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1.
赵彬  唐强  王艳  朱路文  梁玉林  李超男 《中国康复》2019,34(10):529-531
目的:探讨悬吊运动疗法结合功能性电刺激对脑卒中后偏瘫患者下肢功能的影响。方法:90例脑卒中恢复期患者随机分为FES组、SET组和结合组各30例。 3组患者均进行常规康复训练,FES组和SET组在此基础上分别进行功能性电刺激训练和悬吊训练,结合组在常规康复训练基础上再配合功能性电刺激训练和悬吊训练。治疗前后采用Berg平衡量表(BBS)、Fugl Meyer下肢运动功能量表(FMA)、威斯康星步态量表(WGS)评分进行评定。结果:治疗8周后,3组患者BBS、FMA评分较治疗前均明显提高(均P<0.05),WGS评分较治疗前明显降低(均P<0.05);结合组的BBS、FMA评分均明显高于FES组和SET组(均P<0.05),WGS评分均明显低于FES组和SET组(均P<0.05);FES组和SET组治疗后各项评分比较差异无统计学意义。结论:悬吊运动疗法结合功能性电刺激对脑卒中偏瘫患者下肢运动功能、平衡功能和步行能力改善效果显著,并且较单独使用悬吊运动疗法或功能性电刺激治疗更有利于脑卒中偏瘫患者下肢功能的恢复。  相似文献   

2.
目的:探讨运动想象疗法结合神经肌肉电刺激对脑梗死偏瘫患者上肢功能的影响。方法:60例脑梗死患者随机分为对照组、治疗组,2组患者均接受基础药物治疗,其中对照组:常规康复;治疗组:常规康复+运动想象疗法+神经肌肉电刺激。1个月为1个疗程,治疗前后分别进行简易上肢功能检测(STEF)、上肢运动功能FMA评分及改良Barthel指数(MBI)。结果:治疗1个月后, 两组患者的STEF、上肢FMA评分及改良Barthel指数(MBI)评分差异较治疗前均有显著性意义(P<0.05),但治疗组治疗效果较对照组更加显著(P<0.05)。结论:运动想象疗法结合神经肌肉电刺激不仅能改善脑梗死患者上肢功能,而且能促进日常生活活动能力的恢复。  相似文献   

3.
目的 观察多通道功能性电刺激(FES)对脑卒中偏瘫患者下肢功能的影响。 方法 将30例脑卒中偏瘫患者按随机数字表法分为对照组、电刺激A组和电刺激B组,每组10例。3组患者均接受常规康复治疗和药物治疗,电刺激A组每日进行15 min常规康复治疗和15 min多通道FES治疗,共计30 min,每日1次;电刺激B组在电刺激A组基础上,增加FES治疗时间至30 min,每日1次。治疗前及治疗4周后(治疗后),采用Fugl-Meyer量表(FMA)下肢部分、起立-行走测试(TUGT)、10米最大步行速度测试(10 mMWS)、功能性步行分级(FAC)、Barthel指数(BI)进行评定。 结果 治疗前,3组患者TUGT、10 mMWS、FMA、FAC、BI比较,差异无统计学意义(P>0.05)。治疗后,3组患者TUGT、10 mMWS、FMA、FAC、BI均较组内治疗前改善(P<0.05)。与对照组治疗后比较,电刺激A组和电刺激B组TUGT、10 mMWS、FMA、FAC、BI较为优异(P<0.05),且电刺激B组TUGT[(18.01±6.16)s]、10 mMWS[(0.83±0.14)m/s]、FMA[(24.57±2.59)分]、FAC[(4.37±0.43)级]、BI[(71.50±9.14)分]优于电刺激A组(P<0.05)。 结论 增加多通道FES治疗时间可以明显改善脑卒中患者的下肢运动功能,提高生活质量。  相似文献   

