广州医科大学学报

目的:探讨神经肌肉电刺激疗法(NMES)对脑卒中偏瘫患者步态时空参数和对称性参数的影响。方法:选取2018年2月至2020年2月广东省江门市新会区人民医院收治的恢复期脑卒中偏瘫患者120例作为研究对象,随机分为NMES组(n=60)和常规组(n=60)。两组患者均予常规康复治疗,NMES/次,持续治疗4周。采用简易步态测试两组患者治疗前后的时空参数(步频、步幅、步速、步宽)与对称性参数(步长偏差、健侧患侧支撑相比值、患侧健侧摆动相比值)差异,并采用Fugl-Meyer运动功能评定量表(FMA)及Berg平衡量表(BBS)评定两组患者治疗前后功能障碍程度及平衡能力。结果:与治疗前比较,两组患者治疗后步频、步幅、步速及步宽升高(P<0.05),步长偏差、健侧患侧支撑相比值及患侧健侧摆动相比值降低(P<0.05);其中NMES组上述指标优于常规组(P<0.05),FMA及BBS评分高于常规组(P<0.05)。结论:神经肌肉电刺激疗法可使脑卒中偏瘫患者的步态时空参数和对称性参数升高,有效改善步行能力和下肢运动功能,促进快速康复。

Objective:To investigate the effect of neuromuscular electrical stimulation(NMES)on gait spatiotemporal parameters and symmetry indexes in hemiplegic stroke patients.Methods:Included were 120 hemiplegic patients with stroke during their convalescent stage admitted to Xinhui District People's Hospital,Jiangmen of Guangdong Province,between February 2018 and February 2020. The subjects were randomly divided into NMES group(n= 60)and conventional treatment group(n= 60). The patients in the two groups received conventional rehabilitation. The NMES group received NMES therapy in addition to the conventional rehabilitation,which was delivered by once-daily 30-minute stimulation sessions for consecutively four weeks. A simple gait test was used to measure the differences in spatiotemporal parameters(stride frequency,stride length,gait speed,and step width)and symmetry indexes(step length variability,support time ratio of the ipsilateral to contralateral side,and swing time ratio of the ipsilateral to contralateral side)between baseline and after treatment in the two groups. Fugl-Meyer Assessment(FMA)scale and Berg Balance Scale(BBS)were used to assess the dysfunction and balance in the two groups of patients before and after treatment.Results:Compared with baseline,the two groups showed increased stride frequency,stride length,gait speed and step width(P<0.05),lowered step length variability,support time ratio of ipsilateral to contralateral side,and swing time ratio of ipsilateral to contralateral side,after treatment(P<0.05). The changes in these indicators were more favorable in the NMES group than those in the conventional treatment group(P<0.05). The MNES group also showed higher FMA and BBS scores than did the conventional treatment group(P<0.05).Conclusion:NMES therapy can increase the spatiotemporal parameters and symmetry indexes,effectively improve the walking ability and lower limb motor function,and promote rapid recovery in hemiplegic stroke patients.