经皮电刺激对正常人腕手背伸活动影响的临床观察  

Clinical observation of the effect of transcutaneous electrical stimulation on the dorsal extension activity of the wrist and hand in normal subjects

作　　者：朱百慧 吴春芳 张悠然 ZHU Baihui;WU Chunfang;ZHANG Youran(Department of Rehabilitation,Huaihe Hospital of Henan University,Kaifeng 475000,CHN)

机构地区：[1]河南大学淮河医院康复医学科,河南开封475000

出　　处：《河南大学学报（医学版）》2022年第6期431-434,442,共5页Journal of Henan University:Medical Science

基　　金：河南省科技攻关计划(192102310104)。

摘　　要：目的:通过经皮电刺激不同电流强度致不同腕关节活动度的影响,观察对正常人腕手背伸活动的即刻效应。为在临床中针对脑卒中后遗留上肢运动功能障碍的病人,寻求新的、可行性的、安全、依从性较高的治疗方案及治疗思路。方法:采用单因素方差分析检验方法,将30例健康受试者均采用1、2、3三组经皮电刺激至不同腕关节活动度的影响,1组为经皮电刺激电流强度至腕关节活动度为≤20°,观察患者对于经皮电刺激疼痛耐受程度、指端距离的影响,以VAS评分、指端距离测量评估;2组为经皮电刺激电流强度至腕关节活动度为20°~40°,观察患者对于经皮电刺激疼痛耐受程度、指端距离测量的影响,以VAS评分、指端距离测量评估;3组为经皮电刺激电流强度至腕关节活动度为40°~60°,观察患者对于经皮电刺激疼痛耐受程度、指端距离的影响,以VAS评分、指端距离测量评估,以观察经皮电刺激对正常人腕手背伸活动的即刻效应影响。1、2、3三组每组均经过1周洗脱期后再次进行后续试验验证。结果:1、2、3三组均可刺激腕手背伸活动,针对于指端距离测量中,3组优于2组优于1组(P<0.05);对于VAS评分,3组高于2组高于1组(P<0.05)。结论:电流强度较低,受试者疼痛评分较低,疼痛不明显,可接受程度高,依从性好,但掌指关节、指间关节活动不充分。电流强度较高时,受试者疼痛评分较高,疼痛明显,依从性较差,但掌指关节、指间关节较1组2组活动充分。控制电流强度使腕关节活动度在20°~40°时,疼痛可接受,依从性较好,掌指关节、指间关节可活动较充分。Objective: The immediate effects of transcutaneous electrical stimulation on the dorsal extension of the wrist and hand in normal subjects were observed through the effects of different current intensities to different wrist joint mobility. To seek new, feasible, safe and highly compliant treatment options and treatment ideas for patients with residual upper limb motor dysfunction after stroke in clinical practice. Methods: Using one-way ANOVA test, the effects of transcutaneous electrical stimulation to different wrist joint mobility were applied to 30 healthy subjects in groups 1, 2 and 3. In group 2, the effect of transcutaneous electrical stimulation current intensity to wrist mobility of 20°~40° was observed, and the effect of patients on pain tolerance and finger-end distance measurement by VAS score and finger-end distance measurement was evaluated. Each of the three groups 1, 2 and 3 were subjected to a 1 week washout period before a follow-up test to verify the effect of transcutaneous electrical stimulation on the dorsiflexion of the wrist in normal subjects. Results: Groups 1, 2 and 3 all stimulated wrist-hand dorsiflexion. For finger-end distance measurements, group 3 was better than group 2 than group 1(P<0.05);for VAS scores, group 3 was higher than group 2 than group 1(P<0.05). Conclusion: In group 1 experiments, at lower current intensities, those included had lower pain scores, less pronounced pain, high acceptability and good compliance, but inadequate movement of the metacarpophalangeal and interphalangeal joints. In group 3 experiments, at higher current intensities, those included had higher pain scores, pronounced pain and poor compliance, but adequate movement of the metacarpophalangeal and interphalangeal joints compared to group 1, group 2. In group 2, controlling current intensity resulted in acceptable pain, better compliance and more adequate movement of the metacarpophalangeal and interphalangeal joints when wrist mobility was between 20°~40°.

关 键 词：脑卒中 经皮电刺激 断续波 腕关节活动度 

分 类 号：R493[医药卫生—康复医学]