步行支持带联合常规康复治疗脑卒中下肢运动功能障碍效果观察  

Walking support band combined with conventional rehabilitation therapy significantly improves lower limbs motor function in stroke patients

作　　者：董晓琼[1] 吴月峰[1] 张芳[1] 范虹[1] 朱童[1] 许夏彬 DONG Xiaoqiong;WU Yuefeng;ZHANG Fang;FAN Hong;ZHU Tong;XU Xiabin(Department of Rehabilitation Medicine,Shaoxing People’s Hospital,Shaoxing 312000,China)

机构地区：[1]绍兴市人民医院康复医学科,312000

出　　处：《浙江医学》2020年第14期1515-1519,共5页Zhejiang Medical Journal

基　　金：浙江省公益技术应用研究计划项目(LGF20H250002);浙江省医药卫生青年人才项目(2017RC028);绍兴市人民医院青年科研基金项目(2019YB14)。

摘　　要：目的观察步行支持带联合常规康复治疗脑卒中下肢运动功能障碍的临床疗效。方法将2017年1月至2018年1月在绍兴市人民医院住院治疗的脑卒中57例患者随机分为步行支持带组(20例)、踝足矫形器(AFO)组(19例)和常规治疗组(18例)。3组患者均接受脑卒中后偏瘫的常规康复治疗,步行支持带组患者联用步行支持带治疗,AFO组患者加用踝足矫形器治疗,常规治疗组患者只给予常规康复治疗。康复治疗前、4周后采用表面肌电测试和下肢简化FMA-LE运动功能评分量表评定3组患者的足背伸时胫骨前肌平均肌电值(AEMG)值和下肢运动功能。结果(1)治疗后3组患者的患侧足背伸时胫骨前肌AEMG及健、患侧足背伸时胫骨前肌AEMG比值多组间比较差异有统计学意义(P<0.05)。治疗后3组患者的患侧足背伸时胫骨前肌AEMG值及健、患侧足背伸时胫骨前肌AEMG比值与治疗前比较差异均有统计学意义(均P<0.05)。治疗后步行支持带组患者的患侧足背伸时胫骨前肌AEMG值与常规治疗组、AFO组相比均明显增加(均P<0.05),健、患侧足背伸时胫骨前肌AEMG比值与常规治疗组、AFO组相比均明显降低(均P<0.05)。(2)治疗后3组患者的FMA-LE评分多组间比较差异有统计学意义(P<0.05)。治疗后3组患者的FMA-LE评分与治疗前相比差异均有统计学意义(均P<0.05)。治疗后步行支持带组、AFO组患者的FMA-LE评分与常规治疗组相比均明显增加(均P<0.05)。结论步行支持带联合常规康复治疗可明显改善脑卒中患者的下肢运动功能,同时较AFO可更好地促进胫骨前肌的激活。Objective To evaluate the effects of walking support band combined with conventional rehabilitation therapy on lower limbs motor function in stroke patients.Methods Fifty-seven stroke patients were randomly divided into walking support band group(n=20),ankle-foot orthosis(AFO)group(n=19)and conventional rehabilitation therapy group(n=18).The walking support band group was given walking support band combined with conventional rehabilitation therapy,the AFO group was given ankle-foot orthosis combined with conventional rehabilitation therapy,the conventional rehabilitation therapy group was given conventional rehabilitation therapy only.Surface electromyography test and FMA-LE score were used to evaluate the electromyogram(AEMG)value of the anterior tibialis muscle of dorsiflexion and the motor function of lower limbs in the three groups before and 4 weeks after treatment.Results After treatment,the average AEMG value of the affected anterior tibialis muscle of dorsiflexion in the three groups was significantly increased(P<0.05),the AEMG ratio between the unaffected anterior tibialis muscle of dorsiflexion and the affected side in the three groups was significantly decreased(all P<0.05);after treatment,the AEMG value of the affected anterior tibialis muscle of dorsiflexion in the walking support band group was significantly better than the that in the conventional rehabilitation group and the AFO group(all P<0.05),the AEMG ratio between the unaffected anterior tibialis muscle of dorsiflexion and the affected side in the walking support band group was significantly lower than that in the conventional rehabilitation group and AFO group(both P<0.05).After treatment,the FMA-LE score in the three groups was significantly increased(all P<0.05).the FMA-LE score in the walking support band group and AFO group was significantly better than that in the conventional rehabilitation therapy group(both P<0.05).Conclusion Walking support band combined with conventional rehabilitation therapy can significantly improve the lower li

关 键 词：脑卒中 步行支持带 下肢运动功能 表面肌电 

分 类 号：R743.3[医药卫生—神经病学与精神病学]