功能性电刺激联合神经肌肉激活技术训练对外伤性脊髓损伤肌肉和神经康复的影响  

Effects of functional electrical stimulation combined with neuromuscular activation technique training on muscle and nerve rehabilitation in patients with traumatic spinal cord injury

作　　者：谢豪娜 王楠 刘绪涛 XIE Hao-na;WANG Nan;LIU Xu-tao(Department of Needle Push Rehabilitation,Qingdao Traditional Chinese Medicine Hospital,Qingdao Shandong 266000,China.)

机构地区：[1]青岛市中医医院针推康复科,山东青岛266000

出　　处：《临床和实验医学杂志》2023年第19期2106-2110,共5页Journal of Clinical and Experimental Medicine

基　　金：2021年山东省中医药科技项目(编号:2021Q055)。

摘　　要：目的 探讨功能性电刺激联合神经肌肉激活技术训练对靶向肌肉神经重建术后外伤性脊髓损伤患者肌肉和神经康复的影响。方法 前瞻性选取2020年7月至2022年6月在青岛市中医医院接受靶向肌肉神经重建术治疗的76例外伤性脊髓损伤患者作为研究对象,按照随机数字表法将其分为对照组和观察组,各38例。对照组患者在术后进行功能性电刺激治疗,观察组接受功能性电刺激联合神经肌肉激活技术训练。分别在治疗前和治疗后3个月时评价患者美国脊柱损伤协会(ASIA)脊柱神经等级、肌肉功能和肌肉表面肌电信号、改良Barthel指数量表(MBI)、功能独立性量表(FIM)以及血清高迁移率族蛋白1(HMGB1)、半乳糖凝集素-3(galectin-3)和转化生长因子-β1(TGF-β1)水平。结果 治疗后,两组患者ASIA分级显著提高,ASIA评分显著增加,且观察组患者ASIA分级显著优于对照组,ASIA评分显著高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者伸肌群、屈肌群峰力矩和力矩加速能以及腘绳肌与股四头肌肌力比值均显著高于治疗前,且观察组患者伸肌群、屈肌群峰力矩和力矩加速能以及腘绳肌与股四头肌肌力比值均显著高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者腓肠肌、股二头肌、肱四头肌、胫前肌表面肌电信号均显著增强,且观察组患者显著高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组MBI和FIM量表评分显著提高,且观察组MBI和FIM量表评分均显著高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者血清HMGB1、galectin-3和TGF-β1水平均较治疗前显著降低,且观察组患者各指标均显著低于对照组,差异均有统计学意义(P<0.05)。结论 功能性电刺激联合神经肌肉激活技术训练能够显著改善外伤性脊髓损伤患者在肌肉神经重建术后的肌肉和神经功能,提高生活自理能力和运动Objective To explore the effect of functional electrical stimulation combined with neuromuscular activation technique training on muscle and nerve rehabilitation in patients with traumatic spinal cord injury after targeted muscle nerve reconstruction surgery.Methods A total of 76 patients with traumatic spinal cord injury who underwent targeted muscle nerve reconstruction surgery in Qingdao Traditional Chinese Medicine Hospital from July 2020 to June 2022 were divided into a control group and an observation group according to a random number table method,with 38 patients in each group.The control group received functional electrical stimulation therapy after surgery,while the observation group received training on functional electrical stimulation combined with neuromuscular activation techniques.The spinal nerve grade,muscle function and muscle surface electromyography,modified Barthel index scale(MBI),functional independence scale(FIM),serum high mobility group protein 1(HMGB1),galactose lectin-3(galectin-3)and transforming growth factor-β1(TGF-β1)of patients were evaluated before treatment and 3 months after treatment.Results After treatment,the ASIA grading and ASIA score of the two groups of patients significantly increased,the ASIA grading was significantly better than that of the control group,and the ASIA score of the observation group was significantly higher than that of the control group,and the differences were statistically significant(P<0.05).After treatment,the peak torque and acceleration energy of the extensor and flexor groups,as well as the ratio of hamstring to quadriceps femoris muscle strength,were significantly higher in both groups of patients than before treatment.Additionally,the observation group showed significantly higher peak torque and acceleration energy of the extensor and flexor groups,as well as the ratio of hamstring to quadriceps femoris muscle strength than the control group,the differences were statistically significant(P<0.05).After treatment,the surface electromyographic

关 键 词：脊髓损伤 功能性电刺激 神经肌肉激活技术 靶向神经重建术 肌肉功能 神经功能 

分 类 号：R651.2[医药卫生—外科学]