【摘要】 目的 观察痉挛肌电刺激配合基于日常功能的任务性作业训练在脑卒中后下肢痉挛患者功能恢复中的效果。方法 选取2022-02—2023-03聊城市第二人民医院收治的127例脑卒中后下肢痉挛患者为研究对象，采用随机数字表法分为A组（n=42）、B组（n=42）和C组（n=43）,A组采取基于日常功能的任务性作业训练干预，B组使用痉挛肌电刺激治疗仪治疗，C组采用痉挛肌电刺激治疗仪配合基于日常功能的任务性作业训练，分别于治疗前后对比3组CSS、FIM和FMA评分，对3组下肢步态和各关节活动角度进行分析，对比3组患者的生存质量。结果 治疗后，C组CSS评分明显低于A组和B组（P<0.05）,FIM和FMA评分显著高于A组和B组（P<0.05）;3组双支撑相时间、患侧支撑相时间、步态周期、步速、步幅和步频与治疗前比较，差异均有统计学意义（P<0.05）,C组双支撑相时间、患侧支撑相时间和步态周期均明显低于A组和B组（P<0.05）,C组步速、步幅和步频均明显高于A组和B组（P<0.05）;3组踝关节背屈、膝关节屈曲、髋关节屈曲与治疗前对比，差异均有统计学意义（P<0.05）,C组踝关节背屈、膝关节屈曲、髋关节屈曲角度明显高于A组和B组（P<0.05）。治疗后1个月和3个月，C组生存质量得分明显低于A组和B组（P<0.05）。结论 痉挛肌电刺激配合基于日常功能的任务性作业训练可减轻脑卒中患者下肢痉挛的严重程度和残疾程度，提高下肢的肢体功能，有效改善步态参数和下肢的关节活动度，改善预后，提高生存质量。更多还原

【Abstract】 Objective To observe the effects of spastic muscle electrical stimulation(SMES) combined with daily functional-based task-oriented training(DF-TOT) on functional recovery in post-stroke patients with lower limb spasticity.Methods A total of 127 post-stroke patients with lower limb spasticity admitted to Liaocheng Second People’s Hospital from February 2022 to March 2023 were enrolled and randomly divided into Group A(n=42),Group B(n=42),and Group C(n=43) using random number table. Group A received DF-TOT, Group B received SMES, and Group C underwent SMES combined with DF-TOT. The clinical spasticity scale(CSS),functional independence measure(FIM),and Fugl-Meyer assessment(FMA) scores were compared before and after treatment. Lower limb gait parameters(double support phase duration,affected-side support phase duration,gait cycle,walking speed,stride length,and cadence)and joint range of motion(ankle dorsiflexion,knee flexion,and hip flexion)were analyzed. The quality of life(QoL)score was also evaluated.Results After treatment,Group C showed significantly lower CSS scores and higher FIM and FMA scores compared to Group A and Group B(P<0.05). All the three groups exhibited statistically significant improvements in gait parameters and joint angles compared to baseline(P<0.05). Group C demonstrated shorter double support phase duration,affected-side support phase duration,and gait cycle,along with greater walking speed,stride length,cadence,and joint angles than Group A and Group B(P<0.05). At 1 month and 3 months post-treatment,Group C achieved significantly higher QoL scores than the other groups(P<0.05).Conclusion The combination of SMES and DF-TOT alleviates lower limb spasticity severity and disability,enhances limb function,improves gait parameters and joint mobility,and optimizes prognosis and quality of life in post-stroke patients.更多还原