PNF技术联合FES康复踏车对脑卒中患者运动功能的影响  

Effect of PNF combined with FES rehabilitation treadmill on motor function in stroke patients

作　　者：陈飞 周敬杰 张明 李宁 孙飞阳 王营 CHEN Fei;ZHOU Jing⁃jie;ZHANG Ming;LI Ning;SUN Fei⁃yang;WANG Ying(Department of Rehabilitation,Xuzhou Rehabilitation Hospital Affiliated to Xuzhou Medical Uni⁃versity,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属徐州康复医院康复治疗部,江苏徐州221000

出　　处：《哈尔滨医科大学学报》2024年第5期500-505,共6页Journal of Harbin Medical University

基　　金：江苏省科技厅基础研究计划项目(BK20211493);彭城英才-医学青年后备人才培养项目(XWRCHT20220007)

摘　　要：目的 探讨本体感觉神经肌肉促进技术(proprioceptive neuromuscular facilitation, PNF)联合功能性电刺激(functional electrical stimulation, FES)康复踏车对脑卒中患者运动功能的影响。方法 选取2021年12月~2022年7月于徐州医科大学附属徐州康复医院康复治疗部住院的脑卒中患者共84例,随机分为对照组、PNF组及联合组(即PNF联合FES康复踏车组),每组28例,3组患者入组后均接受基础康复锻炼,此外,PNF组在对照组基础上接受PNF,联合组在PNF组基础上联合FES康复踏车,所有患者均干预6周。分析3组患者锻炼前后下肢肌群肌电积分值(integrated electromyography, iEMG)、本体感觉、Berg平衡量表(Berg Balance Scale, BBS)评分、行走能力及下肢肢体功能(Fugl-Meyer下肢运动功能评分(Fugl-Meyer Assessment of lower-limb motor function, FMA-L))。结果 干预后,联合组臀中肌及臀后肌主动运动iEMG显著高于PNF组及对照组,PNF组显著高于对照组,且3组患者上述指标均显著高于同组干预前,差异均存在统计学意义(P均<0.05);干预后,联合组重心移动距离及重心描述面积显著低于PNF组及对照组,PNF组显著低于对照组,且3组患者上述指标均显著低于同组干预前,差异均存在统计学意义(P均<0.05);干预后,联合组BBS评分及起立-行走计时测试(time up and go test, TUGT)显著高于PNF组及对照组,PNF组显著高于对照组,且3组患者上述指标均显著高于同组干预前,差异均存在统计学意义(P均<0.05);干预后,联合组FAM-L评分显著高于PNF组及对照组,PNF组显著高于对照组,且3组患者上述指标均显著高于同组干预前;差异均存在统计学意义(P均<0.05)。结论 脑卒中患者康复治疗中联合运动PNF及FES康复踏车能够改善患者下肢运动功能及神经功能缺损程度,有效提高患者下肢肌力及本体感觉,增加患者关节活动度,提高患者日常生活能力。Objective To investigate the effects of proprioceptive neuromuscular facilitation(PNF)combined with functional electrical stimulation(FES)rehabilitation treadmill on motor function in stroke patients.Methods A total of 84 stroke patients hospitalized in the Depart⁃ment of Rehabilitation of Xuzhou Rehabilitation Hospital Affiliated to Xuzhou Medical Universi⁃ty from December 2021 to July 2022 were included and randomly divided into three groups:control group,PNF group and combination group(namely PNF combined with FES rehabilita⁃tion treadmill),with 28 cases in each group.All patients in the three groups received basic re⁃habilitation exercise after admission.The PNF group received PNF on the basis of the control group,and the comprehensive group was combined with FES rehabilitation treadmill on the ba⁃sis of PNF group.All patients were intervened for 6 weeks.The integrated electromyography(iEMG)proprioception,Berg Balance Scale(BBS)score,walking ability and lower limb func⁃tion(Fugl⁃Meyer Assessment of lower⁃limb motor function,FMA⁃L)of the three groups of pa⁃tients before and after exercise were analyzed.Results After intervention,the active exercise iEMG of gluteus medius and gluteus posterior muscle in combination group was significantly higher than that in PNF group and control group,and PNF group was significantly higher than that in control group,and the above indexes in three groups were significantly higher than be⁃fore intervention,the differences were statistically significant(all P<0.05);After interven⁃tion,the moving distance of the center of gravity and the description area of the center of gravi⁃ty in the combination group were significantly lower than those in the PNF group and the control group,and the PNF group was significantly lower than that in the control group,and the above indicators in the three groups were significantly lower than before intervention,the differences were statistically significant(all P<0.05);After intervention,the BBS score and time up and go tes

关 键 词：本体感觉神经肌肉促进技术 功能性电刺激 脑卒中 康复 运动功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]