神经肌肉电刺激联合肌氧监测指导下抗阻训练治疗中风后偏瘫患者的临床研究

Clinical study on the Treatment of Hemiplegia Patients after Stroke with Resistance Training under the Guidance of neuromuscular electrical Stimulation and Muscle Oxygen Monitoring

目的研究神经肌肉电刺激联合肌氧监测指导下抗阻训练治疗中风后偏瘫患者的疗效。方法以2021年1月至2022年1月于开封市祥符区第一人民医院就诊的86例中风后偏瘫患者为研究对象,使用随机数字表法分为单一组和联合组,每组各43例。单一组采用肌氧监测指导下抗阻训练治疗,联合组采用神经肌肉电刺激联合肌氧监测指导下抗阻训练治疗。比较两组临床疗效,治疗前、治疗30 d后美国国立卫生院神经功能缺损量表(NIHSS)、Fugl-Meyer下肢运动功能评定量表(FMA)、日常生活能力评定量表(ADL)评分、大脑中动脉血流量[搏动指数(PI)、阻力指数(RI)、平均血流速度(Vm)]、步行参数(步幅、步速、患侧步长、双腿支持期)、关节活动度(髋关节活动度、膝关节活动度)。结果联合组治疗有效率(88.37%)高于单一组(69.77%),差异有统计学意义(P<0.05);治疗30 d后联合组NIHSS评分低于单一组,FMA、ADL评分高于单一组,差异有统计学意义(P<0.05);治疗30 d后联合组PI、RI低于单一组,Vm高于单一组,差异有统计学意义(P<0.05);治疗30 d后联合组步幅、步速、患侧步长、双腿支持期高于单一组,差异有统计学意义(P<0.05);治疗30 d后联合组髋关节活动度、膝关节活动度高于单一组,差异有统计学意义(P<0.05)。结论神经肌肉电刺激联、肌氧监测指导下抗阻训练联合治疗中风后偏瘫可取得良好疗效,能改善步行能力,提高关节活动度,促进脑大脑血液循环,从而增强肢体运动功能、日常生活能力。

Objective To study the effect of resistance training under the guidance of neuromuscular electrical stimulation and muscle oxygen monitoring on hemiplegia patients after stroke.Methods A total of 86 patients with post-stroke hemiplegia who were hospitalized in the first people's Hospital of Xiangfu District,Kaifeng City from January 2021 to January 2022 were selected as the study objects.They were divided into a single group and a combined group with 43 patients in each group by using a random number table.The single group was treated with resistance training under the guidance of muscle oxygen monitoring,and the combined group was treated with resistance training under the guidance of neuromuscular electrical stimulation and muscle oxygen monitoring.The clinical effects of the two groups were compared.Before treatment and 30 days after treatment,the scores of NIHSS,Fugl-Meyer lower limb motor function assessment scale(FMA),ADL,middle cerebral artery blood flow[pulsatility index(PI),resistance index(RI),average blood flow velocity(VM)],walking parameters(stride,pace,step length on the affected side,leg support period)and Joint mobility(hip joint mobility,knee joint mobility)were compared.Results The clinical effective rate of the combined group(88.37%)was higher than that of the single group(69.77%)(P<0.05);After 30 days of treatment,the NIHSS score of the combined group was lower than that of the single group,and the scores of FMA and ADL were higher than that of the single group(P<0.05);After 30 days of treatment,the PI and RI of the combined group were lower than those of the single group,and the VM was higher than that of the single group(P<0.05);After 30 days of treatment,the stride length,stride speed,stride length on the affected side and leg support period in the combined group were higher than those in the single group(P<0.05);After 30 days of treatment,the hip joint mobility and knee joint mobility of the combined group were higher than those of the single group,and the difference was statistically significant(P<0.05).Conclusion Resistance training under the guidance of neuromuscular electrical stimulation and muscle oxygen monitoring in the treatment of hemiplegia after stroke can achieve good effects,improve walking ability,improve joint mobility,promote brain blood circulation,and enhance limb motor function and daily living ability.