肌电触发神经肌肉电刺激对脑卒中后上肢运动功能的影响  

Effect of Electromyogram-Triggered Neuromusclar Stimulation on Motor Function of Upper Limbs post Stroke

作　　者：邢亮[1,2] 刘丽旭[1,2] 顾越[1,2] 张锋[3] 张通[1,2] 

机构地区：[1]首都医科大学康复医学院,北京市100068 [2]中国康复研究中心北京博爱医院神经康复中心,北京市100068 [3]北京大学第一医院,北京市100034

出　　处：《中国康复理论与实践》2013年第10期949-952,共4页Chinese Journal of Rehabilitation Theory and Practice

基　　金：财政部中央级公益性科研院所基本科研业务费专项基金项目(No.2011CZ-16);国家“十二五”科技支撑计划项目(No.2011BAI08B11)

摘　　要：目的探讨肌电触发神经肌肉电刺激(ETNS)治疗对脑卒中患者上肢运动功能恢复的影响。方法选择2011年7月~2012年12月45例住院脑卒中患者。随机区组设计分为对照组、神经肌肉电刺激组(NMES组)和ETNS组,各15例。三组均进行常规神经内科药物治疗和康复治疗,另外,NMES组进行NMES治疗,ETNS组进行ETNS治疗,每天1次,20次1个疗程。分别在治疗前及治疗后进行桡侧腕伸肌表面最大肌电幅度测定、简易上肢机能检查、改良Barthel指数评估。结果与治疗前相比,治疗后三组桡侧腕伸肌表面最大肌电幅度、简易上肢机能检查和改良Barthel指数评分均有改善(P<0.05),NMES组和ETNS组优于对照组(P<0.05),且在桡侧腕伸肌表面最大肌电幅度、简易上肢机能检查评分方面,ETNS组优于NMES组(P<0.05)。结论 ETNS和NMES结合常规康复治疗均可以提高脑卒中后上肢运动功能,且ETNS疗效更佳。Objective To explore the effect of electromyogram-triggered neuromusclar stimulation (ETNS) on motor function of upper limbs of stroke patients. Methods 45 stroke patients from July, 2011 to December, 2012 in China Rehabilitation Research Center were ran-domly divided into control group (n=15), neuromuscular electrical stimulation (NMES) group (n=15) and ETNS group (n=15). 3 groups were given routine medication and rehabilitation treatment. They were assessed with the largest surface electromyography (sEMG), Simple Test for Evaluating Hand Function (STEF), and modified Barthel Index before and after treatment. Results After treatment, the range of sEMG of extension carpi radialis and STEF improved in three groups (P<0.05). NMES group and ETNS group were better than the control group (P<0.05), and ETNS group was better than NMES group (P<0.05). The scores of modified Barthel Index rose (P<0.05), NMES group and ETNS group were better than the control group (P<0.05). Conclusion Both NMES and ETNS can improve the motor recovery of upper limbs after stroke, and ETNS is more effective.

关 键 词：反馈 电刺激 脑卒中 上肢 运动功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]