4.
目的 探索任务导向的功能性电刺激疗法在改善脑外伤患者手和上肢功能及ADL能力方面的疗效.方法 将符合入选标准的脑外伤偏瘫患者按随机数字表法分为对照组、功能性电刺激(FES)组和任务导向的功能性电刺激疗法(TFES)组,每组30例;对照组采用常规康复治疗,FES组在常规康复治疗的基础上增加FES治疗,TFES组在常规康复治疗的基础上进行TFES治疗,其参数及电极放置与FES组完全相同;共治疗3个月.最终完成全部研究的患者有86例,其中对照组29例、FES组28例、TFES组29例.分别于治疗前、治疗1个月和治疗3个月时,采用Fugl-Meyer运动功能量表(FMA)评分对手和上肢功能进行评定,使用量角器对腕背伸和手指关节伸展主动活动度进行评定,采用改良Barthel指数(MBI)及功能独立性测评(FIM)评定患者日常生活能力.结果 3组患者治疗前的FMA、MBI和FIM评分及关节活动度(ROM)组间比较,差异均无统计学意义(P>0.05).治疗1个月和3个月后,FES组患者FMA评分分别为(27.21±6.78)和(29.18±9.03)分,腕关节主动背伸活动度分别为7.43°±4.44°和14.86°±7.14°;治疗1个月和3个月后,TFES组患者的FMA评分分别为(29.79±8.64)和(31.86±10.96)分,腕关节主动背伸活动度分别为7.34°±7.35°,18.97°±9.27°;FES组及TFES组在治疗1个月和3个月后的FMA评分及腕关节活动度均优于对照组(P<0.05),TFES组在治疗1个月和3个月后的FMA评分,亦明显优于FES组(P<0.05);TFES组患者治疗3个月后的MBI为(66.14±23.60)分、FIM评分为(82.38 ±25.71)分,明显优于FES组的(60.43±20.22)分和(75.68±23.44)分,且组间差异有统计学意义(P<0.05).结论 任务导向的功能性电刺激有助于脑损伤患者上肢功能的恢复和ADL能力的改善.  相似文献   

5.
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。  相似文献   

6.
功能性电刺激对脑卒中患者体感诱发电位影响的信度研究   总被引:6,自引:1,他引:5  
目的:研究功能性电刺激(FES)治疗脑卒中患者患侧肢体对体感诱发电位(SEP)的影响及SEP的重复测试信度。方法:按FES的治疗部位将9例脑卒中患者按入院时间顺序随机分为刺激偏瘫侧上肢组(上肢组)4例和刺激偏瘫侧下肢组(下肢组)5例。2组患者分别接受1次30min的患侧上肢或下肢FES治疗,刺激频率为30Hz,脉宽为0.2ms,通电/断电比为5s/5s,波升/波降为1s/1s,刺激强度为患者耐受的最大强度。2组患者在治疗前后分别接受双侧上肢或下肢的SEP检测。分析双侧上肢或双侧下肢SEP检测过程中N9、N20和P40的波幅及潜伏期,并比较同一测试时间点SEP的重复检测信度。结果:2组患者2次检测的SEP值等级间相关系数(ICC)值上肢为0.989—1.000,下肢为0.832—1.000,上肢组优于下肢组。治疗前后SEP值比较,治疗后上肢组双侧N9、N20的波幅均升高,健侧N20的潜伏期缩短。下肢组患侧N9、P40的波幅和健侧P40的波幅均升高,健侧N9的波幅下降。结论:利用SEP检测脑卒中后肢体接受FES治疗的神经电生理变化具有较高的信度,且上肢组优于下肢组。  相似文献   

7.
摘要 目的:探讨主动功能性电刺激转车对中重度偏瘫患者上肢功能的影响。 方法:40例中重度偏瘫患者随机分为功能性电刺激转车结合常规治疗组(19例)或常规治疗组(21例)。治疗前后应用上肢Fugl-Meyer (FMA-UE)运动评分(包括近端肢体、腕、手、协调)、改良Ashworth量表(MAS)、改良Barthel指数(MBI)分别评定上肢运动功能、肱二头肌及肱三头肌肌张力、日常生活活动能力。 结果:治疗前,以上各项评估指标组间比较,差异均无显著性意义(P>0.05)。治疗后,两组除肱三头肌MAS及FMA(腕)评分外其余指标均较治疗前增高(P<0.05);试验组仅FMA(近端)较对照组有明显改善(P<0.05),但试验组FMA-UE评分超过最小临床重要差异值的比例较对照组多(P<0.05)。 结论:主动功能性电刺激转车可促进中重度偏瘫患者上肢近端运动功能的恢复。  相似文献   

