运动想象结合经颅超声神经肌肉刺激对脑卒中患者上肢功能及日常生活能力改善效果研究

Effects of motor imagery combined with transcranial ultrasound neuromuscular electrical stimulation on upper limb and daily living ability in patients with stroke

目的观察运动想象结合经颅超声神经肌肉刺激对改善脑卒中患者上肢功能及日常生活能力临床疗效。方法2019年1-6月在该科住院脑卒中伴上肢功能障碍的患者45例,采用随机数字表法分为对照组、观察组和试验组,每组15例。三组均进行常规药物治疗及康复训练,观察组同时配合运动想象,试验组在观察组的基础上加用经颅超声神经肌肉电刺激治疗。于治疗前及治疗4周后分别采用Fugl-Mayer评定量表(FMA)、改良Bathel指数(MBI)评定脑卒中上肢功能及日常生活能力。结果三组患者治疗前FMA、MBI评分比较,差异均无统计学意义(P>0.05)。治疗4周后,三组患者FMA、MBI评分较治疗前均有显著改善,且观察组及试验组较对照组改善明显,试验组较观察组改善明显,差异均有统计学意义(P<0.05)。结论在康复训练基础上,运动想象联合经颅超声神经肌肉电刺激可显著提高脑卒中后上肢功能及日常生活能力。

Objective To observe effects of motor imagery combined with transcranial ultrasound neuromuscular electrical stimulation on upper limb and activity of daily living in stoke patients.Methods From January to June 2019,45 patients with cerebral apoplexy and upper limb dysfunction hospitalized in the department were divided into control group,observation group and experimental group by random number table method,with 15 patients in each group.All three groups received conventional drug treatment and rehabilitation training,the observation group was combined with motor imagination,and the experimental group was treated with transcranial ultrasound neuromuscular electrical stimulation on the basis of the observation group.Fugl-Mayer rating scale(FMA)and modified Bathel index(MBI)were used to assess the upper limb and daily living ability of stroke before and 4 weeks after treatment.Results There were no statistically significant differences in FMA and MBI scores between the three groups before treatment(P>0.05).After 4 weeks of treatment,FMA and MBI scores in the three groups were significantly improved compared with those before treatment,and the improvement in the observation group and the experimental group were significantly better than those in the control group,and the improvement in the experimental group were significantly better than those in the observation group,with statistically significant differences(P<0.05).Conclusion On the basis of rehabilitation training,motor imagination combined with transcranial ultrasound neuromuscular electrical stimulation can significantly improve upper limb function and daily living ability after stroke.