前庭电刺激对脑卒中患者侧倾功能障碍的效果

doi:10.3969/j.issn.1006-9771.2024.02.011

Abstract

Abstract:

Objective To investigate the effect of galvanic vestibular stimulation on stroke patients with lateropulsion.
Methods From February to October, 2023, 30 stroke patients with lateropulsion in the First Affiliated Hospital of Nanjing Medical University were divided into control group (n = 15) and experimental group (n = 15) randomly. The control group received routine rehabilitation and sham galvanic vestibular stimulation, and the experimental group received routine rehabilitation and true galvanic vestibular stimulation, for two weeks. They were assessed with Scale for Contraversive Pushing (SCP), subjective visual vertical (SVV), Line Cancellation Test (LCT), Star Cancellation Test (SCT), Berg Balance Scale (BBS), Holden Functional Ambulation Category (FAC) and Barthel Index (BI) before and after treatment.
Results All the indexes improved in both groups after intervention (|t| > 2.461, Z > 3.000, P < 0.05), except the SVV orientation, SVV certainty and SCT in the control group; while the SCP, SVV certainty, LCT and FAC were better in the experimental group than in the control group (|t| > 2.189, Z = -2.862, P < 0.05), and the differences before and after intervention were better in the experimental group than in the control group (|t| > 2.382, P < 0.05), except LCT. SCP was correlated with SVV orientation, SVV certainty, SCT, BBS, BI and FAC (|r| > 0.381, P < 0.05).
Conclusion Galvanic vestibular stimulation can improve the lateropulsion, balance, walking function and activities of daily living in stroke patients, which may be related to improvement for spatial cognitive function, especially vertical perception.

Key words: stroke, lateropulsion, galvanic vestibular stimulation, spatial cognition, vertical perception

CLC Number:

R743.3

GONG Xiang, WANG Menghuan, WU Cunshu, CHEN Junwen, XIAO Yue, YANG Yun, SUN Wanting, LU Jun, XU Guangxu. Effect of galvanic vestibular stimulation on stroke patients with lateropulsion[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(2): 210-216.

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References 46

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组别	n	性别(男/女)/n	年龄/岁	病程/月	卒中性质(梗死/出血)/n	卒中部位(小脑幕上/小脑幕下)/n	偏瘫侧(左/右)/n
对照组	15	10/5	56.53±11.02	2.12±2.78	7/8	11/4	11/4
试验组	15	11/4	60.42±13.21	2.34±2.2	10/5	13/2	12/3
t值			0.876	0.683
P值		1^a	0.388	0.788	0.462^a	0.651^a	0.674^a

组别	n	干预前	干预后	差值	t值^a	P值^a
对照组	15	13.52±13.15	10.00±11.87	-3.52±4.26	3.199	0.006
试验组	15	6.85±10.06	1.85±3.74	-5.00±7.87	2.461	0.027
t值		-1.559	-2.536	-0.641
P值		0.130	0.021	0.527

组别	n	干预前	干预后	差值	t值^a	P值^a
对照组	15	17.31±14.61	16.41±16.80	-0.90±5.28	0.657	0.522
试验组	15	16.92±17.82	9.36±13.46	-7.56±6.68	4.385	0.001
t值		-0.065	-1.269	-3.032
P值		0.949	0.215	0.005

组别	n	干预前	干预后	差值	t值^a	P值^a
对照组	15	4.60±3.41	4.32±3.19	-0.28±0.62	2.027	0.098
试验组	15	4.78±3.61	2.81±2.40	-1.96±1.98	3.826	0.002
t值		0.137	-1.457	-3.128
P值		0.892	0.157	0.006

组别	n	干预前	干预后	差值	t值^a	P值^a
对照组	15	1.84±0.99	1.87±1.27	0.04±0.67	-0.196	0.847
试验组	15	2.02±1.62	1.13±0.35	-0.89±1.36	2.527	0.024
t值		0.357	-2.189	-2.382
P值		0.724	0.044	0.024

Effect of galvanic vestibular stimulation on stroke patients with lateropulsion

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组别	n	干预前	干预后	差值	t值^a	P值^a
对照组	15	1.90±1.13	1.58±1.06	-0.32±0.27	4.461	0.001
试验组	15	1.77±1.05	0.47±0.66	-1.30±0.59	8.510	< 0.001
t值		-0.335	-3.455	-5.838
P值		0.740	0.002	< 0.001

组别	n	干预前	干预后	差值	t值^a	P值^a
对照组	15	19.67±14.92	23.33±15.70	3.67±4.22	-3.365	0.005
试验组	15	20.33±15.31	29.73±15.20	9.40±5.32	-6.849	< 0.001
t值		0.121	1.135	3.272
P值		0.905	0.266	0.003

时间	对照组						试验组						Z值	P值
时间	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
干预前	8	3	4	0	0	0	4	5	3	0	3	0	-1.527	0.127
干预后	3	6	4	2	0	0	0	2	7	0	2	4	-2.862	0.004
Z值	-3.407						-3.000
P值	0.001						0.003

组别	n	干预前	干预后	差值	t值^a	P值^a
对照组	15	48.67±18.94	55.00±17.83	5.63±4.80	-5.104	< 0.001
试验组	15	51.67±21.77	67.33±20.25	15.67±5.63	-10.783	< 0.001
t值		0.403	1.770	4.885
P值		0.690	0.088	< 0.001

指标	r值	P值
SVV方向性	0.402	0.028
SVV稳定性	0.490	0.006
SCT	0.438	0.015
BBS	-0.381	0.038
BI	-0.398	0.029
FAC	-0.615	< 0.001

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