超声电刺激结合目标设置理念下康复训练治疗对脑卒中偏瘫患者周围神经电生理学和形态学的影响

The effects of ultrasonic electrical stimulation combined with rehabilitation training therapy under goal setting concept on electrophysiology and morphology of peripheral nerve in patients with stroke hemiplegia

目的探讨超声电刺激结合目标设置理念下康复训练治疗对脑卒中偏瘫患者周围神经电生理学和形态学的影响。方法选取80例脑卒中偏瘫患者,按照随机数字表法分为对照组和观察组各40例,对照组采用早期常规康复治疗,观察组在此基础上给予超声电刺激结合目标设置理念下康复训练治疗。另选取同期40例体检健康人作为健康组。比较三组周围神经电生理学、形态学。比较观察组与对照组治疗前后肢体运动功能、自理能力、生活质量。结果观察组和对照组胫神经及腓总神经的感觉神经传导速度(SCV)、运动神经传导速度(MCV)均低于健康组,观察组治疗后胫神经及腓总神经的SCV、MCV均高于对照组(P<0.05);观察组和对照组偏瘫侧正中神经(MN)各位点宽度均低于健康组(P<0.05);观察组治疗后偏瘫侧MN各位点宽度均大于对照组,上肢运动功能评分、下肢运动功能评分、Barthel评分、QOL评分均高于对照组(P<0.05)。结论超声电刺激结合目标设置理念下康复训练治疗能够促进脑卒中偏瘫患者周围神经传导功能恢复,改善周围神经形态,恢复肢体运动功能,提升自理能力及生活质量。

Objective To explore the effects of ultrasonic electrical stimulation combined with rehabilitation training therapy under goal setting concept on electrophysiology and morphology of peripheral nerve in patients with stroke hemiplegia.Methods Eighty patients with stroke hemiplegia were divided into control or observation group by random number table method,40 in each group.The control group was given early routine rehabilitation therapy while the observation group was given ultrasonic electrical stimulation combined with rehabilitation training therapy under goal setting concept on this basis.Another 40 healthy people who underwent physical examinations during the same period were enrolled as healthy group.The electrophysiology and morphology of peripheral nerve among the three groups were compared.Limb motor function,self-care ability and quality of life before and after treatment between the observation group and the control group were also compared.Results After treatment,sensory conduction velocity(SCV)and motor conduction velocity(MCV)of tibial nerve and common peroneal nerve in the observation group and the control group were lower than those in the healthy group.SCV and MCV of tibial nerve and common peroneal nerve in the observation group were higher than those in the control group(P<0.05).After treatment,width of median nerve(MN)at hemiplegia side in the observation group and the control group was lower than that in the healthy group(P<0.05).After treatment,width of MN at hemiplegia side in the observation group was higher than that in the control group.scores of upper and lower limbs motor function in the observation group were higher than those in the control group.Scores of Barthel and QOL in the observation group were higher than those in the control group(P<0.05).Conclusion Ultrasonic electrical stimulation combined with rehabilitation training therapy under goal setting concept can promote the recovery of peripheral nerve conduction function in patients with stroke hemiplegia,improve the peripheral nerve morphology,restore the limbs motor function and improve the self-care ability and quality of life.