points vs.11.00[8.25,15.75]points;BBS:5.50[2.00,13.50]points vs.3.50[2.00,14.00]points;iEMG:17.85[14.10,20.39]V·s vs.18.25[11.83,20.38]V·s;AROM:0.00°[0.00°,0.00°]vs.0.00°[0.00°,0.00°],all P>0.05).After 3-week intervention,the FMA-LE,BBS,iEMG and AROM in the experimental group were 23.00(21.25,25.00)points,37.50(27.00,42.00)points,62.00(54.65,64.88)V·s and 5.00°(5.00°,10.00°)respectiv
作者
姜文
郭川
徐胜
卞海波
王彤
朱兰
Jiang Wen;Guo Chuan;Xu Sheng;Bian Haibo;Wang Tong;Zhu Lan(the Center of Rehabilitation,Changzhou Dean Hospital,Changzhou,Jiangsu 213002,China)
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2022年第8期548-553,571,共7页
Chinese Journal of Cerebrovascular Diseases
基金
国家重点研发计划项目(2018YFC2001600、2018YFC2001603)。
关键词
卒中
反复促通疗法
肌电反馈式助力电刺激
偏瘫
表面肌电
运动功能
Stroke
Repetitive facilitative exercise
Power-assisted electrical stimulation
Hemiplegia
Electromyography
Motor function
