经颅直流电刺激联合对侧控制型功能性电刺激对脑卒中患者上肢功能的效果  

Effect of transcranial direct current stimulation combined with contralateral control functional electrical stimulation on upper limb function of stroke patients

作　　者：陈甜甜 徐东平[2] 孙凤宝 赖俊媚 曾杜纯 CHEN Tiantian;XU Dongping;SUN Fengbao;LAI Junmei;ZENG Duchun(Zhejiang University of Chinese Medicine,Hangzhou,Zhejiang 310053,China;Zhejiang Provincial People's Hospital,Department of Cardiovascular Medicine,People's Hospital Affiliated to Hangzhou Medical College,Hangzhou,Zhejiang 310014,China;Rehabilitation Center of Zhejiang Provincial People's Hospital,Department of Rehabilitation Medicine,People's Hospital Affiliated to Hangzhou Medical College,Hangzhou,Zhejiang 310014,China)

机构地区：[1]浙江中医药大学,浙江杭州市310053 [2]浙江省人民医院,杭州医学院附属人民医院心血管内科,浙江杭州市310014 [3]浙江省人民医院康复中心,杭州医学院附属人民医院康复医学科,浙江杭州市310014

出　　处：《中国康复理论与实践》2023年第5期527-532,共6页Chinese Journal of Rehabilitation Theory and Practice

基　　金：浙江省医药卫生科技计划项目(No.2021KY464);浙江省中医药科技计划项目(No.2021ZB020)。

摘　　要：目的探讨阳极经颅直流电刺激(atDCS)联合对侧控制型功能性电刺激(CCFES)对脑卒中患者上肢运动功能的影响。方法2022年1月至12月,浙江省人民医院脑卒中住院患者60例,随机分为atDCS组、CCFES组和联合组,各20例。3组均接受常规康复治疗,atDCS组接受损伤侧初级运动(M1)区atDCS,CCFES组接受肱三头肌和伸腕肌群CCFES,联合组联合采用损伤侧M1区atDCS和肱三头肌和伸腕肌群CCFES,共6周。治疗前后采用Fugl-Meyer评定量表上肢部分(FMA-UE)、Wolf运动功能测试(WMFT)、双侧肱三头肌和伸腕肌群肌电均方根(RMS)比进行评定。结果治疗后,3组FMA-UE评分、WMFT评分、肱三头肌RMS比和伸腕肌群RMS比均显著提高(|t|>5.007,P<0.001),联合组各项指标均最优(F>14.492,P<0.001)。结论atDCS联合CCFES治疗可显著改善脑卒中患者上肢运动功能。Objective To investigate the effect of anodal transcranial direct current stimulation(atDCS)combined with contralaterally controlled functional electrical stimulation(CCFES)on upper limb motor function of stroke patients.Methods From January to December,2022,60 stroke patients from Zhejiang Provincial People's Hospital were randomly divided into atDCS group(n=20),CCFES group(n=20)and combined group(n=20).All the groups accepted routine rehabilitation,while atDCS group accepted atDCS on the primary motor(M1)area of the damaged hemisphere,CCFES group accepted CCFES on the triceps brachii and extensors carpi muscles,and the combined group accepted atDCS on the M1 area of damaged hemisphere and CCFES on triceps brachii and extensors carpi muscles,for six weeks.They were assessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Wolf Motor Function Test(WMFT),and the electromyography root mean square(RMS)ratio of bilateral triceps brachii muscles and extensor carpi muscles,before and after treatment.Results The FMA-UE score,WMFT score,and the RMS ratio of the triceps brachii muscles and extensor carpi muscles improved in all the groups after treatment(|t|>5.007,P<0.001),and improved the most in the combined group(F>14.492,P<0.001).Conclusion atDCS combined with CCFES can effectively improve upper limb motor function of stroke patients.

关 键 词：脑卒中 经颅直流电刺激 对侧控制型功能性电刺激 上肢 运动功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]