神经肌肉电刺激联合康复训练对卒中后下肢瘫痪患者肌电图、下肢功能的影响  

Effects of Neuromuscular Electrical Stimulation Combined with Rehabilitation Training on Electromyography and Lower Extremity Function in Patients with Lower Extremity Paralysis After Stroke

作　　者：邱志茹[1] 王军杰[1] 张晓艳 王雪君 王梦杰 QIU Zhiru;WANG Junjie;ZHANG Xiaoyan;WANG Xuejun;WANG Mengjie(Department of Neuroelectrophysiology,Stroke Center,Zhengzhou First People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第一人民医院卒中中心神经电生理室,河南郑州450000

出　　处：《河南医学研究》2022年第20期3729-3732,共4页Henan Medical Research

摘　　要：目的分析神经肌肉电刺激联合康复训练对卒中后下肢瘫痪患者肌电图、下肢功能恢复情况的影响。方法选取郑州市第一人民医院2019年3月至2021年10月收治的82例卒中后下肢瘫痪患者作为研究对象。采用随机数字表法将患者分为两组,41例为研究组,接受神经肌肉电刺激联合康复训练,41例为参照组,接受常规康复训练。治疗前后检测两组患者胫骨前肌、腓肠肌、股四头肌的表面肌电图积分肌电值(iEMG)、均方根(RMS)值,给予患者三维步态分析,记录患者跨步长比率、步频及步速,给予患者Fugl-Meyer运动功能量表(下肢功能部分)、Berg平衡量表(BBS)、改良Barthel指数评定量表(MBI)、健康状况调查表(SF-36)评价。结果研究组患者胫骨前肌、腓肠肌、股四头肌iEMG水平高于参照组(P<0.05),参照组胫骨前肌、腓肠肌、股四头肌RMS水平低于参照组(P<0.05)。研究组患者跨步长比率、步频及步速水平高于参照组(P<0.05)。研究组患者下肢运动功能、BBS、MBI、SF-36评分高于参照组(P<0.05)。结论神经肌肉电刺激联合康复训练对脑卒中后下肢瘫痪康复具有较好效果,胫骨前肌、腓肠肌、股四头肌功能得到改善,iEMG、RMS水平下降,肢体运动功能、平衡能力、日常生活水平及生活质量均得到提升。Objective To observe the effect of neuromuscular electrical stimulation combined with rehabilitation training on electromyography and lower extremity function in patients with lower extremity paralysis after stroke.Methods A total of 82 patients with post-stroke lower extremity paralysis who were treated in Zhengzhou First People’s Hospital from March 2019 to October 2021 were selected.According to the random number table method,41 patients were divided into the study group,which received neuromuscular electrical stimulation combined with rehabilitation training,and 41 patients were divided into the reference group,which received conventional rehabilitation training.Before and after treatment,the surface electromyogram integral electromyogram(iEMG)and root mean square(RMS)values of the tibialis anterior muscle,gastrocnemius muscle and quadriceps femoris muscle of the two groups of patients were detected.The three-dimensional gait analysis of the patients was performed,and the strides of the patients were recorded.Length ratio,cadence and gait speed,Fugl-Meyer motor function scale(lower limb function),Berg balance scale(BBS),modified Barthel index(MBI),the MOS item short from health survey(SF-36)of patients were evaluated.Results The iEMG level of the tibialis anterior muscle,gastrocnemius muscle and quadriceps femoris muscle in the study group were higher than that in the reference group(P<0.05),and the RMS level of the tibialis anterior muscle,gastrocnemius muscle and quadriceps femoris muscle in the reference group was lower than that in the reference group(P<0.05).The stride length ratio,stride frequency and stride speed in the study group were higher than those in the reference group(P<0.05).The lower extremity motor function,BBS,MBI and SF-36 scores of the patients in the study group were higher than those in the reference group(P<0.05).Conclusion Neuromuscular electrical stimulation combined with rehabilitation training in the treatment of post-stroke lower limb paralysis patients can increase the iEMG le

关 键 词：神经肌肉电刺激 康复训练 卒中后下肢瘫痪 肌电图 肢体运动功能 平衡能力 

分 类 号：R743.3[医药卫生—神经病学与精神病学]