神经肌肉电刺激同步功能训练治疗功能性踝关节不稳疗效观察  

Curative Effect of Synchronous Functional Training of Neuromuscular Eelectrical Stimulation on Patients with Functional Ankle Instability

作　　者：裴子文 耿治中 言功立 李丹阳[2] 陈建[2] PEI Ziwen;GENG Zhizhong;YAN Gongli;LI Danyang;CHEN Jian(Wuhan Municipal First Hospital,Wuhan,Hubei 430022,China;Wuhan Sports University,Wuhan,Hubei 430079,China)

机构地区：[1]武汉市第一医院,湖北武汉430022 [2]武汉体育学院,湖北武汉430079

出　　处：《康复学报》2019年第6期49-54,共6页Rehabilitation Medicine

基　　金：湖北省自然科学基金项目(2016098);武汉体育学院青年教师科研基金项目(201601)

摘　　要：目的:探讨神经肌肉电刺激(NMES)同步功能训练治疗功能性踝关节不稳(FAI)的临床疗效。方法:将50例武汉体育学院校医院门诊收治的FAI患者按照随机数字表法分为NMES组和对照组,每组各25例。2组均进行常规功能训练,包括热身活动、踝关节周围肌群力量训练、平衡训练和训练后放松活动;NMES组在进行肌力训练和平衡训练的同时,对患侧腓骨肌进行NMES治疗,每次20 min,每周3次,持续8周。治疗前后采用等速肌力测试系统测试"离心/向心"模式下踝关节外翻峰值力矩(E-PT)评定患者腓骨肌肌力变化,采用Y平衡测试(YBT)评估患者姿势稳定性的改善效果,采用Cumberland踝关节不稳问卷(CAIT)和自觉踝关节稳定性量表(PAI)评估患者自觉踝关节功能改善程度。结果:2组治疗前E-PT、YBT、CAIT和PAI评分比较,差异均无统计学意义(P>0.05)。治疗8周后,2组E-PT、YBT和CAIT评分较治疗前明显提高(P<0.05),PAI评分较治疗前明显降低(P<0.05);治疗8周后组间比较,NMES组E-PT、YBT和CAIT评分明显高于对照组(P<0.05),PAI评分明显低于对照组(P<0.05)。结论:神经肌肉电刺激同步功能训练可增强FAI患者踝关节外翻肌力和姿势稳定性,提升自觉踝关节功能表现,较单纯的常规功能训练效果更好,值得临床推广。Objective: To observe the effects of synchronous functional training of neuromuscular electrical stimulation(NMES)on patients with functional ankle instability(FAI). Methods: A total of 50 FAI patients treated in the hospital of Wuhan Sports University were randomly assigned to NMES group and control group by random number table method, with 25 cases in each group. Both groups performed conventional functional exercise including warm up activities, resistance training of the muscle groups around the ankle joint, balance training and stretching exercise after the training. The NMES group received NMES on peroneal muscles(PM) of affected side while performing muscle strength training and balance training for eight weeks, 20 minutes each time, three times a week. The PM muscle strength of patients was evaluated with Peak Torque of Evertor(E-PT) measured by the isokinetic system in eccentric/concentric mode before and after the treatment, the improvement of posture stability was assessed by the Y Balance Test(YBT), and the self-reported ankle function were evaluated by Cumberland ankle instability tool(CAIT). Results: There were no significant differences in E-PT, YBT score, CAIT score and PAI score between the two groups before the treatment(P>0.05). After eight weeks of treatment, the E-PT, YBT score, and CAIT score in both groups were significantly increased, and PAI score was significantly decreased compared with those before the treatment(P<0.05). After eight weeks of treatment, the E-PT, YBT score and CAIT score in the NMES group were significantly higher than those of the control group(P<0.05), PAI score was significantly lower than that of the control group(P<0.05). Conclusion: The synchronous functional training of NMES can significantly enhance the evertor strength, posture stability, and self-perceived ankle function in FAI patients. The curative effect of the method is better than that of only conventional functional exercise, and the method is worthy of clinical promotion and application.

关 键 词：功能性踝关节不稳 神经肌肉电刺激 肌力 姿势稳定性 

分 类 号：R684[医药卫生—骨科学]