调制中频电刺激联合常规康复治疗对脑卒中偏瘫患者躯干屈曲功能恢复的影响

摘要

Objective To explore the effects of intermediate frequency modulation electrical stimulation combined with conventional rehabilitation on functional recovery of bilateral active trunk flexor muscles and bilateral synergistic trunk flexor muscles in patients with hemiplegic stroke. Methods Forty hemiplegic stroke patients were treated with conventional rehabilitation (control group,n = 20) or in combination with intermediate frequency modulation electrical stimu-lation( treatment group, n -20) for 40 days. Surface electromyogram (sEMG) was recorded to measure the maximum (MAX) and root mean square (RMS) values and bilateral active trunk flexor muscle,bilateral synergistic trunk flexor muscle MAX,RMS and the ratio of bilateral active trunk flexor muscle MAX to bilateral synergistic trunk flexor muscle MAX. Activities of daily liv-ing (ADD were assessed by using Fugl-Meyer Balance Function Assessment Scale and Barthel Index. Results After treatment,the surface electromyography MAX and RMS vales were signifi-cantly changed (P<0. 05). Furthermore,the MAX and RMS values and the ratio of bilateral ac-tive trunk flexor muscle MAX to bilateral synergistic trunk flexor muscle MAX in treatment group were obviously different from those in control group(all P<0. 05). In control group, Bar-thel ADL index score was not significantly changed after treatment (P>0. 05). However, there were obvious differences in ADL ability and Barthel ADL index score between control group and treatment group (P<0. 05). Conclusion Intermediate frequency modulation electrical stimulation combined with conventional rehabilitation can improve motor function,balance capacity and ADL ability of bilateral active trunk flexor muscles and bilateral synergistic trunk flexor muscles in pa-tients with hemiplegic stroke.%目的 探讨调制中频电刺激联合常规康复治疗对脑卒中偏瘫患者躯干屈曲双侧主动肌及躯干屈曲双侧协同肌功能恢复的影响.方法 将40 例脑卒中偏瘫患者按不同的治疗方法分为2组:对照组和治疗组,每组20 例.2组患者均采用常规康复治疗.在此基础上,治疗组加用调制中频电刺激治疗.2组疗程均为40 d.观察2组患者治疗前后表面肌电信号(sEMG)特征值[最大值(MAX)和均方根值(RMS)]和躯干屈曲双侧主动肌、躯干屈曲双侧协同肌MAX、RMS及躯干屈曲双侧主动肌MAX/躯干屈曲双侧协同肌MAX比值、日常生活活动能力(采用Fulg-Meyer平衡功能评定量表评定)、Barthel指数(采用Barthel指数量表评定)的情况.结果 2组患者治疗后表面肌电MAX、RMS值与治疗前比较差异均有统计学意义(均P＜0.05),治疗组患者治疗后表面肌电MAX、RMS值与对照组比较差异均有统计学意义(均P＜0.05),治疗组患者治疗后躯干屈曲双侧主动肌、躯干屈曲双侧协同肌MAX、RMS值及躯干屈曲双侧主动肌MAX/躯干屈曲双侧协同肌MAX比值与对照组比较差异均有统计学意义(均P＜0.05).对照组患者治疗后Barthel ADL指数评分值与治疗前比较差异无统计学意义(P＞0.05),治疗组患者治疗后日常生活活动能力、Barthel ADL指数评分值与对照组比较差异均有统计学意义(均P＜0.05).结论 调制中频电刺激联合常规康复治疗对脑卒中偏瘫患者躯干屈曲双侧主动肌及躯干屈曲双侧协同肌的运动功能、平衡能力及日常生活活动能力均具有良好的改善作用.