步行模式下肌电生物反馈性功能性电刺激对脑卒中患者即刻足底压力的影响  

Effect of Electromyography Feedback Functional Electrical Stimulation on Plantar Pressure under Walking in Stroke Patients

作　　者：元香南[1] 李晓婷[1] 李菡婷 刘宇[1] 孙师[1] 万峪岑 张志强[1] 

机构地区：[1]中国医科大学附属盛京医院康复科,辽宁沈阳市110022

出　　处：《中国康复理论与实践》2015年第10期1191-1196,共6页Chinese Journal of Rehabilitation Theory and Practice

基　　金：中国医科大学附属盛京医院三新项目(No.113)

摘　　要：目的研究步行模式下肌电生物反馈性功能性电刺激治疗对脑卒中患者即刻步行速度、足底压力的影响。方法 18例脑卒中患者,患肢因脑卒中引起足下垂内翻,患者存在部分主动踝背屈能力(肌力>2级)。肌电生物反馈性功能性电刺激前后,受试者在足底压力测量步道上分别进行测试。分析比较脑卒中患者刺激前后步行的足底压力特点;比较步行速度、初始触地时间、触地时间占支撑相百分比、峰压力值、冲量、触地面积等指标。结果刺激后脑卒中患者偏瘫侧的初始触地点大部分由足跖部外侧移至足跟部;偏瘫侧足跟部初始触地时间提前,足跖部外侧的触地时间相对延后,足跟峰压力值、冲量、触地面积均增加(P<0.05)。同时,非偏瘫侧足跟部初始触地时间也提前(P<0.05)。结论肌电生物反馈性功能性电刺激可改善脑卒中患者步行异常模式,使得患者在提高步行稳定性及诱发正常步行模式上获益。Objective To evaluate the therapeutic effects of electromyography feedback functional electrical stimulation（FES） on plantar pressure of stroke patients. Methods 18 subjects were included in this study, who were with drop foot resulting from stroke, but could partly dorsiflex the paretic limb＇s ankle（Manual Muscle Test〉 2）. They were tested on the RS-footscan plate before and after stimulation.The plantar pressure data of paretic foot and walking velocity before and after stimulation were compared. Results The initial touchdown points of most paretic foot were changed from Meta（metatarsal） 5 to heel; the time of initial touchdown of heel medial and heel lateral significantly improved, while that of Meta 3, Meta 4 and Meta 5 significantly delayed; the peak force, impulse and contact area of the heel significantly improved after stimulation（P〈0.05）. At the same time, the time of initial touchdown of heel medial and heel lateral of nonparetic foot significantly improved（P〈0.05）. Conclusion Electromyography feedback functional electrical stimulation can improve the gait pattern and the stability of patients with stroke.

关 键 词：脑卒中 肌电生物反馈性功能性电刺激 步态 足底压力 

分 类 号：R743.3[医药卫生—神经病学与精神病学]