信号式功能性电刺激对脑卒中患者认知功能的影响  

Effects of Instructional Functional Electrical Stimulation on Cognitive Deficit in Patients with Stroke

作　　者：张安静[1] 李丽[1] 白玉龙[1] 胡永善[1] 吴毅[1] 姜鹭春[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,上海200090

出　　处：《中国康复》2011年第4期253-255,共3页Chinese Journal of Rehabilitation

基　　金：卫生部卫生技术评估重点实验室开放基金课题(CHTA2006-01)

摘　　要：目的:探讨信号式功能性电刺激对脑卒中患者认知功能的影响。方法:脑卒中偏瘫患者34例,分为A组8例、B组8例、C组7例及D组11例,分别配合给予信号式功能性电刺激、国产低频电刺激、肌电反馈电刺激及操作同A组,但无电刺激输出。于治疗前、治疗后20d时用简易精神评定量表(MMSE)及功能综合评定量表(FCA)的认知部分对各组患者进行精神状态及认知功能评定。结果:经过20d的治疗,A、C组FCA认知部分和MMSE评分与治疗前及B、D组比较均有明显提高(P<0.05);A组与C组治疗前后的差值比较差异无统计学意义。B、D组与治疗前及治疗后2组间差值比较均差异无统计学意义。结论:信号式功能性电刺激与肌电反馈电刺激治疗均可促进脑卒中患者受损的神经功能恢复,改善情绪障碍,提高认知功能。Objective：To explore the effects of instructional functional electrical stimulation（IFES） on the cognitive deficit in patients with stroke.Methods：Thirty-four patients with stroke were randomly divided into four groups as follows：the IFES group,the traditional electrical stimulation（TES） group,the electromyogram-triggered neuromuscular stimulation（ETNS） group and the no electrical stimulation group.All the subjects received the same rehabilitation training and internal medicine treatment.Besides,the patients in IFES,TES and ETNS groups were given a 20-day program of electrical stimulation to the extensor muscles of wrist（20 min/day,5 days a week） via surface electrodes.All subjects were assessed with the cognitive part of the functional comprehensive assessment（FCA） and the mini-mental state examination（MMSE） before and at the 20th day after treatment.Results：No significant differences were found in every rating scale among the groups at the recruitment.After treatment for 20 days,every group made progress in some extent,especially in the IFES group and the ETNS group（（P）0.05）.On the 20th day,no significant differences in all the scales were found between the IFES group and the ETNS group.However,there was no significant differences in all the scales between the TES group and the no stimulation group（P0.05）.What＇s more,there were no differences between the TES group and the no stimulation group in all the scales.Conclusion：The study indicated that IFES could improve the impaired neural function and enhance the cognitive function in patients with stroke.The result in the IFES group was similar to that of the ETNS group but better than that of the TES group and the no electrical stimulation group.

关 键 词：康复治疗 脑卒中 信号式功能性电刺激 认知功能障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]