肌电诱发神经肌肉电刺激对脑梗死偏瘫患者肌肉表面肌电图及步态时空参数的影响观察

Observation on the effects of myoelectricity-induced neuromuscular electrical stimulation on muscle surface electromyography and gait spatiotemporal parameters in patients with hemiplegia due to cerebral infarction

目的 探讨肌电诱发联合神经肌肉电刺激(NMES)对脑梗死偏瘫患者肌肉表面肌电图及步态时空参数的影响。方法 选取2020年10月至2022年10月我院收治的脑梗死偏瘫患者270例,根据随机数表法分为肌电诱发组与NMES组各135例。检测并分析两组患侧肌肉表面肌电值、粗大运动功能量表(GMFM)评分、日常生活活动能力指数(BI)及步态时空参数水平变化。结果 治疗6周后,肌电诱发组肱二头肌、胫骨前肌、腓肠肌表面肌电值、GMFM和BI评分显著高于NMES组(P<0.05);两组步态周期、双足支撑时间、步宽显著降低(P<0.05),步频、步速、步长、步幅、患侧支撑时间、健侧支撑时间显著增大(P<0.05),肌电诱发组步态周期、双足支撑时间、步宽显著低于NMES组(P<0.05),患侧支撑时间、步频、步速、步长、步幅显著大于NMES组(P<0.05)。结论 肌电诱发NMES治疗可显著改善脑梗死偏瘫患者步态,促进神经功能恢复,提高患者生活质量。

Objective To explore the effects of myoelectricity-induced neuromuscular electrical stimulation(NMES)on muscle surface electromyography(sEMG)and gait spatiotemporal parameters in patients with cerebral infarction and hemiplegia.Methods A total of 270 patients with cerebral infarction and hemiplegia admitted to our hospital were enrolled between October 2020 and October 2022.The patients were divided into a myoelectricity-induced NMES group and a NMES group by using random number table method,135 in each group.The changes in sEMG,gross motor function scale(GMFM)scores,daily living activity index(BI),and gait spatiotemporal parameters of the two groups were detected and analyzed.Results After 6 weeks of treatment,sEMG values of tibialis anterior muscle,biceps and gastrocnemius in the myoelectricity-induced group were significantly greater than those in the NMES group(P<0.05).The scores of GMFM and BI in the myoelectricity-induced group were significantly higher than those in the NMES group(P<0.05).After 6 weeks of treatment,gait cycle,feet support time and stride width were significantly decreased in both groups(P<0.05),while stride frequency,walking speed,step length,stride length,support time of ffected side and healthy side were significantly increased(P<0.05).The gait cycle,feet support time and stride width in the myoelectricity-induced group were significantly lower than those in the NMES group(P<0.05),while support time of affected side,stride frequency,walking speed,step length and stride length were significantly higher(P<0.05).Conclusions The myoelectricity-induced NMES can significantly improve the gait of patients with cerebral infarction and hemiplegia,promote the recovery of neurological function,and improve the quality of life of the patients.