功能性电刺激结合快速步行训练对脑卒中偏瘫患者功能的影响  

Effects of functional electrical stimulation combined with fast gait training on walking performance in hemiplegic stroke patients

作　　者：杨婷[1] 林强[1] 程凯[1] 杨倩[1] 谢增艳 

机构地区：[1]南京医科大学附属南京医院康复医学科,南京210006

出　　处：《中国康复》2017年第6期451-454,共4页Chinese Journal of Rehabilitation

摘　　要：目的:观察功能性电刺激结合快速步行训练对脑卒中偏瘫后遗症期患者社区性步行能力及生理耗能的影响。方法:将30例脑卒中偏瘫足下垂患者随机分为观察组和对照组各15例,均接受神经内科常规药物及康复功能训练;观察组采用功能性电刺激(FES)结合快速步行训练,FES刺激患侧腓总神经和胫前肌;对照组采用常规的减重跑台快速步行训练。分别在治疗前、治疗后评定6分钟步行距离(6MWD)及生理耗能指数(PCI)。结果:治疗4周后,2组PCI较治疗前有显著降低(P<0.05),6MWD均较治疗前显著增加(P<0.05);静息心率治疗前后比较差值无统计学意义。2组治疗后,观察组的PCI明显低于对照组(P<0.05),而6MWD、静息心率组间差异无统计学意义。结论:功能性电刺激结合快速步行训练和传统的减重跑台快速步行训练都能够显著改善脑卒中偏瘫后遗症期患者的社区性步行能力及生理耗能;功能性电刺激结合快速步行训练降低生理耗能更明显。Objective： To explore the effects of functional electrical stimulation （FES） combined with fast gait training on community walking and energy cost of hemiplegic stroke patients during sequelae stage. Methods： Thirty hemiplegic stroke patients with foot drop were divided into two groups randomly. Both two groups were given routine medical treatment and rehabilitation training. FES （two electrodes were respectively placed on peroneal nerve and the tibialis anterior muscle） combined with fast gait training was given to the treatment group while control group received conventional weight support treadmill fast gait training only. Both two groups were treated twice per day and 5 days per week for 4 weeks. The distances of 6 min walking test （6MWT） and physiological consumption index （PCI） were assessed before and after treatment. Results： After 4-week treatment, both two groups showed significant improvements in 6MWT and PCI （P〈0.05）. There was no significant difference in 6MWT between two groups, but PCI was significantly decreased in the treatment group after treatment （P〈0.05）. Conclusions： FES combined with fast gait training and conventional weight support treadmill fast gait training can both improve community walking ability and decrease energy consumption in hemiplegic stroke patients during sequelae stage while FES combined with fast gait training has distinct advantage on energy consumption.

关 键 词：功能性电刺激 步行训练 偏瘫 功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]