信号式功能性电刺激对脑卒中偏瘫患者上肢运动功能和功能独立性的影响  

Effects of Instructional Functional Electrical Stimulation on the Motor Function and Functional Independence of Upper Extremity in Hemiplegic Stroke Patient

作　　者：张安静[1] 白玉龙[1] 胡永善[1] 吴毅[1] 姜鹭春[1] 李丽[1] 路微波 徐一鸣[1] 朱秉[1] 田威 

机构地区：[1]复旦大学附属华山医院康复医学科,上海200040 [2]上海市杨浦区老年医院康复医学科

出　　处：《中国运动医学杂志》2011年第4期326-329,共4页Chinese Journal of Sports Medicine

基　　金：卫生部卫生技术评估重点实验室开放基金课题(CHTA2006-01);上海市卫生局课题(2008局级85)

摘　　要：目的:探讨信号式功能性电刺激对脑卒中偏瘫患者早期运动功能的影响。方法:48例脑卒中患者随机分为4组,即信号式功能性电刺激治疗组(简称信号组)、传统低频电刺激治疗组(简称低频组)、肌电反馈电刺激治疗组(简称肌电组)以及无电刺激治疗组。入组后,所有患者给予常规康复治疗,包括内科常规药物治疗和基础的康复治疗。此外,各电刺激组患者予以相应的电刺激治疗。分别在治疗前、治疗后20天时采用简化Fugl-Meyer运动功能评定(上肢部分)和功能综合评定量表(FCA)对患者功能进行评定并对结果进行统计分析。结果:治疗前各组两项评分均未见显著性差异(P>0.05)。治疗后20天时,各组上肢运动功能都有不同程度恢复,但肌电组、低频组、信号组与治疗前比较差异具有统计学意义(P<0.05);无电刺激治疗组与治疗前比较差异不显著(P>0.05)。治疗20天后,肌电组、信号组简化Fugl-Meyer运动功能评定(上肢部分)和FCA评分与无电刺激组、低频组比较均有显著性差异(P<0.05),但信号组与肌电组相比差异无统计学意义(P>0.05)。结论:信号式功能电刺激促进脑卒中患者上肢运动功能和FCA恢复的效果近似于肌电生物反馈电刺激,但好于国产低频电刺激和无电刺激。Objective To explore the effects of instructional functional electrical stimulation（IFES）on the motor function and functional independence of upper extremity in hemiplegic stroke patient.Methods Forty eight hemiplegic patients after stroke were randomly divided into four groups：IFES group,traditional electrical stimulation（TES）group,electromyogram-triggered neuromuscular stimulation（ETNS）group and control group（without any stimulation）.All subjects underwent the same rehabilitation training and internal medicine treatment.The extensor muscles of wrist of patients in IFES,TES and ETNS groups received 20-day electrical stimulation via surface electrodes.Motor function of upper extremity and functional independence of all subjects were assessed with the simplified Fugl-Meyer scores and the functional comprehensive assessment（FCA）before treatment and on the 20th day after treatment.Results No significant differences were found in every rating scale among the groups at the recruitment.After 20-day treatment,the motor function of upper extremity and functional independence in all groups revealed progress in some extent,especially significantly in IFES group,ETNS group and TES group（P 0.05）.Compared with the control group and the TES group,there were significant differences in the Fugl-Meyer scores and the FCA scores of the IFES group and the ETNS group on the 20th day（P 0.05）,while no statistic differences were found between IFES group and the ETNS group（P 0.05）.Conclusion The study indicated that IFES could enhance the motor function and improve the functional dependence of upper extremity in hemiplegic stroke patient.Therapeutic efficacy in IFES group was similar to that in ETNS group but better than that in TES group and control group.

关 键 词：康复治疗 脑卒中 信号式功能性电刺激 运动功能 功能独立性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]