姿势控制联合功能性电刺激对脑卒中偏瘫足下垂步态稳定性及步行能力的影响  

The effect of posture control combined with functional electrical stimulation on foot drop gait stability and walking ability in stroke hemiplegia

作　　者：陈芝英 CHEN Zhiying(Yuhuan People's Hospital,Yuhuan 317600,China)

机构地区：[1]玉环市人民医院,浙江玉环317600

出　　处：《浙江实用医学》2024年第3期203-207,共5页Zhejiang Practical Medicine

基　　金：玉环市社发类科技计划项目(202207)。

摘　　要：目的 研究姿势控制联合功能性电刺激对脑卒中足下垂患者步态稳定性及步行能力的影响。方法 选择2022年1月~2023年8月浙江省玉环市人民医院收治的脑卒中足下垂患者90例,按照随机数字表法分为常规组和电刺激组,每组45例。常规组给予包括神经肌肉电刺激、针灸以及患肢综合训练等常规对症治疗;电刺激组给予姿势控制联合功能性电刺激治疗,即先评估步态和姿势,确定需要改进的关键区域,再给予静态和动态姿势训练,8周内训练时间由每次5~10分钟延长至20~30分钟,并在此基础上使用功能性电刺激治疗仪对偏瘫侧下肢部位的股二头肌、胫骨前肌、腓肠肌及股四头肌的运动点给予电刺激治疗,30min/次,1次/d;并外将躯干、膝关节以及踝关节等部位固定在肢体智能反馈训练系统仪器上训练,每次20分钟,1次/d。两组每周治疗6天,持续治疗8周。比较两组下肢运动功能(FMA评分)、足下垂步态稳定性指标(步频、步幅、步宽、足偏角)、步行能力(FAC评分)、日常生活能力(MBI评分)和生活质量(GQOL-74评分)。结果 治疗后,电刺激组下肢FMA评分、步频、步幅、FAC评分、MBI评分及GQOL-74各项评分均较常规组高,而步宽、足偏角均较常规组低(P<0.05或P<0.01)。结论 姿势控制联合功能性电刺激可改善脑卒中足下垂步态稳定性,促进步行能力恢复,改善下肢运动功能,提升日常生活能力及生活质量。Objective To investigate the effects of posture control combined with functional electrical stimulation on gait stability and walking ability in patients with post-stroke foot drop.Method Ninety patients with post-stroke foot drop admitted to Yuhuan People's Hospital in Zhejiang Province from January 2022 to August 2023 were selected and randomly divided into a conventional group and an electrical stimulation group,with 45 cases in each group,using a random number table method.The routine group was given routine symptomatic treatment,including neuromuscular electrical stimulation,acupuncture and moxibustion and comprehensive training of affected limbs;The electrical stimulation group received posture control combined with functional electrical stimulation therapy,which first evaluated gait and posture,identified key areas that needed improvement,and then provided static and dynamic posture training.The training time was extended from 5-10 minutes per session to 20-30 minutes within 8 weeks;On this basis,a functional electrical stimulation therapy device is used to provide electrical stimulation therapy to the motor points of the biceps femoris,tibialis anterior muscle,gastrocnemius muscle,and quadriceps femoris muscle in the hemiplegic lower limb area,30 minutes per session,once a day;In addition,fix the trunk,knee joints,ankle joints and other parts on the limb intelligent feedback training system instrument for training,20 minutes per session,once a day.Two groups received treatment for 6 days per week for 8 weeks.Compare the lower limb motor function(FMA score),foot drop gait stability indicators(step frequency,stride length,step width,foot deviation angle),walking ability(FAC score),daily living ability(MBI score),and quality of life(GQOL-74 score)between two groups.Results After treatment,the FMA score,step frequency,stride length,FAC score,MBI score,and CQOL-74 scores of the lower limbs in the electrical stimulation group were higher than those in the conventional group,while the step width and foot deviati

关 键 词：脑卒中足下垂 姿势控制 动作反馈 功能性电刺激 步态稳定性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]