8.
目的研究脑卒中患者佩带便携式上肢功能性电刺激(FES)设备对其手部功能性动作即刻功能变化的影响。 方法选取脑卒中患者20例,全部佩带便携式上肢FES设备接受治疗,开始刺激前,将8块电极片分别按第1、第2、第3和第4通道四个刺激通道位置粘贴,刺激频率为40Hz,脉冲宽度为患者能够完成动作的最小宽度,刺激时间为患者能够完成动作的最短时间。电刺激顺序为:第1通道、第2/3通道、第1通道、第4通道。每个通道电刺激的刺激间隔为2000~3000ms,用支具将腕关节固定于功能位,通过15min的康复练习,协助患者能较熟练地在FES的辅助下完成抓、握和对捏动作,记录刺激参数。分别于患者佩带便携式上肢FES设备前(佩戴前)和戴后FES产生手部功能性动作即刻(佩戴后),对患者进行各项功能指标评定,评定内容包括Fugl-Meyer运动功能评分(FMA)、上肢功能试验(UEFT)、目测类比法(VAS)和改良的Barthel指数(MBI)评分,并进行统计学分析比较。 结果佩戴便携式上肢FES设备前,20例脑卒中患者的FMA、UEFT和MBI评分分别为(19.4±7.1)、(3.6±3.7)和(53.8±26.2)分,佩戴便携式上肢FES设备后,患者的FMA评分[(30.4±9.6)分]、UEFT评分[(26.9±5.9)分]和MBI评分[(65.8±17.7)分]均较佩戴前明显提高,且差异有统计学意义(P<0.05)。佩戴后患者的VAS评分[(1.3±0.7)分]较佩戴前[(1.4±0.4)分]有所下降,但差异并无统计学意义(P&rt;0.05)。 结论脑卒中患者佩戴便携式上肢FES设备可即刻改善患者的上肢功能和患者日常生活活动能力,但对患者疼痛程度改善不明显。  相似文献   

9.
目的观察功能性电刺激(FES)对老年脑卒中偏瘫患者早期疗效的影响。 方法40例老年脑卒中患者分为FES组和对照组,每组20例。2组患者均行常规药物治疗和基本的康复训练。FES组加用FES治疗,每天治疗1次,每次30 min,共3周(15次)。对照组在治疗期间不接受任何电刺激。2组患者在治疗前、治疗3周后分别采用Fugl-Meyer运动功能量表(FMA)、Berg平衡量表(BBS)及Barthel指数(BI)进行功能评定。 结果FES组患者上肢FMA评分治疗前、后比较,差异有统计学意义(P<0.01),治疗后FES组上肢FMA评分与对照组相比,差异有统计学意义(P<0.05)。2组患者下肢FMA治疗前、后比较,差异有统计学意义(P<0.05),治疗后FES组下肢FMA评分与对照组相比,差异有统计学意义(P<0.05)。2组患者BBS评分治疗前、后比较,差异有统计学意义(P<0.05),治疗后FES组BBS评分与对照组相比,差异有统计学意义(P<0.05)。 FES组患者BI评分治疗前、后比较,差异有统计学意义(P<0.01);治疗后FES组BI评分与对照组相比,差异有统计学意义(P<0.05)。 结论FES治疗能提高老年脑卒中早期患者偏瘫肢体运动功能,改善患者的平衡能力,进而提高患者日常生活活动能力。  相似文献   

10.
目的 观察电刺激引导下A型肉毒毒素(BTX-A)注射治疗脑卒中后偏瘫上肢肌痉挛的疗效。 方法 采用随机数字表法将120例脑卒中后偏瘫伴上肢痉挛患者分为A、B、C共3组,每组40例。A组患者给予常规康复干预,B组患者在此基础上辅以徒手定位法BTX-A注射,C组患者则辅以电刺激引导下BTX-A注射。于治疗前、治疗4周后分别采用改良Ashworth痉挛量表(MAS)、上肢Fugl-Meyer运动功能量表(FMA)、改良Barthel指数(MBI)及焦虑、抑郁自评量表(SAS和SDS)对3组患者肌张力、肢体运动功能、日常生活活动(ADL)能力及焦虑、抑郁状态进行评分。 结果 治疗前3组患者MAS、上肢FMA、MBI、SAS及SDS评分组间差异均无统计学意义(P>0.05)。治疗后3组患者上肢FMA、MBI评分均显著提高(P<0.05),MAS、SAS及SDS评分均明显降低(P<0.05);进一步比较发现,治疗后B组、C组上肢FMA及MBI评分均较A组明显增高(P<0.05),MAS、SAS及SDS评分均较A组明显降低(P<0.05);C组患者上肢FMA、MBI评分亦较B组明显增高(P<0.05),MAS评分较B组明显降低(P<0.05);治疗后B组、C组SAS及SDS评分组间差异仍无统计学意义(P>0.05)。 结论 在常规康复干预基础上辅以电刺激引导下BTX-A注射治疗,能明显改善脑卒中后偏瘫患者上肢肌痉挛状态,提高患者ADL能力并减轻焦虑、抑郁情绪,该联合疗法值得临床推广、应用。  相似文献   

