经皮穴位电刺激结合任务导向训练对亚急性期脑卒中患者下肢运动功能和踝关节控制的影响  

Effects of transcutaneous electrical stimulation of acupoints combined with task-related training on sub-acute stroke patients with lower limb and ankle dysfunction

作　　者：唐朝正[1] 丁政[1] 陈昌成 陈创[1] 李春燕[1] 张晓莉[2] 孙莉敏[2] 吴毅[2] 贾杰[1] 

机构地区：[1]福建中医药大学,福州350000 [2]复旦大学附属华山医院康复医学科 [3]上海体育学院附属骨伤医院运动医学科

出　　处：《中华物理医学与康复杂志》2015年第4期276-279,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：“十二五”国家科技支撑手功能项目（2013BAI10B03）,国家自然科学青年基金项目（81401859）,上海市科委课题（13441902802）,上海市卫生和计划生育委员会资助项目（201440634）,上海市闸北区卫生局面上资助项目（2014MS06）共同资助

摘　　要：目的探讨经皮穴位电刺激结合任务导向训练对亚急性期脑卒中患者下肢运动功能和踝关节控制的影响。方法将32例亚急性期脑卒中后偏瘫患者按随机数字表法分为治疗组和对照组，每组16例。所有患者均给予常规康复治疗，治疗组在此基础上增加30min的经皮穴位电刺激和60rain任务导向训练，对照组则增加30min假经皮穴位电刺激和60min任务导向训练。于治疗前和治疗3周、6周后，采用改良Fugl-Meyer量表下肢部分（mFMA—LE）、综合痉挛量表（CSS）以及步行相关改良Barthel指数（wr—MBI）评定2组患者的运动功能、踝关节痉挛程度和日常生活活动（ADL）能力。结果治疗3周和6周后，2组患者的mFMA—LE,CSS和Wr-MBI评分与组内治疗前比较，差异有统计学意义（P〈0．05）。治疗3周后，治疗组患者的mFMA—LE和wr-MBI评分分别为（14．12±3．35）分和（28．62±6．45）分，治疗6周后，其mFMA-LE、CSS和wr-MBI评分分别为（17．06±2．64）分、（9．06±1．48）分和（31．75±5．17）分，上述治疗组各项评分与对照组同时间点比较，差异均有统计学意义（P〈0．05）。结论经皮穴位电刺激结合任务导向训练可显著改善亚急性期脑卒中偏瘫患者下肢运动功能和步行能力，并增强其踩关节的控制能力。Objective To investigate the effects of transcutaneous electrical stimulation of acupoints i TEAS） combined with task-related training （TRT） as treatment for subacute stroke patients with poor lower extremity and ankle control. Methods Thirty-two stroke patients were randomly divided into an experiment group and a control group with 16 in each. All of the patients received conventional rehabilitation. In addition, the experiment group was given 30 min of TEAS combined with 60 min of TRT, while the control group was given sham TEAS combined with TRT. Before and after 3 and 6 weeks of treatment the subjects＇ lower limb motor function was evaluated using the modified Fugl-Meyer scale for the lower extremities （mFMA-LE）. Spasticity was quantified using a composite spasm scale （CSS） and ability in the activities of daily living was evaluated using a walking-related modified Barthel index （wr-MBI）. Results There were significant improvements in the average mFMA-LE, CSS and wr-MBI scores in both groups after 3 weeks and 6 weeks of treatment. All of the measurements in the experimental group （ ex- cluding the CSS score after 3 weeks of treatment） were improved significantly more than in the control group at the same time points. Conclusion TEAS combined with TRT can significantly improve the lower limb motor function, walking performance and control of the affected ankle in subacute stroke patients.

关 键 词：脑卒中 经皮穴位电刺激 任务导向训练 下肢运动功能 步行能力 

分 类 号：R743.3[医药卫生—神经病学与精神病学]