对侧功能性电刺激与任务导向性训练不同方式联用对脑卒中手功能的影响  

Effect of different combinations of contralaterally controlled functional electrical stimulation and task oriented training on hand function in stroke

作　　者：张敏杰 金星 孟兆祥 王鑫 王建建 柯明慧 Zhang Minjie;Jin Xing;Meng Zhaoxiang(Department of Rehabilitation Medicine,Clinical Medicine College of Yangzhou University,Yangzhou 22500,China)

机构地区：[1]苏北人民医院康复科,江苏扬州225000

出　　处：《中国康复》2024年第2期67-71,共5页Chinese Journal of Rehabilitation

基　　金：国家自然基金面上项目(82072533)。

摘　　要：目的:研究对侧控制型电刺激(CCFES)与任务导向性训练不同方式联用对脑卒中患者手功能恢复的影响。方法:选取我院病程在1个月内的60例脑卒中患者,将其按随机数字法分为同步组即CCFES与任务导向性训练同步进行(30例)与分步组即CCFES治疗后序贯进行任务导向型训练(30例)。于入组前、治疗4周后分别采用Fugl-Meyer运动功能评分(FMA)、Wolf运动功能测试量表(WMFT)、表面肌电图(sEMG)及Barthel指数(BI)对患者的上肢、腕手运动功能及日常生活独立性进行评定。结果:治疗后2组RMS比值、FMA、WMFT及BI评分均较治疗前明显提高(P<0.01,0.05),且同步组各项评定较分步组更高(P<0.01,0.05)。结论:CCFES与任务导向性训练同步组在改善脑卒中患者的上肢及手功能更有优势。Objective:To investigate the effect of different combinations of contralaterally controlled functional electrical stimulation(CCFES)and task oriented training on hand function in stroke.Methods:A total of 60 subjects with stroke within 1 month treated in our hospital were randomly assigned into synchronous group(30 cases)receiving CCFES and task-oriented training simultaneously,and the desynchronous group(30 cases)receiving task-oriented training sequentially after CCFES treatment.Both groups received 20 min of electrical stimulation/time,and all received routine rehabilitation training,and the treatment program was 5 times per week for 4 weeks.Fugl-Meyer Motor function score(FMA),The Wolf Motor Function Test(WMFT),Surface Electromyography(sEMG)and Barthel Index(BI)were used to evaluate upper limb and wrist motor function and independence of daily living before and after 4 weeks of treatment,respectively.Results:Before treatment,there was no significant difference in upper limb FMA,Wolf,RMS ratio(affected side myoelectric RMS/unaffected side myoelectric RMS during active dorsal wrist extension)and BI between the two groups.Compared with before treatment,the above evaluation scores in both groups were improved after treatment(P<0.05),and better in synchronous group(P<0.05).Conclusion:CCFES and task-oriented training simultaneously were superior in improving upper limb and hand function in stroke.

关 键 词：对侧控制型功能性电刺激 任务导向性训练 脑卒中 手功能 双侧对称运动 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]