主动功能性电刺激转车对中重度偏瘫患者上肢功能的影响

关键词：脑卒中  偏瘫  上肢  电刺激  转车

Keywords:stroke  hemiplegia  upper extremity  electric stimulation therapy  cycling

摘要：

      摘要 目的：探讨主动功能性电刺激转车对中重度偏瘫患者上肢功能的影响。 方法：40例中重度偏瘫患者随机分为功能性电刺激转车结合常规治疗组（19例）或常规治疗组（21例）。治疗前后应用上肢Fugl-Meyer (FMA-UE)运动评分（包括近端肢体、腕、手、协调）、改良Ashworth量表(MAS)、改良Barthel指数(MBI)分别评定上肢运动功能、肱二头肌及肱三头肌肌张力、日常生活活动能力。 结果：治疗前，以上各项评估指标组间比较，差异均无显著性意义(P>0.05)。治疗后，两组除肱三头肌MAS及FMA（腕）评分外其余指标均较治疗前增高(P<0.05)；试验组仅FMA(近端)较对照组有明显改善(P<0.05)，但试验组FMA-UE评分超过最小临床重要差异值的比例较对照组多(P<0.05)。 结论：主动功能性电刺激转车可促进中重度偏瘫患者上肢近端运动功能的恢复。

Abstract:

      Abstract Objective: To investigate the effects of active functional electrical stimulation cycling (FES-cycling) on moderate-to-severe upper limb motor function after stroke. Method: Forty subjects were randomly divided into FES-cycling combined with conventional treatment group (n=19) or conventional treatment group (n=21). Fugl-Meyer Assessment-Upper Extremity (FMA-UE) motor score (including proximal limb， wrist， hand and coordination subsections)， Modified Ashworth Scale (MAS) and Modified Barthel Index (MBI) were used to evaluate upper-limb motor function， the muscle tone of biceps muscle and triceps muscle and activities of daily living. Result: There was no significant difference found in all above indexes before intervention (P>0.05). Significant differences between before and after intervention were observed in the FMA-UE， FMA (proximal limb)， FMA (hand)， FMA (coordination)， MAS for biceps and MBI， but not in FMA (wrist) and MAS for triceps. Only FMA (proximal limb) in the experiment group was significantly improved better than the control group (P<0.05)，but the proportion of subjects who exceeded the minimal clinically important difference of FMA-UE was higher in comparison to the control group （P<0.05）. Conclusion: Active FES-cycling could promote the proximal arm motor recovery in moderate-to-severe hemiplegic patients.