智能助力功能性电刺激治疗脑卒中后踝关节运动障碍的临床研究  

Effects of intelligent power-assisted functional electrical stimulation therapy on ankle joint function in post-stroke subjects

作　　者：王国宝[1] 鲍勇[2] 谢青[1,2] 高怡[2] 张洁[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院康复医学科,上海200025 [2]上海交通大学医学院附属瑞金医院卢湾分院康复医学科

出　　处：《中华物理医学与康复杂志》2014年第7期529-531,共3页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：上海市卫生局科研项目局级课题（2011283）,上海市科学技术委员会科研计划项目（11DZ1921305）

摘　　要：目的 观察新型智能助力功能性电刺激（PAFES）治疗脑卒中患者踝关节运动障碍的临床疗效.方法 将符合入选标准脑卒中后踝关节运动障碍患者随机分成对照组、PAFES组和神经肌肉电刺激（NMES）组,每组患者30例.3组患者均进行常规康复治疗,PAFES组患者在常规康复治疗的基础上对其患侧下肢行PAFES治疗,NMES组则在常规康复治疗的基础上对患肢胫前肌行被动NMES治疗.3组患者均于治疗前和治疗4周后（治疗后）采用踝背屈主动关节活动度（AROM）、Fugl-Meyer运动功能评分（FMA）、Barthel指数（BI）和10s踝足屈伸运动（AFEM）进行评估,并比较其疗效.结果 治疗后,3组患者踝背屈的AROM、FMA、BI、AFEM等指标与组内治疗前比较,差异均有统计学意义（P＜0.05）.PAFES组治疗前、后踝背屈AROM的差值为（8.19±3.39）°,显著优于NMES组的（8.96±3.68）°和对照组的（3.88 ±4.10）°,差异均有统计学意义（P＜ 0.05）;PAFES组治疗前、后FMA及BI评分的差值亦显著优于NMES组和对照组,差异均有统计学意义（P＜0.05）.结论 新型智能PAFES可显著改善脑卒中患者患肢的主动踝背屈关节活动度、下肢运动功能和日常生活活动能力.Objective To observe the effect of power-assisted functional electrical stimulation （PAFES）therapy on ankle joint function recovery in stroke patients.Methods Ninety hemiplegic stroke patients were randomly and evenly divided into a control group,a PAFES group,and a neuromuscular electrical stimulation （NMES）group.All groups received conventional rehabilitation training.PAFES group adopted PAFES treatment on affected lower extremities and NMES group was given the NMES therapy on the tibialis anterior of the affected lower limbs,in addition to conventional rehabilitation training.The active range of motion （AROM） of ankle dorsiflexion,FuglMeyer motor assessment （FMA）,Barthel index （BI） and Ankle flexion and extension movement （AFEM） in 10 seconds were evaluated before the trial and after 4 weeks treatment.Results After treatment,there were significant differences in the AROM of ankle dorsiflexion,FMA,BI and AFEM （P 〈 0.05） compared with before treatment within each group.The improvement of AROM of ankle dorsiflexion in PAFES group （8.19 ± 3.39） ° and the values in NMES group （8.96 ± 3.68） ° were to a significantly greater extend than control group （3.88 ± 4.10） ° （P 〈0.05） ; the improvement of FMA and BI in PAFES group was also superior to those in NMES group and control group （P 〈 0.05）.Conclusion The intelligent PAFES therapy could help improve AROM of ankle dorsiflexion,the motor function of the affected lower extremity and the ability of the activities of daily living in stroke patients.

关 键 词：脑卒中 电刺激 肌电反馈 踝关节 运动功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]