悬吊训练结合功能电刺激对脑卒中偏瘫上肢功能的影响

Effects of sling exercise therapy combined with functional electrical stimulation on upper limb function in stroke patients with hemiplegia

目的分析悬吊训练(SET)结合功能电刺激(FES)对脑卒中偏瘫上肢功能的影响。方法选取杭州市红十字会医院2020年11月至2022年12月脑卒中偏瘫患者70例,采用随机抽签法分为3组:实验组24例、对照组A 23例、对照组B 23例。3组均接受常规康复治疗,对照组A给予FES治疗,对照组B给予SET治疗,实验组给予SET联合FES治疗。4周后,比较3组Brunnstrom分期,上肢运动功能(FMA-UE)评分,视觉模拟评分(VAS),改良Barthel指数(MBI),肩关节活动度(前屈、外展、外旋、内旋),肩手肌群平均肌电值(三角肌前束、斜方肌上束)。结果治疗后实验组Brunnstrom V期改善程度大于对照组A、对照组B(P<0.05);治疗后实验组FMA-UE评分、MBI高于对照组A、对照组B,VAS低于对照组A、对照组B(P<0.05);治疗后实验组前屈、外展、外旋、内旋角度大于对照组A、对照组B(P<0.01);治疗后实验组三角肌前束、斜方肌上束平均肌电值高于对照组A、对照组B(P<0.01)。结论SET联合FES治疗脑卒中偏瘫可改善关节活动度,增强肌力,还可减轻患者疼痛程度,改善上肢功能,提升生活活动能力。

Objective To analyze the effect of sling exercise therapy(SET)combined with functional electrical stimulation(FES)on upper limb function of hemiplegia after stroke.Methods A total of 70 stroke patients with hemiplegia in Hangzhou Red Cross Hospital from November 2020 to December 2022 were selected and divided into 3 groups by random drawing method:experimental group(24 cases),control group A(23 cases)and control group B(23 cases).All the 3 groups received conventional rehabilitation treatment,control group A was given FES treatment,control group B was given SET treatment,and the experimental group was given SET combined with FES treatment.After 4 weeks,Brunnstrom stage,Fugl-Meyer Assessment for Upper Extremity(FMA-UE)score,Visual Analogue Scale(VAS)score,Modified Barthel Index(MBI),shoulder range of motion(anterior flexion,abduction,external rotation,internal rotation),and average EMG value of shoulder and hand muscle group(deltoid anterior bundle,trapezius superior bundle)were compared among the 3 groups.Results The improvement of Brunnstrom stage V in experimental group was greater than that in control group A and control group B after treatment(P<0.05).After treatment,FMA-UE score and MBI in experimental group were higher than those in control group A and control group B,and VAS score was lower than that of control group A and control group B(P<0.05).After treatment,the angles of anterior flexion,abduction,external rotation and internal rotation in experimental group were higher than those in control group A and control group B(P<0.01).After treatment,the average EMG value of the deltoid anterior bundle and the trapezius superior bundle in experimental group was higher than that in control group A and control group B(P<0.01).Conclusion SET combined with FES in the treatment of hemiplegia after stroke can improve the range of motion of joints,enhance muscle strength,reduce the degree of pain,improve the function of upper limbs,and improve the ability of life activities.