助力电刺激联合任务导向性训练对卒中足下垂患者下肢运动功能的作用

Effect of power electrical stimulation in combination with task-oriented training on lower extremity motor function in stroke patients with foot drop

目的探讨助力电刺激联合特定任务性训练对卒中足下垂患者下肢运动功能的作用。方法回顾性纳入卒中后足下垂患者50例,分为试验组和对照组,每组患者25例。对照组采用常规康复治疗,试验组在此基础上应用助力电刺激联合任务导向性训练。对两组患者训练2次/d,40 min/次,5 d/周,连续6周。均于治疗前后进行踝关节活动度、跖屈肌群肌张力及胫前肌肌力的测定,运用Berg平衡积分、Fugl-Meyer下肢运动积分、改良Barthel指数、Holden步行功能分级等对患者的平衡和下肢运动功能进行评定。同时对步速、步长进行治疗前后的比较。结果治疗6周后,试验组患者踝关节活动度、跖屈肌群张力、胫前肌肌力评分较治疗前均有改善,且各指标明显优于对照组(t值分别为6.261、-6.163、2.968,均P<0.05);Berg平衡积分、步速、步长评分较治疗前也均有提高,且各指标明显优于对照组(t值分别为10.733、9.074、9.013,均P<0.01);下肢运动积分、改良Barthel指数、Holden步行功能分级评分较治疗前均有提高,且各指标明显优于对照组(t值分别3.261、7.573、4.010,均P<0.05)。结论应用助力电刺激联合任务导向性训练可有效改善卒中足下垂患者的下肢运动功能。

Objective Toinvestigatetheeffectofpowerelectricalstimulation（PES）incombination withtask-specifictrainingonlowerextremitymotorfunctioninstrokepatientswithfootdrop.Methods Fifty patients with poststroke foot drop were enrolled retrospectively. They were divided into either an experimental group or a control group （n=25 in each group）. The control group received routine rehabilitation treatment. On this basis,the experimental group was given PES in combination with task-oriented training. Both groups of patients were trained 2 times a day,once for 40 minutes,5 days a week for 6 weeks. The ankle active range of motion,plantar flexor muscle tension,and tibialis anterior muscle strength were determined before and after treatment. The balance and lower extremity motor function of the patients were assessed by using Berg balance scale score,Fugl-Meyer lower extremity score,modified Barthel index,and Holden walk grading. At thesametime,thewalkingspeedandsteplengthbeforeandaftertreatmentwerecompared.Results Six weeks after treatment,the ankle activity,plantar flexors tension,and tibialis anterior muscle strength scores in patients of the experimental group were improved compared with before treatment,and each indicator was significant better than the control group （t=6. 261,-6. 163,and 2. 968,respectively;all P〈0. 05）. Berg balance scale,walking speed and step length scores were also improved as compared with before treatment, and each indicator was better than the control group （t=10. 733,9. 074,and 9. 013,respectively;all P〈0.01）. The lower limb motion scores,modified Barthel indexes,and Holden walk grading scores were improved compared with before treatment,and each indicator was significantly better than the control group （t=3.261,7.573,and4.010,respectively;allP〈0.05）.Conclusion Usingpowerelectricalstimulation in combination with task-oriented training may effectively improve the lower extremity motor function in stroke patients with foot drop.