神经肌肉电刺激联合肌氧监测指导下肢抗阻训练治疗中风后偏瘫患者的临床研究

Clinical study of neuromuscular electrical stimulation combined with muscle oxygen monitoring in the treatment of hemiplegia after stroke with lower extremity resistance training

目的:探讨神经肌肉电刺激(Neuromuscular electrical stimulation,NMES)联合肌氧监测指导下肢抗阻训练治疗中风后偏瘫患者的临床疗效。方法:选取2020年5月至2021年5月我院收治的60例中风后偏瘫患者作为研究对象,采用随机数字表法将其分为对照组和观察组,各30例。对照组患者采取常规康复训练和NMES治疗,观察组患者在对照组基础上增加肌氧监测指导下肢抗阻训练治疗。两组连续干预4 w。比较两组干预前后平衡功能、下肢运动功能、步态参数、步行功能、10 m步行时间速度(Maximum walking speed,MWS)、患侧腿竖脊肌、腹直肌均方根(Rootmean square,RMS)值。结果:干预后观察组Berg平衡量表(Berg balance scale,BBS)评分、Fugl-Meyer运动功能评估量表(Fugl-Meyer scale of motor function assessment,FMA)评分、改良Barthel指数(Modified Barth-el index,MBI)评分、功能性步行分级量表(Functional ambulation categories,FAC)评分、10 m MWS均高于对照组(P<0.05);干预后观察组步速、步频、患侧步长均高于对照组(P<0.05);干预后观察组患侧腿前屈45°(竖脊肌、腹直肌)、后伸30°(竖脊肌、腹直肌)RMS值均高于对照组(P<0.05)。结论:NMES结合肌氧监测指导下肢抗阻训练可改善中风后偏瘫患者平衡功能、下肢运动功能,并提升日常生活活动能力。

Objective:To investigate the clinical efficacy of neuromuscular electrical stimulation(NMES)combined with muscle oxygen monitoring in the treatment of hemiplegia after stroke under the guidance of lower extremity resistance training.Methods:A total of 60 patients with post stroke hemiplegia admitted to our hospital from May 2020 to May 2021 were selected as research objects,and they were randomly divided into control group and observation group with 30 patients in each group.The patients in the control group were treated with routine rehabilitation training and NMES.The patients in the observation group added muscle oxygen monitoring on the basis of the control group to guide the treatment of lower limb resistance training.The two groups were intervened continuously for 4 weeks.The balance function,lower limb motor function,gait parameters,walking function,maximum walking speed(MWS),root mean square(RMS)values of the affected leg erector spinal muscle and rectus abdominis muscle were compared between the two groups before and after intervention.Results:After intervention,the scores of Berg balance scale(BBS),Fugl Meyer scale of motor function assessment(FMA),Modified Barthel index(MBI),Functional ambulation categories(FAC)and 10 m MWS in the observation group were higher than those in the control group(P<0.05).After intervention,the step speed,step frequency and step length of the affected side in the observation group were higher than those in the control group(P<0.05).After intervention,the RMS values of the affected leg in the observation group were higher than those in the control group(P<0.05).Conclusion:NMES combined with muscle oxygen monitoring can improve the balance function and lower limb motor function of hemiplegic patients after stroke,and enhance the ability of activities of daily living.