减重结合功能性电刺激对脑卒中患者下肢运动功能的疗效

doi:10.3969/j.issn.1006-9771.2024.05.008

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (5): 554-559.doi: 10.3969/j.issn.1006-9771.2024.05.008

减重结合功能性电刺激对脑卒中患者下肢运动功能的疗效

熊杏秀^1a, 张正辉^1b(), 邓春燕^1c, 李云波^1b, 陈镇鹏^1a, 李元杰^1a, 宋景^1a

1.佛山市禅城区人民医院康复医院，a.康复治疗中心；b.老年康复科；c.质控科，广东佛山市 528000

收稿日期:2024-02-17 修回日期:2024-04-11 出版日期:2024-05-25 发布日期:2024-06-12
通讯作者: 张正辉，男，副主任医师。E-mail： 250971663@qq.com E-mail:250971663@qq.com
作者简介:熊杏秀(1984-)，女，汉族，广东开平市人，主管技师，主要研究方向：康复治疗技术。
基金资助:
佛山市自筹经费类科技计划项目(医学类科技攻关)(2220001004359)

Effect of combination of partial body weight support and functional electrical stimulation on lower limb motor function after stroke

XIONG Xingxiu^1a, ZHANG Zhenghui^1b(), DENG Chunyan^1c, LI Yunbo^1b, CHEN Zhenpeng^1a, LI Yuanjie^1a, SONG Jing^1a

1. a. Rehabilitation Treatment Center; b. Annual Rehabilitation Department; c. Quality Control Department, Rehabilitation Hospital of Chancheng District People's Hospital in Foshan City, Foshan, Guangdong 528000, China

Received:2024-02-17 Revised:2024-04-11 Published:2024-05-25 Online:2024-06-12
Contact: ZHANG Zhenghui, E-mail: 250971663@qq.com
Supported by:
Foshan Self Funded Science and Technology Plan (Medical Science and Technology Research)(2220001004359)

摘要/Abstract

摘要：

目的观察减重结合功能性电刺激对脑卒中患者下肢运动功能的疗效。

方法 2023年1月至2024年2月，选择佛山市禅城区人民医院康复医院住院脑卒中患者60例，随机分为对照组(n = 30)和观察组(n = 30)。对照组接受常规康复，观察组增加天轨系统减重结合功能性电刺激，共3周。治疗前后采用平衡评定与训练仪、Berg平衡量表(BBS)、FMA评定量表下肢部分(FMA-LE)、Holden步行功能分级(FAC)进行评定。

结果治疗后，两组X轴轨迹长、动摇平均速度、动摇总轨迹长、Y轴轨迹长、单位面积轨迹长、BBS评分、FMA-LE评分、FAC评分均较治疗前显著改善(|t| > 4.809, P < 0.001)。除X轴轨迹长和动摇平均速度外，其他指标观察组均优于对照组(|t| > 2.268, P < 0.05)。

结论增加减重结合功能性电刺激能更有效改善脑卒中患者的下肢运动功能、平衡功能和步行功能。

关键词: 脑卒中, 减重训练, 功能性电刺激, 下肢, 运动, 平衡, 步行

Abstract:

Objective To observe the effect of combination of partial body weight support and functional electrical stimulation on lower limb motor function for stroke patients.

Methods From January, 2023 to February, 2024, 60 stroke patients from Rehabilitation Hospital of Chancheng District People's Hospital in Foshan City were randomly divided into control group (n = 30) and observation group (n = 30). The control group received routine rehabilitation, while the observation group received a combination of celestial orbit system and functional electrical stimulation in addition, for three weeks. They were assessed with Balance assessment and training system, Berg Balance Scale (BBS), Fugl-Meyer Assessment-Lower Extremities (FMA-LE) and Holden Functional Ambulation Category (FAC) before and after treatment.

Results X-axis trajectory length, average speed of swaying, total wobble trajectory, Y-axis trajectory length, trajectory length per unit area, BBS score, FMA-LE score and FAC score improved in both groups after treatment (|t| > 4.809, P < 0.001); and all the indexes improved more in the observation group than in the control group (|t| > 2.268, P < 0.05), except X-axis trajectory length and average speed of swaying.

Conclusion Supplement of the combination of partial body weight support and functional electrical stimulation is more effective on lower limb motor function, balance and walking for stroke patients.

Key words: stroke, partial body weight support, functional electrical stimulation, lower limb, motor function, balance, walking

中图分类号:

R743.3

熊杏秀, 张正辉, 邓春燕, 李云波, 陈镇鹏, 李元杰, 宋景. 减重结合功能性电刺激对脑卒中患者下肢运动功能的疗效[J]. 《中国康复理论与实践》, 2024, 30(5): 554-559.

