神经肌肉关节促进法对脑梗死偏瘫患者下肢肌张力的影响

Effect of neuromuscular joint facilitation treatment on lower extremity muscle tone in hemiplegic patients with cerebral infarction

目的探讨神经肌肉关节促进法(NJF)对脑梗死偏瘫患者下肢肌张力的治疗作用及效果。方法收集脑梗死患者136例,根据是否使用NJF治疗分为治疗组(66例)与对照组(70例)。分别在治疗前、治疗10 d后采用改良Ashworth量表评定2组患者偏瘫侧的下肢肌张力,Brunnstrom分期评定2组患者偏瘫侧下肢运动功能,根据转移时所需帮助量的程度评定患者的转移能力(包括卧坐转移、坐站转移),Bobath法平衡功能评定患者平衡能力,Holden功能性步行量表评定患者步行能力。结果治疗10 d后治疗组患者下肢高肌张力降低比例为21.2%,高于对照组的1.4%(P<0.001);治疗组患者坐站转移能力好转比例为47.0%,高于对照组的27.1%(P<0.05)。结论NJF治疗有利于降低脑梗死偏瘫患者下肢的高肌张力,使其趋于正常水平,有助提高其坐站转移能力。

Objective To evaluate the intervention effect and efficacy of neuromuscular joint facilitation(NJF)treatment on the lower extremity muscle tone in hemiplegic patients with cerebral infarction.Methods A total of 136 patients with cerebral infarction were enrolled and divided into the treatment group(n=66)and control group(n=70)according to whether NJF treatment was adopted.The lower extremity muscle tone on the hemiplegic side in the two groups was evaluated by the modified Ashworth scale before and 10 d after intervention.The lower extremity motor function on the hemiplegic side was assessed by Brunnstrom stages.The transfer ability of all patients was evaluated according to the amount of assistance needed for transfer(including lying-sitting transfer,sitting-standing transfer).The balance capability was evaluated by Bobath balance grading.The walking ability was evaluated by Holden functional ambulation category scale(FAC).Results After 10 d intervention,the lower extremity high muscle tone in the treatment group was reduced by 21.2%,higher than 1.4% in the control group,and the difference was statistically significant(P<0.001).The proportion of patients with improved sitting-standing transfer capability in the treatment group was 47.0%,higher compared with 27.1%in the control group,and the difference was statistically significant(P<0.05).Conclusion NJF treatment is beneficial to adjust the lower extremity muscle tension to normal level and effectively improve the ability of sitting and standing transfer in hemiplegic patients with cerebral infarction.