【摘要】 目的:探讨功能性电刺激(FES)对脑卒中偏瘫患者下肢功能的影响。方法:37例脑卒中早期患者分层后随机分为FES组(19例,年龄60.8±10.8岁,病程25.9±21.3d)和对照组(18例,年龄64.1±9.7岁,病程22.7±16.6d)。2组常规治疗相同,对照组不给予任何电刺激,FES组采用日本生产的低频电刺激治疗仪(KR7型)治疗,电极放在患侧胫前肌及腓骨长、短肌的运动点上;刺激参数为频率30Hz,脉宽200μs,通电/断电比5s/5s,波升/波降(1s/1s),电流以患者最大耐受强度为限。治疗每天1次,每次30min,共3周(15次)。用综合痉挛量表(CSS)评定踝关节痉挛,Fugl-Meyer运动评定量表中下肢部分(FMA)评定下肢运动功能,脑卒中患者姿势评定量表(PASS)和Berg平衡量表(BBS)评定平衡功能。结果:2组患者一般资料及治疗前各项评定结果差异无显著性意义。治疗2周和3周后,FES组与对照组(FESvs对照)CSS、FMA评分差异有显著性意义(P<0.05),增加率为2周时CSS:8.9%±23.2%vs36.3%±47.3%,FMA:105.5%±75.7%vs51.4%±47.3%。3周时CSS:10.4%±18.3%vs47.7%±56.4%,FMA:127.1%±89.4%vs64.3%±51.8%。结论:FES能延缓早期脑卒中患者偏瘫下肢痉挛的发生、减轻痉挛程度,改善下肢运动能力。更多还原

【Abstract】 Objective: To assess the efficacy of functional electrical stimulation (FES) in enhancing functional recovery of the lower extremity in subjects with acute stroke. Method: In a randomized controlled trial, 37 subjects with first stroke were randomly assigned into 2 groups: FES group or control group. The electrodes of the FES group(n=19) were applied on the motor point of the tibial muscle, peroneal muscle and peroneus brevis. The stimulation current intensity was set to produce full ankle extension with a duty cycle of 5 seconds on and 5 seconds off. The stimulus pulse was a symmetric biphasic waveform with amplitude ranging between 0 to 90mA, frequency 30Hz, pulse width of 200ms, and rise and fall time of 2s each. The current amplitude was adjusted to meet subject′s comfort. It lasted for 30 minutes per day, 5 days per week for 3 weeks. All subjects in the 2 groups received standard rehabilitation program. Measurements included composite spasticity scale(CSS) for the ankle planter flexors, Fugl-Meyer motor assessment(FMA) for the lower extremity, Postural Assessment Scale for Stroke patients(PASS) and Berg Balance Scale(BBS) for stability. Measurements were recorded before and after 2 and 3 weeks of treatment. Result: Before treatment, there were no significant differences between the two groups for age, time post-stroke, stroke severity, and the baseline of measurements. After 2 and 3 weeks of treatment, the percentage of CSS score in the FES group was 8.9%±23.2% and 10.4%±18.3%, which was significantly lower than the control group (36.3%±47.3% and 47.7%±56.4%).The percentage of FMA score in the FES group was 105.5%±75.7% and 127.1%±89.4%, significantly higher than the control group. Conclusion: Three weeks of FES to the affected lower extremity of subjects with early stroke improved their function recovery.更多还原