摘要
目的 探讨体外冲击波疗法(ESWT)联合肌电生物反馈治疗脑卒中后下肢痉挛的临床效果。方法 选取2019年3月至2020年3月在新乡市第一人民医院康复医学科住院的90例脑卒中后偏瘫侧下肢痉挛患者作为研究对象,随机将其分A、B、C组,各30例。三组患者均给予常规康复治疗,在此基础上B组于胫前肌处给予肌电生物反馈治疗,C组于跟腱及腓肠肌处给予ESWT+胫前肌处肌电生物反馈治疗。比较三组患者治疗前(T_(0))、治疗2周后(T_(1))、治疗4周后(T_(2))、治疗结束4周后(T_(3))的下肢Fugl-Meyer运动功能评定量表(FMA)评分、踝关节被动活动度(PROM)及综合痉挛量表(CSS)评分。结果 A组T_(1)时的下肢FMA评分、PROM、CSS评分和T_(0)时比较,差异无统计学意义(P>0.05);T_(2)、T_(3)时,A组的下肢FMA评分、PROM、CSS评分均优于T_(0)时(P<0.05)。B组T_(1)时的PROM和T_(0)时比较,差异无统计学意义(P>0.05);T_(1)、T_(2)、T_(3)时,B组的下肢FMA、CSS评分均优于T_(0)时(P<0.05)。T_(1)、T_(2)、T_(3)时,C组的下肢FMA评分、PROM、CSS评分均优于T_(0)时(P<0.05)。A、B组T_(1)时的PROM、CSS评分比较,差异无统计学意义(P>0.05);T_(2)、T_(3)时,B组的下肢FMA评分、PROM、CSS评分均优于A组(P<0.05)。T_(1)、T_(2)、T_(3)时,C组的下肢FMA评分、PROM、CSS评分均优于A、B组(P<0.05)。结论 ESWT联合肌电生物反馈治疗脑卒中后下肢痉挛的临床效果显著,且经济、安全、无创,患者的接受程度较高。
Objective To investigate the clinical effect of extracorporeal shock wave therapy(ESWT) combined with electromyographic biofeedback in the treatment of lower limb spasticity after stroke.Methods A total of 90 patients with hemiplegic lower limb spasticity after stroke who hospitalized in the rehabilitation medicine department of Xinxiang First People’s Hospital from March 2019 to March 2020 were selected as the research objects.The patients were randomly divided into group A,B and C,with 30 cases in each group.All patients in the three groups were given routine rehabilitation treatment,the group B was given electromyographic biofeedback treatment at the tibialis anterior muscle on this basis,and the group C was given ESWT at Achilles tendon and gastrocnemius muscle + electromyographic biofeedback treatment at the tibialis anterior muscle on this basis.The lower limb Fugl-Meyer Assessment(FMA) score,passive range of motion(PROM) and Composite Spasticity Scale(CSS) score of the three groups were compared before treatment(T_(0)),after2 weeks of treatment(T_(1)),after 4 weeks of treatment(T_(2)) and after 4 weeks of end of treatment(T_(3)).Results There were no significant differences in lower limb FMA score,PROM,CSS score of the group A at T_(1)and T_(0)(P>0.05);at T_(2)and T_(3),the lower limb FMA score,PROM,CSS score of the group A were better than those at T_(0)(P0.05);at T_(1),T_(2)and T_(3),the lower limb FMA and CSS scores of the group B were better than those at T_(0)(P0.05);at T_(2)and T_(3),the lower limb FMA score,PROM and CSS score of the group B were better than those of the group A(P<0.05).At T_(1),T_(2)and T_(3),the lower limb FMA score,PROM and CSS score of the group C were better than those of the group A and B(P<0.05).Conclusion ESWT combined with electromyographic biofeedback in the treatment of lower limb spasticity after stroke has a significant clinical effect,which is economical,safe and non-invasive,and the patients acceptance is higher.
作者
崔小灿
孟洋洋
于琳琳
丰光达
牛雪飞
CUI Xiaocan;MENG Yangyang;YU Linlin;FENG Guangda;NIU Xuefei(Rehabilitation Medicine Department,Xinxiang First People's Hospital,Xinxiang 453000,China)
出处
《临床医学研究与实践》
2022年第26期34-37,共4页
Clinical Research and Practice
关键词
体外冲击波
肌电生物反馈
脑卒中
下肢痉挛
extracorporeal shock wave
electromyographic biofeedback
stroke
lower limb spasticity
