头针联合助行功能性电刺激促进脑卒中后步行及平衡功能的前瞻性研究

关键词：脑卒中  步行功能  平衡功能  头针  助行功能性电刺激

Keywords:post-stroke  walking function  balance function  scalp acupuncture  functional electrical stimulation

摘要：

      摘要 目的：探讨头针联合助行功能性电刺激（FES）对脑卒中患者步行及平衡功能的影响。 方法：采取平行随机对照研究，纳入符合标准的脑卒中步行功能障碍患者36例，随机分为头针联合助行FES组和助行FES组，每组各18例。两组在常规康复治疗基础上，助行FES组加助行FES，头针联合助行FES组增加头针干预。训练及头针每次30min，两组干预均为1次/d，持续1周。分别在干预前、干预1周后行功能性步行能力量表（FAC）、起立-行走计时测试（TUG）、10m步行计时测试（10MWT）6min步行试验（6MWT）和平衡功能（睁、闭眼运动轨迹面积及长度）的评定并分析干预周期中不良事件的发生率。 结果：①36例研究对象均完成了整个试验，两组干预基线情况一致（P>0.05）；②干预前后组内对比，步行功能（TUG、10MWT、6MWT）和平衡功能（睁、闭眼运动轨迹面积和长度）均较干预前提高（P<0.05）；③干预前后组间对比：头针联合助行FES组对平衡功能闭眼时运动轨迹面积和长度的改善优于单纯助行FES组（P<0.05），步行功能和平衡功能（睁眼状态下），两组干预前后差值对比无显著性意义（P>0.05）；④研究中无不良事件，无脱落。 结论：头针联合助行FES可以有效改善脑卒中后步行功能及平衡功能，其改善平衡功能的效果优于单纯助行FES。

Abstract:

      Abstract Objective： To explore the clinical efficacy of 1 week scale acupuncture combined with functional electrical stimulation on the walking and balance function in post-stroke patients. Method： This study was a parallel randomized controlled clinical trial study， involving 36 qualified subjects，which were randomly divided into two groups： Scale acupuncture combined FES group， or FES group， with 18 patients in each group. Patients received routine rehabilitation intervention， and patients in the FES group was given additional FES treatment， and patients in scalp acupuncture combined with FES group were given additional scalp acupuncture and FES treatment， once a day， 30min each time，for 1 week. Changes in the walking function and balance function were evaluated before and after intervention. The Functional Ambulation Category Scale （FAC）， Time up and go test （TUG）， the 10 Meters Walking Test （10MWT）， and the 6 Minute Walk Test （6MWT） were used to evaluate the walking function. Under both eyes-open and eyes-closed trials， the center of pressure （COP） area and perimeter of body sway were used to evaluate the motor function. All adverse events will be recorded. Result： All 36 participants completed the intervention. ①Before the intervention， there were no significant differences in age， gender， BMI， MoCA scale scores， and FAC， TUG， 6MWT， 10 MWT and the COP between the two groups （P>0.05）. ②After 1 weeks of intervention， the results of intra-group comparison of walking function and balance function were higher in both two groups（P<0.05）. ③After 1 weeks of intervention， the results of inter-group comparison of balance function showed that the eyes-closed COP area and perimeter of scalp acupuncture combined FES group were significantly higher than that of the FES group （P<0.05）. There was no significantly difference in walking function between the two groups （P>0.05）. ④There was no adverse event during the test flow. Conclusion： 1 week scalp acupuncture combined with FES have potential protective effect on the walking function and balance function in post-stroke patients. The eyes-closed balance function of scalp acupuncture combined FES group was significantly improved than that of FES group.