作者：丁彬鸿，冒文静，吴素青，冒鑫炜，张萌

单位：

226500江苏省如皋市人民医院康复医学科 通信作者：丁彬鸿，E-mail：dbh1569487320yyn@163.com

Units：

Department of Rehabilitation Medicine, the People's Hospital of Rugao, Rugao 226500, China Corresponding author: DING Binhong, E-mail: dbh1569487320yyn@163.com

关键词：

脑卒中; 偏瘫; 电刺激疗法; Bobath疗法; 步态分析;

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.151

Funds：

江苏省自然科学基金资助项目（BK20170820）

摘要：

目的 探讨功能性电刺激联合Bobath疗法对脑卒中偏瘫患者的影响。方法 选取2020年9月至2021年6月如皋市人民医院收治的脑卒中偏瘫患者76例。按照随机数字表法将患者分为参照组和试验组,各38例。参照组采用Bobath疗法,试验组采用功能性电刺激联合Bobath疗法。比较两组治疗前、治疗14 d后运动功能[Fugl-Meyer运动功能评定量表(FMA)下肢部分评分]、平衡能力[Berg平衡量表(BBS)评分]、日常生活能力[Barthel指数(BI)量表评分]、步态指标(步长、步宽、步速、步态周期)及下肢关节活动度(髋关节最大屈曲度、伸展度及膝关节最大屈曲度、伸展度),并对比治疗满意度。结果 治疗后,两组FMA下肢部分、BBS、BI量表评分分别高于本组治疗前,且试验组高于参照组(P<0.05);治疗后,两组步长、步宽、步速和髋关节最大屈曲度、伸展度及膝关节最大屈曲度分别大于本组治疗前,步态周期、膝关节最大伸展度分别小于本组治疗前,且试验组步长、步宽、步速和髋关节最大屈曲度、伸展度及膝关节最大屈曲度大于参照组,步态周期、膝关节最大伸展度小于参照组(P<0.05)。试验组治疗总满意度为94.7%(36/38),高于参照组的78.9%(30/38)(χ2=4.145,P=0.042)。结论 功能性电刺激联合Bobath疗法治疗脑卒中偏瘫能提高患者肢体功能与平衡能力,并改善日常生活能力,促进步态的恢复,提升治疗满意度,值得临床推广应用。

Abstract：

【Abstract】 Objective To investigate the effect of functional electrical stimulation combined with Bobath therapyof patients with hemiplegia after stroke. Methods A total of 76 patients with hemiplegia after stroke in the People's Hospitalof Rugao from September 2020 to June 2021 were selected, and they were divided into reference group (n=38) and experimentalgroup (n=38) by random number table method. The reference group was given Bobath therapy, while the experimental group wasgiven functional electrical stimulation combined with Bobath therapy. The motor function [lower limb Fugl-Meyer Motor FunctionAssessment (FMA) score] , balance ability [Berg Balance Scale (BBS) score] , activities of daily living [Barthel Index (BI) scalescore] , gait indexes (step length, step width, pace, gait cycle) and lower limb joint activity (maximum flexion and extension of thehip joint, maximum flexion and extension of the knee joint) were compared between the two groups before treatment and after 14days of treatment, and treatment satisfaction between the two groups were compared. Results After treatment, the scores of lowerlimb FMA, BBS and BI scale of the two groups were higher than those before treatment, respectively, and the scores of lower limbFMA, BBS and BI scale in the experimental group were higher than those in the reference group (P < 0.05) . After treatment, thestep length, step width, pace, maximum flexion and extension of the hip joint, maximum flexion of the knee joint of the two groupswere higher than those before treatment, and the gait cycle and extension of the knee joint of the two groups were lower than thosebefore treatment, respectively; the step length, step width, pace, maximum flexion and extension of the hip joint, maximum flexion ofthe knee joint in the experimental group were higher than those in the reference group, and the gait cycle and extension of the kneejoint in the experimental group were lower than those in the reference group (P < 0.05) . The overall treatment satisfaction in theexperimental group was 94.7% (36/38) , which was higher than that in the reference group [78.9% (30/38) ] (χ2 =4.145, P=0.042) .Conclusion Functional electrical stimulation combined with Bobath therapy in the treatment of hemiplegia after stroke canimprove limb function and balance ability of patients, improve activities of daily living, promote gait recovery and improvetreatment satisfaction. It is worthy of clinical application.

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