11.
ABSTRACT: BACKGROUND: We developed an electroencephalogram-based brain computer interface system to modulate functional electrical stimulation (FES) to the affected tibialis anterior muscle in a stroke patient. The intensity of FES current increased in a stepwise manner when the event-related desynchronization (ERD) reflecting motor intent was continuously detected from the primary cortical motor area. METHODS: We tested the feasibility of the ERD-modulated FES system in comparison with FES without ERD modulation. The stroke patient who presented with severe hemiparesis attempted to perform dorsiflexion of the paralyzed ankle during which FES was applied either with or without ERD modulation. RESULTS: After 20 minutes of training, the range of movement at the ankle joint and the electromyography amplitude of the affected tibialis anterior muscle were significantly increased following the ERD-modulated FES compared with the FES alone. CONCLUSIONS: The proposed rehabilitation technique using ERD-modulated FES for stroke patients was feasible. The system holds potentials to improve the limb function and to benefit stroke patients.  相似文献   

12.
[Purpose] This study sought to determine the effects of brain-computer interface-based functional electrical stimulation (BCI-FES) on brain activation in patients with stroke. [Subjects] The subjects were randomized to in a BCI-FES group (n=5) and a functional electrical stimulation (FES) group (n=5). [Methods] Patients in the BCI-FES group received ankle dorsiflexion training with FES for 30 minutes per day, 5 times under the brain-computer interface-based program. The FES group received ankle dorsiflexion training with FES for the same amount of time. [Results] The BCI-FES group demonstrated significant differences in the frontopolar regions 1 and 2 attention indexes, and frontopolar 1 activation index. The FES group demonstrated no significant differences. There were significant differences in the frontopolar 1 region activation index between the two groups after the interventions. [Conclusion] The results of this study suggest that BCI-FES training may be more effective in stimulating brain activation than only FES training in patients recovering from stroke.Key words: Brain-computer interface, Stroke rehabilitation, Brain activation  相似文献   

13.
PURPOSE: To assess the effects of daily power-assisted functional electrical stimulation (FES) home program therapy in chronic stroke. METHODS: A total of 20 consecutively enrolled stroke patients with spastic upper-extremity impairments > 1 year after stroke were recruited for this non-blinded randomized controlled trial. Subjects were assigned to control and FES groups and followed for 5 months. The FES group used a power-assisted FES device to induce greater muscle contraction by electrical stimulation in proportion to the integrated electromyography (EMG) signal picked up on surface electrodes. Target muscles were the extensor carpi radialis longus (ECRL) and extensor carpi radialis brevis (ECRB), extensor digitorum communis (EDC), extensor indicis proprius (EIP), and deltoid (Del). Patients underwent 30 approximately 60 min FES sessions at home about 6 days/week. Root mean square (RMS) of ECRL, EDC and Del maximum voluntary EMGs, active range of motion (ROM) of wrist and finger extension and shoulder flexion, modified Ashworth scale (MAS), and clinical tests were investigated before and after FES training. RESULTS: The FES group displayed significantly greater improvements in RMS, active ROM, MAS and functional hand tests, and was able to smoothly perform activities of daily life using the hemiplegic upper extremities. CONCLUSIONS: Daily power-assisted FES home program therapy can effectively improve wrist and finger extension and shoulder flexion. Proprioceptional sensory feedback might play an important role in power-assisted FES therapy.  相似文献   

