经颅直流电刺激联合任务导向性训练对脑卒中偏瘫上肢功能的影响

Effect of Transcranial Direct Current Electrical Stimulation Combined with Task Oriented Training on Upper Limb Function of Stroke Hemiplegic

目的:研究并探讨经颅直流电刺激联合任务导向性训练对脑卒中偏瘫上肢功能的影响。方法:选择本院2016年3月-2018年3月收治的68例脑卒中偏瘫患者为研究对象,采取随机数字表法将患者分为对照组和观察组,每组34例。对照组实施单纯任务导向性训练,观察组实施任务导向性训练联合经颅直流电刺激治疗。比较两组治疗前、治疗后2周、治疗后4周的康复效果,疗效评定采用神经功能缺损评分(NIHSS)、偏瘫上肢功能测试(香港版)(FTHUE-HK)、Fugel-Meyer运动功能评分法(FMA)(上肢部分)、Barthel指数(BI)、Brunnstrom上肢和手分级进行评定。结果:在康复效果方面,观察组总有效率高于对照组(P<0.05)。治疗后2、4周,观察组的神经功能缺损评分均低于对照组(P<0.05),其FTHUE-HK、Fugel-Meyer上肢运动功能评分、日常生活能力评分均高于对照组(P<0.05),其Brunnstrom上肢和手分级也均优于对照组(P<0.05)。结论:在脑卒中偏瘫患者康复阶段实施经颅直流电刺激联合任务导向性训练,可有效改善患者神经功能、上肢功能、日常生活能力,有利于提高其康复效果,改善预后。

Objective:To study the effects of transcranial direct current stimulation combined with taskoriented training on upper limb function of stroke hemiplegia.Method:68 stroke hemiplegic patients admitted in our hospital from March 2016 to March 2018 were selected,they were randomly divided into the control group and observation group,by digital random table method,34 cases in each group.The control group was treated with task-oriented training,the observation group was treated with task-oriented training combined with transcranial direct current stimulation.Before treatment,2 and 4 weeks after treatment,the rehabilitation effect were compared between the two groups,the curative effect was evaluated by NIHSS score and FTHUE-HKU,Fugel-Meyer motor function score for hemiplegia,BIBA Barthel index and Brunnstrom upper limb and hand grade.Result:The total effective rate of the observation group was higher than that of the control group(P<0.05).2 and 4 weeks after treatment,the scores of neurological defects in the observation group were all lower than those in the control group(P<0.05),FTHUE-HK,Fugel-meyer upper limb motor function score and daily living ability score were all higher than those in control group(P<0.05),Brunnstrom upper limb and hand grading were also better than those in control group(P<0.05).Conclusion:In the rehabilitation stage of hemiplegia patients with stroke,transcranial direct current stimulation combined with task-oriented training can effectively improve the neurological function,upper limb function and daily life ability of the patients,it is helpful to improve the rehabilitation effect and improve the prognosis.