经颅直流电刺激联合上肢机器人对脑梗死恢复期患者上肢运动功能及表面肌电图信号影响研究

Effects of transcranial direct current electrical stimulation combined with upper limb robots on upper limb motor function and surface electromyogram signal in patients with cerebral infarction during convalescence

目的观察经颅直流电刺激联合上肢机器人对脑梗死恢复期患者痉挛上肢运动功能及表面肌电图信号的影响。方法将脑梗死恢复期患者72例随机分为对照组和治疗组各36例,对照组采用常规康复运动疗法,治疗组在对照组基础上联合经颅直流电刺激联合上肢机器人治疗。比较2组临床疗效以及治疗前后Fugl-Meyer运动功能评估(Fugl-Meyer motor Assessment,FMA)评分、改良Ashworth量表(Modified Ashworth Scale,MAS)评分、患侧上肢肱二头肌协同收缩率和肱三头肌协同收缩率。结果治疗组临床疗效优于对照组,治疗组总有效率明显高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组FMA评分明显高于治疗前,MAS评分、肱二头肌协同收缩率、肱三头肌协同收缩率明显低于治疗前,治疗组FMA评分明显高于对照组,MAS评分、肱二头肌协同收缩率、肱三头肌协同收缩率明显低于对照组,差异均有统计学意义(P<0.05)。结论经颅直流电刺激联合上肢机器人能够有效改善脑梗死恢复期患者痉挛上肢运动功能,降低肌张力,促进患者康复,值得临床推广。

Objective To observe the effects of transcranial direct current stimulation combined with upper limb robots on motor function and surface electromyogram signal of spastic upper limbs in patients with cerebral infarction during convalescence.Methods A total of 72 patients with cerebral infarction in convalescent stage were randomly divided into control group and treatment group,36 cases in each group.The control group was treated with routine rehabilitation exercise therapy,while the treatment group was treated with transcranial direct current stimulation combined with upper limb robot on the basis of the control group.The clinical efficacy,Fugl-Meyer motor Assessment(FMA),Modified Ashworth Scale(MAS),biceps brachii synergistic contraction rate and triceps brachii synergistic contraction rate were evaluated before and after treatment.Results The clinical efficacy of the treatment group was better than that of the control group,and the total effective rate of the treatment group was significantly higher than that of the control group(P<0.05).After treatment,the FMA scores of the two groups were significantly higher than those before treatment.The MAS scores,biceps brachii synergistic contraction rate and triceps brachii synergistic contraction rate were significantly lower than those before treatment.The FMA scores of the treatment group were significantly higher than those of the control group,while the MAS scores,biceps brachii synergistic contraction rate and triceps brachii synergistic contraction rate were significantly lower than those of the control group(P<0.05).Conclusion Transcranial direct current stimulation combined with upper limb robots can effectively improve the motor function of spastic upper limbs in patients with cerebral infarction in convalescence,reduce muscle tension and promote the rehabilitation of patients,which is worthy of clinical promotion.