| 徐奕鹏,侯甜,曲源,张虹,李金贤.基于行走模式的单关节与双关节功能性电刺激对脑卒中患者下肢功能及脑部弥散张量成像的影响[J].中国康复,2023,38(11):664-669 |
| 基于行走模式的单关节与双关节功能性电刺激对脑卒中患者下肢功能及脑部弥散张量成像的影响 |
| Effects of single-joint stimulation and double-joint stimulation based on walking pattern on lower limb function and brain DTI changes in convalescent patients with cerebral apoplexy |
| |
| DOI： |
| 中文关键词: 功能性电刺激 脑卒中 下肢运动功能 弥散张量成像 |
| 英文关键词: functional electrical stimulation stroke lower limb motor function diffusion tensor imaging |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2022D01C113）；新疆维吾尔自治区人民医院院内项目（20190311） |
|
| 摘要点击次数: 852 |
| 全文下载次数: 704 |
| 中文摘要: |
| 目的：探讨采用基于行走模式的单关节与双关节功能性电刺激（FES）对脑卒中恢复期患者下肢功能其脑部弥散张量成像（DTI)的影响。方法：纳入2021年3月～2022年3月在新疆维吾尔自治区人民医院就诊的脑卒中患者84例，按肌群刺激方式随机分为诱发踝、膝双关节活动肌群的双关节组及仅诱发踝关节肌群活动的单关节组，每组42例。双关节组患者接受基于正常行走模式的FES治疗仪的四通道治疗模式，单关节组患者接受同一FES治疗仪的双通道治疗模式共3周。评估2组患者治疗1周、2周及3周后下肢运动功能、平衡功能、步行功能以及日常生活活动能力的变化；同时比较2组患者治疗3周后DTI相关指标变化。结果：治疗1周、2周、3周后，2组患者Fugl-Meyer运动评定量表（FMA）、脑卒中患者姿势评定量表（PASS）、Berg平衡量表（BBS）及改良Barthel指数（MBI）评分均较治疗前升高(均P<0.05)；治疗后各时间点双关节组患者上述评分高于单关节组(均P<0.05)；治疗2周、3周后双关节组患者Holden步行功能分级高于单关节组患者(均P<0.05)；治疗3周后，2组患者各向异性分数比值(rFA)较治疗前均升高、各向异性分数不对称性(FAasy)较治疗前均降低，且双关节组患者rFA高于单关节组、FAasy低于单关节组(均P<0.05)。结论：基于正常行走模式的双关节FES对脑卒中患者的运动功能、平衡功能、行走功能及日常生活活动能力的改善优于单关节FES；DTI提示多通道FES较单关节FES更有利于患者脑组织病灶恢复，对于提高脑卒中患者康复治疗水平具有临床意义。 |
| 英文摘要: |
| Objective: To investigate the effects of walking pattern-based single-joint stimulation versus double-joint stimulation on lower limb function and changes in brain diffusion tension imaging (DTI) in convalescent patients with cerebral apoplexy. Methods: A total of 84 patients with stroke diagnosed in our hospital from March 2021 to March 2022 were randomly divided into multi-channel group (n=42) and double-channel group (n=42). The patients in the multi-channel group received the four-channel treatment mode of the FES therapeutic instrument, and those in the dual-channel group received the dual-channel treatment mode of the same FES therapeutic instrument. The lower limb motor function (FMA score), balance function (PASS score, BBS score, BBA score), walking function (Holden walking function grade) and activities of daily living (MBI score) were compared between the two groups after treatment for 1 week, 2 weeks and 3 weeks. The changes in related indexes (FA, rFA, RAasy) of magnetic resonance DTI were compared between the two groups at 3rd week after treatment. Results: After treatment for 1 week, 2 weeks and 3 weeks, the FMA score, PASS score, BBS score, BBA score and MBI score in the two groups were significantly higher than those before treatment, and there were significant differences between the two groups at each time point after treatment, especially in the multi-channel group (P<0.05). At 2nd and 3rd week after treatment, the improvement of Holden’s walking function in the multi-channel group was better than that in the dual-channel group (P<0.05). At 3rd week of treatment, the rFA in the two groups was signifi-cantly higher than that before treatment, and the FAasy was significantly lower than that before treatment, and there were significant differences in all indexes between the two groups. The changes of rFA and FAasy were more significant in the multi-channel group than in the dual-channel group (P<0.05). Conclusion: Multi-channel FES based on normal walking mode is more effective than dual-channel FES for stroke patients, and can significantly improve motor function, balance, walking function and activities of daily living. In addition, DTI suggested that multi-channel FES is more beneficial to the recovery of brain tissue lesions, which is significant to improve the rehabilitation treatment and prognosis of stroke patients. |
|
查看全文
下载PDF阅读器 HTML全文 |
| 关闭 |
|
|
|