14.
OBJECTIVE: To test the efficacy of functional electric stimulation (FES)-assisted exercise therapy (FES-ET) on a workstation in the subacute phase of recovery from a stroke. DESIGN: Single-blind, randomly controlled comparison of high- and low-intensity treatment. SETTING: Laboratory in a rehabilitation hospital. PARTICIPANTS: Nineteen stroke survivors (10 men, 9 women; mean age +/- standard deviation, 60.6+/-5.8y), with upper-extremity hemiplegia (mean poststroke time, 48+/-17d). The main inclusion criteria were: stroke occurred within 3 months of onset of trial and resulted in severe upper-limb dysfunction, and FES produced adequate hand opening. INTERVENTION: An FES stimulator and an exercise workstation with instrumented objects were used by 2 groups to perform specific motor tasks with their affected upper extremity. Ten subjects in the high-intensity FES-ET group received FES-ET for 1 hour a day on 15 to 20 consecutive workdays. Nine subjects in the low-intensity FES-ET group received 15 minutes of sensory electric stimulation 4 days a week and on the fifth day they received 1 hour of FES-ET. MAIN OUTCOME MEASURES: Primary outcome measure included the Wolf Motor Function Test (WMFT). Secondary outcome measures included the Motor Activity Log (MAL), the upper-extremity portion of the Fugl-Meyer Assessment (FMA), and the combined kinematic score (CKS) derived from workstation measurements. The WMFT, MAL, and FMA were used to assess function in the absence of FES whereas CKS was used to evaluate function assisted by FES. RESULTS: Improvements in the WMFT and CKS were significantly greater in the high-intensity group (post-treatment effect size, .95) than the low-intensity group (post-treatment effect size, 1.3). The differences in MAL and FMA were not statistically significant. CONCLUSIONS: Subjects performing high-intensity FES-ET showed significantly greater improvements on the WMFT than those performing low-intensity FES-ET. However, this was not reflected in subjects' self-assessments (MAL) or in their FMA scores, so the clinical significance of the result is open to debate. The CKS data suggest that high-intensity FES-ET may be advantageous in neuroprosthetic applications.  相似文献   

15.
[Purpose] The purpose of this study was to determine the effects of brain-computer interface (BCI)-based functional electrical stimulation (FES) on balance and gait function in patients with stroke. [Subjects] Subjects were randomly allocated to a BCI-FES group (n=5) and a FES group (n=5). [Methods] The BCI-FES group received ankle dorsiflexion training with FES according to a BCI-based program for 30 minutes per day for 5 days. The FES group received ankle dorsiflexion training with FES for the same duration. [Results] Following the intervention, the BCI-FES group showed significant differences in Timed Up and Go test value, cadence, and step length on the affected side. The FES group showed no significant differences after the intervention. However, there were no significant differences between the 2 groups after the intervention. [Conclusion] The results of this study suggest that BCI-based FES training is a more effective exercise for balance and gait function than FES training alone in patients with stroke.Key words: Brain-computer interface, Functional electrical stimulation, Gait  相似文献   

16.
OBJECTIVE: To test a functional electric stimulation (FES)-assisted exercise therapy system for improvement of motor function of the hemiplegic upper extremity. DESIGN: A before-after trial, with 2-month follow-up. SETTING: A university research laboratory. PARTICIPANTS: A convenience sample of 6 subjects (3 men, 3 women). Main inclusion criteria were that stroke had occurred more than 1 year before the study (mean time poststroke, 5.6+/-4.4y) and had resulted in hemiplegia, and that FES produced adequate hand opening. INTERVENTION: A prototype workstation with instrumented objects was used by subjects to perform a set of tasks with their affected hand during 1-hour sessions for 12 consecutive workdays. A FES stimulator was used to assist hand opening.Main outcome measures Kinematic data, provided by the workstation sensors, and 3 clinical tests. RESULTS: Kinematic data indicated statistically significant improvement in subjects' performance (pre-/posttreatment effect size [pre/post ES] of the mean performance scores=5.46; mean pretreatment/follow-up ES [pre/FU ES]=3.44). Two of 3 clinical tests showed improvement in hand function (mean pre/post ES=.51; mean pre/FU ES=.61). CONCLUSIONS: Improvement in hemiplegic hand function because of FES-assisted therapy was documented in a small group of people with hemiplegia whose motor impairment would exclude them from participation in constraint-induced movement therapy. However, the long-term clinical relevance of such improvement needs further study.  相似文献   

17.
Purpose. To assess the effects of daily power-assisted functional electrical stimulation (FES) home program therapy in chronic stroke.

Methods. A total of 20 consecutively enrolled stroke patients with spastic upper-extremity impairments >1 year after stroke were recruited for this non-blinded randomized controlled trial. Subjects were assigned to control and FES groups and followed for 5 months. The FES group used a power-assisted FES device to induce greater muscle contraction by electrical stimulation in proportion to the integrated electromyography (EMG) signal picked up on surface electrodes. Target muscles were the extensor carpi radialis longus (ECRL) and extensor carpi radialis brevis (ECRB), extensor digitorum communis (EDC), extensor indicis proprius (EIP), and deltoid (Del). Patients underwent 30 ~ 60 min FES sessions at home about 6 days/week. Root mean square (RMS) of ECRL, EDC and Del maximum voluntary EMGs, active range of motion (ROM) of wrist and finger extension and shoulder flexion, modified Ashworth scale (MAS), and clinical tests were investigated before and after FES training.