XIONG Xingxiu, ZHANG Zhenghui, DENG Chunyan, LI Yunbo, CHEN Zhenpeng, LI Yuanjie, SONG Jing. Effect of combination of partial body weight support and functional electrical stimulation on lower limb motor function after stroke[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(5): 554-559.

图/表 5

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组别	n	性别(男/女)/n	年龄/岁	病程/月	卒中类型 (出血/梗死)/n	偏瘫部位 (左/右)/n
对照组	30	22/8	59.43±11.37	2.00(1.20,3.00)	7/23	13/17
观察组	30	19/11	60.27±12.92	1.25(1.00,3.20)	8/22	16/14

变量	组别	n	测试	$\bar{x} \pm s$	t值	P值
X轴轨迹长/cm	对照组	30	前测	33.57±15.07	4.809	< 0.001
	对照组	30	后测	22.91±11.95	4.809	< 0.001
	观察组	30	前测	32.53±16.11	8.226	< 0.001
	观察组	30	后测	19.18±10.04	8.226	< 0.001
	治疗前均值差			-1.04±4.027	-0.258	0.797
	治疗后均值差			-3.73±2.85	-1.308	0.196
动摇平均速度/(cm·s^-1)	对照组	30	前测	2.47±0.79	5.387	< 0.001
	对照组	30	后测	1.74±0.71	5.387	< 0.001
	观察组	30	前测	2.28±1.01	7.956	< 0.001
	观察组	30	后测	1.41±0.71	7.956	< 0.001
	治疗前均值差			-0.19±0.23	-0.823	0.414
	治疗后均值差			-0.32±0.18	-1.759	0.084
动摇总轨迹长/cm	对照组	30	前测	62.23±18.51	6.767	< 0.001
	对照组	30	后测	45.76±18.74	6.767	< 0.001
	观察组	30	前测	56.89±21.64	11.131	< 0.001
	观察组	30	后测	35.50±16.18	11.131	< 0.001
	治疗前均值差			-5.34±5.20	-1.026	0.309
	治疗后均值差			-10.25±4.52	-2.268	0.027
Y轴轨迹长/cm	对照组	30	前测	45.44±16.16	5.493	< 0.001
			后测	34.23±15.68
	观察组	30	前测	42.22±17.54	8.964	< 0.001
			后测	25.12±11.40
	治疗前均值差			-3.22±4.35	-0.740	0.462
	治疗后均值差			-9.11±3.94	-2.574	0.013
单位面积轨迹长/(cm·cm^-2)	对照组	30	前测	11.65±3.88	10.251	< 0.001
			后测	5.38±3.12
	观察组	30	前测	12.37±7.72	5.927	< 0.001
			后测	8.49±6.49
	治疗前均值差			0.72±1.58	0.455	0.651
	治疗后均值差			3.11±1.31	2.364	0.021

组别	n	测试	$\bar{x} \pm s$	t值	P值
对照组	30	前测	15.87±1.76	-15.619	< 0.001
对照组	30	后测	25.50±3.62	-15.619	< 0.001
观察组	30	前测	15.23±1.83	-35.554	< 0.001
观察组	30	后测	28.60±2.03	-35.554	< 0.001
治疗前均值差			-0.63±0.46	-1.367	0.177
治疗后均值差			3.10±0.76	4.095	< 0.001

组别	n	测试	$\bar{x} \pm s$	t值	P值
对照组	30	前测	15.17±1.95	-14.087	< 0.001
对照组	30	后测	30.47±6.27	-14.087	< 0.001
观察组	30	前测	15.40±1.91	-36.894	< 0.001
观察组	30	后测	41.33±4.33	-36.894	< 0.001
治疗前均值差			0.23±0.50	0.469	0.641
治疗后均值差			10.87±1.39	7.815	< 0.001

组别	治疗前						治疗后						Z值	P值
组别	0级	1级	2级	3级	4级	5级	0级	1级	2级	3级	4级	5级	Z值	P值
对照组	0	30	0	0	0	0	0	0	11	12	5	2	-4.850	< 0.001
观察组	0	30	0	0	0	0	0	0	1	13	14	2	-4.889	< 0.001
Z值	< 0.001						-3.005
P值	> 0.990						0.003

减重结合功能性电刺激对脑卒中患者下肢运动功能的疗效

Effect of combination of partial body weight support and functional electrical stimulation on lower limb motor function after stroke

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