基于正常行走模式的功能性电刺激对老年脑卒中患者步行功能的影响

Effect of normal walking pattern-based functional electrical stimulation on walking function of elderly ischemic stroke patients

目的在常规康复训练基础上,对比基于正常行走模式的功能性电刺激与常规功能性电刺激对老年脑卒中患者步行功能恢复的疗效。方法选择2017年2~10月在山东省立第三医院康复中心进行康复治疗的脑卒中患者36例,随机分为对照组18例和治疗组18例。2组在常规康复治疗基础上,治疗组增加基于行走模式的功能性电刺激训练,30min/次,1次/d,每周6d,对照组采取常规神经肌肉电刺激训练,30min/次,1次/d,每周6d。2组分别在治疗前、治疗3周及6周对步行功能相关参数进行测定,包括Holden步行能力评分、10m步行速度、步行时空相关参数。结果治疗组治疗3周和6周有效率明显高于对照组(94.4%vs 83.3%,P<0.05;100.0%vs94.4%,P<0.05)。治疗组和对照组治疗3周和6周10m步行速度、步长、步速、步频较治疗前明显增快,步宽较治疗前明显缩窄,差异有统计学意义(P<0.05)。治疗组治疗6周10m步行速度、步长、步速、步频较对照组明显增快,步宽较对照组明显缩窄,差异有统计学意义(P<0.05)。结论基于正常行走模式的功能性电刺激较常规功能性电刺激更能改善老年脑卒中偏瘫患者的步行能力。

Objective To compare the effect of normal walking pattern-based functional electrical stimulation and conventional functional electrical stimulation on walking function of elderly ischemic stroke（IS）patients based on conventional rehabilitation training.Methods Thirty six IS patients admitted to our hospital for rehabilitation were randomly divided into control group（n=18）and treatment group（n=18）.The patients in treatment group underwent conventional rehabilitation plus walking pattern-based functional electrical stimulation training（30 min,once a day）for 6 days a week and those in control group received conventional rehabilitation plus conventional neuromuscular electrical stimulation training（30 min,once a day）for 6 days a week.The walking function-related parameters,including Holden walking function score,10-minue walking speed,walking time and space,were detected before treatment and at weeks 3 and 6 after treatment.Results The effective rate of conventional functional electrical stimulation on walking function was significantly higher in treatment group than in control group at weeks 3 and 6 after treatment（94.4%vs 83.3%,P〈0.05;100.0% vs 94.4%,P〈0.05）.The 10-minute walking speed,step length,step speed were significantly faster and the step frequency was significantly higher at weeks 3 and 6 after treatment while the step width was significantly shorter before treatment in treatment group than in control group（P〈0.05）.Conclusion The effect of normal walking pattern-based functional electrical stimulation is better than that of conventional functional electrical stimulation on the walking function of elderly IS patients with hemiparalysis.