Results. The FES group displayed significantly greater improvements in RMS, active ROM, MAS and functional hand tests, and was able to smoothly perform activities of daily life using the hemiplegic upper extremities.

Conclusions. Daily power-assisted FES home program therapy can effectively improve wrist and finger extension and shoulder flexion. Proprioceptional sensory feedback might play an important role in power-assisted FES therapy.  相似文献   

18.
[Purpose] The purpose of the present study was to examine the effects of ankle joint muscle strengthening and proprioceptive exercises accompanied by functional electrical stimulation on stroke patients’ balance ability. [Methods] For six weeks beginning in April 2015, 22 stroke patients receiving physical therapy at K Hospital located in Gyeonggi-do were divided into a functional electrical stimulation (FES), ankle proprioceptive exercise and ankle joint muscle strengthening exercise group (FPS group) of 11 patients and an FES and stretching exercise group (FS group) of 11 patients. The stimulation and exercises were conducted for 30 min per day, five days per week for six weeks. Balance ability was measured using a BioRescue and the Berg balance scale, functional reach test, and the timed up-and-go test were also used as clinical evaluation indices. Repeated measures ANOVA was conducted to examine differences between before the exercises and at three and six weeks after beginning the exercises within each group, and the amounts of change between the two groups were compared. [Results] In the comparison within each group, both groups showed significant differences between before and after the experiment in all the tests and comparison between the groups showed that greater improvement was seen in all values in the FPS group. [Conclusion] In the present study, implementing FES and stretching exercises plus ankle joint muscle strengthening and proprioceptive exercises was more effective at improving stroke patients balance ability than implementing only FES and stretching exercises.Key words: Proprioceptive, Strengthening, Stroke  相似文献   

19.
Purpose.?To evaluate the clinical efficacy of functional electrical stimulation (FES) therapy of the tibialis anterior (TA) muscle on gait restoration and enhancing motor recovery with stroke patients.

Method.?Thirty hemiparetic participants with spastic foot-drop impairments who were at least 3 months post-stroke were recruited from a rehabilitation institute and were assigned either to a control group or a FES group. Both the groups participated in a conventional stroke rehabilitation program for 60?min per day, 5 days a week, for 12-weeks. The FES group received the electrical stimulation to the TA muscle for correction of foot-drop.

Results.?Functional electric stimulation (FES) resulted in a 26.3% (p?<?0.001) improvement of walking speed measured with 10-m walkway, whereas the improvement in the control group was only 11.5% (p?<?0.01). The FES group also showed significantly greater improvements compared to control group in other gait parameters (e.g. cadence, step length), physiological cost index (PCI), ankle range of motion, spasticity of calf muscle, Fugl–Meyer scores, and the maximum value of the root mean square (RMSmax), which reflects the capacity of the muscle output.

Conclusions.?These findings suggest that, the FES therapy combined with conventional therapy treatment more effectively improves the walking ability and enhances the motor recovery when compared with conventional therapy alone in stroke survivors.  相似文献   

20.
王桂丽  贾杰 《中国康复》2016,31(6):434-437
目的:观察动作反馈的功能性电刺激(FES)对脑卒中足下垂合并足内翻患者下肢运动功能和步行能力的影响。方法:脑卒中足下垂合并足内翻患者34例,随机分为观察组和对照组各17例,2组均进行基础康复治疗,观察组另行功能电刺激下20min步行训练,对照组行相同时间的常规步行训练。在康复治疗前和治疗4周后采用Fug1-Meyer量表下肢部分(FMA-LE)、起立-行走计时测试(TUGT)、徒手肌力测试(MMT)和改良Ashworth量表(MAS)对两组患者进行功能评估;观察组另记录步态不对称指数(GAI)和非偏瘫侧摆动时间变异(STV)。结果:治疗4周后,观察组患者FMA-LE、TUGT、MMT、MAS、GAI和STV评分均较治疗前显著提高(P0.05),对照组TUGT及MMT评分较治疗前明显提高(P0.05),其余各评分治疗前后比较均差异无统计学意义;治疗后组间比较,观察组FMA-LE、TUGT和MAS评分均显著高于对照组(P0.05),但MMT评分组间比较差异无统计学意义。结论:动作反馈功能性电刺激能显著改善脑卒中足下垂合并足内翻患者的运动功能和步行能力,并能提高踝背屈肌力、缓解踝关节相关肌群痉挛。  相似文献   

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