摘要
目的:探讨脑卒中患者使用功能性电刺激(FES)辅助跑步机训练的前、后步行能力相关指标的变化。方法:选择2019年6月~2020年6月期间在我院住院的脑卒中下肢偏瘫患者共106例,随机分成观察组和对照组各53例,观察组采用FES辅助跑步机训练,对照组跑步机训练。比较两组患者干预前后的步态时空参数(步速、步频、跨步长、步宽)、步态时相参数(患侧站立百分比、健侧与患侧站立相比值、双站立相百分比)、下肢关节最大活动角度(髋、膝、踝)与地面反作用力峰值。结果:治疗后,两组患者的步态时空参数(步速、步频、跨步长和步宽)均较治疗前有所改善(P<0.05),且观察组治疗后的步态时空参数(步速、步频、跨步长和步宽)显著优于对照组(P<0.05)。治疗后,两组患者的患侧站立百分比均较治疗前增加,健侧与患侧站立相比值、双站立相百分比均较治疗前下降(P<0.05),且观察组治疗后的步态时相参数(患侧站立百分比、健侧与患侧站立相比值、双站立相百分比)均显著优于对照组(P<0.05)。治疗后,两组患者的下肢关节最大活动角度(患侧髋、膝、踝关节)、患侧垂直地面反作用力峰值占体重百分比和患侧向前地面反作用力峰值占体重百分比均较治疗前增加(P<0.05),且观察组治疗后的下肢关节最大活动角度与地面反作用力峰值显著优于对照组(P<0.05)。结论:在常规康复治疗的基础上,FES和跑步机训练协同干预可以改善脑卒中偏瘫患者的行走动作协调性、提高步速,值得临床推广。
Objective:To investigate the changes of related indexes of walking ability before and after treadmill training assisted by functional electrical stimulation(FES) in patients with stroke.Methods:A total of 106 stroke patients with lower extremity hemiplegia hospitalized in our hospital from June 2019 to June 2020 were randomly divided into observation group and control group,with 53 cases in each group.The observation group was trained with FES assisted treadmill and the control group was trained with treadmill.The gait temporal and spatial parameters(gait speed,gait frequency,stride length and gait width),gait phase parameters(percentage of standing on the affected side,value of standing on the healthy side compared with the affected side,percentage of double standing phase),maximum movement angle of lower limb joints(hip,knee and ankle) and peak ground reaction force were compared between the two groups before and after intervention.Results:After treatment,the gait spatiotemporal parameters(gait speed,gait frequency,stride length and stride width) of the two groups were improved compared with those before treatment(P<0.05),and the gait spatiotemporal parameters(gait speed,gait frequency,stride length and stride width) of the observation group were significantly better than those of the control group(P<0.05).After treatment,the percentage of patients standing on the affected side in the two groups increased compared with that before treatment,and the value of standing on the healthy side compared with that on the affected side and the percentage of biphasic phase decreased compared with that before treatment(P<0.05).Moreover,the gait phase parameters(the percentage of standing on the affected side,the value of standing on the healthy side compared with that on the affected side and the percentage of biphasic phase) in the observation group were significantly better than those in the control group(P<0.05).After treatment,the maximum movement angle of lower limb joints(hip,knee and ankle joints on the affected side),the percentage of peak vertical ground reaction force on the affected side in body weight and the percentage of peak forward ground reaction force on the affected side in body weight of the two groups were increased compared with those before treatment(P<0.05),and the maximum movement angle of lower limb joints and peak ground reaction force in the observation group were significantly better than those in the control group(P<0.05).Conclusion:On the basis of routine rehabilitation treatment,the cooperative intervention of FES and treadmill training can improve the walking coordination and step number of stroke patients with hemiplegia,which is worthy of clinical promotion.
作者
马启寿
廖燕锬
李中元
陈美云
郑晓清
MA qi-shou;LIAO yan-tan;LI zhong-yuan;CHEN mei-yun;ZHENG xiao-qing(Rehabilitation Hospital affiliated to Fujian University of Traditional Chinese Medicine,FuJian FuZhou 350003;Fujian Key Laboratory of Rehabilitation Technology,FuJian FuZhou 350003;Fujian University of traditional Chinese Medicine,FuJian FuZhou 350108)
出处
《按摩与康复医学》
2022年第14期22-25,28,共5页
Chinese Manipulation and Rehabilitation Medicine
基金
中央引导地方科技发展专项(2018L3009)
福建省教育厅中青年课题(JAT190264)。
关键词
功能性电刺激
跑步机训练
脑卒中
步行能力
肌张力
Functional electrical stimulation
Treadmill training
Stroke
Walking ability
Muscle tension
