步态诱发功能性电刺激对脑卒中后足下垂患者步态时空参数的影响

摘要

目的:采用步态分析,观察步态诱发功能性电刺激对脑卒中后足下垂患者步态时空参数的影响.方法:选择40例符合入选标准的脑卒中后足下垂患者,随机分组到实验组和对照组,均给予常规药物治疗及基本常规康复训练.实验组在此治疗基础上采用给予患侧下肢步态诱发功能性电刺激,根据患者踝关节背伸、内翻程度调节正负电极片位置及具体适应的刺激量30min/次,1次/d,每周6次,共3周.对照组在治疗期间不给予任何电刺激.采用三维步态分析仪器分别于治疗前、治疗3周后检测并获取两组患者步态参数.结果:治疗3周后,两组患者步速、步幅、步频、健侧摆动相均较治疗前明显均提高(P＜0.05),步态周期、步宽、双支撑相、患侧摆动相、健侧支撑相、患侧支撑相均较治疗前显著减小(P＜0.05).组间比较显示,治疗组患者的步行速度、步幅、步频、步行周期、步宽、双支撑相、改善程度均明显优于对照组(P＜0.05).两组患者对称性步态参数治疗前后差异显著,且实验组改善程度显著优于对照组(P＜0.05).结论:步态诱发功能性电刺激治疗能有效改善脑卒中后足下垂患者步速、步频、步行周期等时空参数,提高脑卒中后足下垂患者的步行能力及步态的对称性.%Objective:To explore the effects of gait triggered functional electrical stimulation on the temporal-spatial parameters of gait in foot drop patients after stroke through gait analysis.Method:Forty patients with foot drop were randomly divided into two groups:observation group(n=20)and control group(n=20).Both groups received training and basic drug.The patients in observation group received electrical stimulation on common peroneal nerve and tibialis anterior muscle of affected side for 30min daily over 3 weeks by using low-frequency electrical pulse stimulator.According the degree of ankle back-stretching and varus,positive and negative electrode plate position and adaptive stimulus quantity were adjusted.The control group received no electrical stimulation.Gait parameters were collected and calculated by gait analysis system before and 3 weeks post-treatment.Result:In observation group and control group,the gait parameters all improved,such as walking velocity,stride length,cadence,gait cycle,stride width,nonparetic leg swing phase,paretic swing phase,paretic stance phase,nonparetic stance phase,double limb support phase and symmetry parameters(P＜0.05).The parameters improved more significantly in observation group than those in control group except nonparetic leg swing phase,paretic swing phase,paretic stance phase and nonparetic stance phase(P＜0.05).Conclusion:Gait triggered functional electrical stimulation can improve the temporal-spatial parameters of gait such as walking velocity,cadence,gait cadence of foot-drop patients after stroke.So gait triggered functional electrical stimulation can improve gait function and gait symmetry.