基于正常行走模式的功能性电刺激对脑卒中患者行走功能即时影响的随机对照研究

被引：18

作者：

张顺喜 ^{[1
]}

郭永亮 ^{[2
]}

贺灵慧 ^{[2
]}

吕晓 ^{[2
]}

燕铁斌 ^{[3
]}

机构：

[1] 广州市第一人民医院康复医学科

[2] 广东省三九脑科医院

[3] 中山大学孙逸仙纪念医院康复医学科广东省康复与养老工程技术研究中心

来源：

中国康复医学杂志 | 2019年 / 34卷 / 05期

基金：

广州市科技计划项目;

关键词：

功能性电刺激; 脑卒中; 步态分析; 随机对照研究;

D O I：

暂无

中图分类号：

R743.3 [急性脑血管疾病（中风）];

学科分类号：

100204 [神经病学];

摘要：

目的:通过三维步态分析系统,观察基于正常行走模式的功能性电刺激(FES)对脑卒中患者行走功能的即时影响,为其临床应用及推广提供依据。方法:将符合入组条件的47例脑卒中患者随机分为电刺激组(16例)、安慰电刺激组(15例)和对照组(16例)。电刺激组给予基于正常行走模式设计的四通道FES助行仪治疗,患者戴机行走5min;刺激肌肉分别为偏瘫侧胫前肌、股四头肌、腓肠肌及腘绳肌。安慰电刺激组的电刺激位置及行走时间与电刺激组相同,行走(5min)过程中没有电流输出;对照组不给予电刺激,只让患者行走5min。三组患者分别在治疗前及治疗5min后接受三维步态检查,并对结果进行分析。结果:三组组内治疗后与治疗前比较:电刺激组的步行周期、支撑时间、步行速度、步频、踝背伸角度、踝关节触地时角度均有改善(P<0.05);安慰电刺激组仅在踝关节背伸和踝关节触地时角度有改善(P<0.05);对照组所有参数均无改善,且跨步长缩短、踝关节背伸角度降低(P<0.05)。三组组间比较:治疗后只有触地时踝关节背伸角度差异有显著性意义(P<0.05)。进一步进行治疗前后变化率的组间比较,发现三组患者患侧步行周期、支撑时间、步行速度、步频、步长、跨步长、触地时踝关节背伸角度的差异均有显著性意义(P<0.05)。结论:应用基于正常行走模式的FES治疗5min即可改善脑卒中患者的即时步行功能,长期效果尚待研究。

引用

页码：527 / 532

页数：6

共 13 条

[1]

Virtual Reality Rehabilitation With Functional Electrical Stimulation Improves Upper Extremity Function in Patients With Chronic Stroke: A Pilot Randomized Controlled Study [J].

Lee, Stephanie Hyeyoung ;

Lee, Ji-Yeong ;

Kim, Mi-Young ;

Jeon, Yu-Jin ;

Kim, Suyoung ;

Shin, Joon-Ho .

ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 2018, 99 (08) :1447-1453

[2]

An assessment of the relationship between the items of the observational Wisconsin Gait Scale and the 3-dimensional spatiotemporal and kinematic parameters in post-stroke gait.[J].Agnieszka Guzik;Mariusz Drużbicki;Grzegorz Przysada;Agnieszka Brzozowska-Magoń;Andżelina Wolan-Nieroda;Andrzej Kwolek.Gait & Posture.2018,

[3]

FES-assisted Cycling Improves Aerobic Capacity and Locomotor Function Postcerebrovascular Accident [J].

Aaron, Stacey E. ;

Vanderwerker, Catherine J. ;

Embry, Aaron E. ;

Newton, Jennifer H. ;

Lee, Samuel C. K. ;

Gregory, Chris M. .

MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, 2018, 50 (03) :400-406

[4]

Restoration of reaching and grasping movements through brain-controlled muscle stimulation in a person with tetraplegia: a proof-of-concept demonstration.[J].A Bolu Ajiboye;Francis R Willett;Daniel R Young;William D Memberg;Brian A Murphy;Jonathan P Miller;Benjamin L Walter;Jennifer A Sweet;Harry A Hoyen;Michael W Keith;P Hunter Peckham;John D Simeral;John P Donoghue;Leigh R Hochberg;Robert F Kirsch.The Lancet.2017, 1008

[5]

Effect of normal-walking-pattern-based functional electrical stimulation on gait of the lower extremity in subjects with ischemic stroke: A self controlled study [J].

Xu, Benlei ;

Yan, Tiebin ;

Yang, Yuanle ;

Ou, Ruiqing ;

Huang, Shuping .

NEUROREHABILITATION, 2016, 38 (02) :163-169

[6]

Relationship between hip flexion and ankle dorsiflexion during swing phase in chronic stroke patients [J].

Roche, N. ;

Bonnyaud, C. ;

Geiger, M. ;

Bussel, B. ;

Bensmail, D. .

CLINICAL BIOMECHANICS, 2015, 30 (03) :219-225

[7]

Stroke and Stroke Care in China Huge Burden, Significant Workload, and a National Priority [J].

Liu, Liping ;

Wang, David ;

Wong, K. S. Lawrence ;

Wang, Yongjun .

STROKE, 2011, 42 (12) :3651-3654

[8]

Guidelines for the Primary Prevention of Stroke A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association [J].

Goldstein, Larry B. ;

Bushnell, Chair Cheryl D. ;

Adams, Robert J. ;

Appel, Lawrence J. ;

Braun, Lynne T. ;

Chaturvedi, Seemant ;

Creager, Mark A. ;

Culebras, Antonio ;

Eckel, Robert H. ;

Hart, Robert G. ;

Hinchey, Judith A. ;

Howard, Virginia J. ;

Jauch, Edward C. ;

Levine, Steven R. ;

Meschia, James F. ;

Moore, Wesley S. ;

Nixon, J. V. ;

Pearson, Thomas A. .

STROKE, 2011, 42 (02) :517-584

[9]

Repeatability and variability of baropodometric and spatio-temporal gait parameters – Results in healthy subjects and in stroke patients.[J].F.A. Valentini;B. Granger;D.S. Hennebelle;N. Eythrib;G. Robain.Neurophysiologie Clinique / Clinical Neurophysiology.2011, 4

[10]

Test–retest reliability of 3D kinematic gait variables in hip osteoarthritis patients.[J].D. Laroche;A. Duval;C. Morisset;J.-N. Beis;P. d’Athis;J.-F. Maillefert;P. Ornetti.Osteoarthritis and Cartilage.2010, 2

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