上肢机器人训练联合多通道功能性电刺激对老年卒中患者上肢运动功能的影响  

The effect of upper limb robot training combined with multi⁃channel functional electrical stimulation on upper limb motor function in elderly stroke patients

作　　者：周欢霞[1] 段宏霞 赵忠志 胡军 Zhou Huanxia;Duan Hongxia;Zhao Zhongzhi;Hu Jun(Department of Rehabilitation Therapeutics,Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine,Shanghai,200137,P.R.China;Second Rehabilitation Hospital of Shanghai City,Shanghai,200441,P.R.China)

机构地区：[1]上海中医药大学附属第七人民医院康复治疗科,上海200137 [2]上海市第二康复医院,上海200441

出　　处：《老年医学与保健》2023年第4期690-695,共6页Geriatrics & Health Care

基　　金：上海市浦东新区卫生健康委员会优秀青年医学人才培养计划(PWRq2020-13);上海市卫生健康委员会青年科研项目(20214Y0285)。

摘　　要：目的观察上肢机器人训练联合多通道功能性电刺激对老年脑卒中患者上肢功能、肌肉功能和日常生活能力的影响。方法以2022年10月—2023年1月上海中医药大学附属第七人民医院收治的40例脑卒中患者作为研究对象,按照数字表法随机分为试验组(n=20)和对照组(n=20)。2组均接受常规护理及康复治疗,在此基础上,对照组接受上肢机器人训练,试验组在进行上肢机器人训练的同时辅以多通道功能性电刺激治疗,30 min/次,1次/d,5 d/周,连续8周,共40次治疗。干预前后,分别采用Fugl-Meyer运动量表上肢部分(FMA-UE)、改良Ashworth量表(MAS)、表面肌电的积分肌电值(iEMG)和均方根(RMS)以及改良Barthel指数(MBI)评估并比较2组的上肢运动功能、肌痉挛、肌肉功能和日常生活能力。结果干预前,2组各指标值差异均无统计学意义(P>0.05)。干预后,2组FMA-UE评分、iEMG值、RMS值以及MBI评分均显著高于同组治疗前(P<0.05),而肱二头肌、肱三头肌MAS等级评分显著低于同组治疗前(P<0.05);试验组FMA-UE评分、iEMG值(三角肌前束、肱二头肌、肱三头肌)、RMS值(三角肌前束、肱三头肌)、MBI评分均明显高于对照组,而肱二头肌MAS等级评分明显低于对照组,差异均有统计学意义(P<0.05)。结论上肢机器人训练联合多通道功能性电刺激可显著改善老年脑卒中患者上肢功能、肌肉功能和日常生活能力,其效果可能优于单独的上肢机器人训练。Objective To observe the effect of upper limb robot training combined with multi⁃channel functional electri⁃cal stimulation on upper limb function,muscle function and daily living ability in elderly stroke patients.Methods A total of 40 stroke patients admitted to Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine from October 2022 to January 2023 were selected as the study subjects,and randomly divided into experimental group(n=20)and control group(n=20)according to the numerical table method.Both groups received routine nursing and rehabilitation treatment.On this basis,the control group received the upper limb robot training,and the experimental group received multi⁃channel function⁃al electrical stimulation treatment and upper limb robot training.The treatment was performed 40 times,30 min/time,1 time/d,5 days/week for 8 weeks.Before and after intervention,the upper extremity part of the Fugl⁃Meyer Assessment Scale(FMA⁃UE),Modified Ashworth Scale(MAS),integrated electromyography(iEMG)value and root mean square(RMS)value of surface electromyography,and Modified Barthel Index(MBI)were used to evaluate and compare the upper limb motor func⁃tion,muscle spasms,muscle function,and daily living ability of the two groups.Results Before intervention,there was no significant difference in each index value between the two groups(P>0.05).After intervention,the FMA⁃UE score,iEMG value,RMS value,and MBI score of the two groups were significantly higher than those of the same group before treatment(P<0.05),while the MAS grade scores of the biceps and triceps brachii were significantly lower than those of the same group before treatment(P<0.05);the FMA⁃UE score,iEMG value(deltoid anterior bundle,biceps brachii,triceps brachii),RMS value(deltoid anterior bundle,triceps brachii)and MBI score of the experimental group were significantly higher than those of the control group,while the MAS grade score of the biceps brachii was significantly lower than that of the control group,with

关 键 词：老年 功能电刺激 上肢机器人 脑卒中 表面肌电 运动功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]