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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)評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。
   【关键词】 功能性电刺激; 脑卒中; 偏瘫; 下肢运动功能
   【Abstract】 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(10MWS)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.
   【Key words】 Functional electrical stimulation; Stroke; Hemiplegia; Lower limbs motor function
   First-author’s address:Heilongjiang Provincial Hospital,Harbin 150036,China
   doi:10.3969/j.issn.1674-4985.2019.11.035
   近年来,脑卒中的死亡率逐年下降,其中40%的患者留有严重功能障碍,以步行障碍最为常见,严重影响患者生活质量[1]。采用有效的方法,改善脑卒中患者的下肢运动功能,已经成为康复工作的热点。有研究表明,功能性电刺激(function electrical stimulation,FES)可以改善脑卒中后偏瘫肢体的运动功能[2-4]。FES是按照编订的程序,作用于功能障碍的肢体,刺激运动神经,诱发患肢肌肉运动或模拟正常运动来替代或矫正肢体功能的方法[5-6]。本研究通过临床随机对照方法,观察功能性电刺激对脑卒中偏瘫患者下肢运动功能的影响。现报道如下。
  1 资料与方法
  1.1 一般资料 选取2018年9-12月黑龙江省医院康复科收治的脑卒中偏瘫患者60例。纳入标准:(1)符合中华医学会全国第四届脑血管病学术会议通过的诊断标准,且经头颅CT或MRI检查诊断明确;(2)生命体征平稳72 h以上;(3)患侧下肢肌力≥3级者;(4)之前脑血管病未留后遗症者;(5)意识清楚。排除标准:(1)神经功能恶化、严重心肺功能不全者;(2)存在意识障碍、认知障碍,不能配合治疗者。按照随机数字表法将患者分为治疗组和对照组,每组30例。本研究经伦理学委员会批准,患者均知情同意。
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