踝足矫形器辅助本体感觉训练对脑卒中后偏瘫患者运动功能及表面肌电图的影响

目的:探讨踝足矫形器辅助本体感觉训练对脑卒中后偏瘫患者运动功能及表面肌电图的影响。方法:将脑卒中后偏瘫患者116例随机分为2组各58例,对照组给予动态式踝足矫形器治疗,研究组给予动态式踝足矫形器辅助本体感觉训练治疗。比较2组治疗前后运动、平衡功能、表面肌电图、三维步态时空与时相参数的变化情况。结果:治疗3个月后,2组Fugl-Meyer运动量表(FMA)、Berg平衡量表(BBS)评分均高于治疗前(均P<0.05),且研究组均更高于对照组(均P<0.05)。2组治疗后股四头肌、腓肠肌、胫骨前肌的肌电积分值(iEMG)均高于治疗前(均P<0.05),且研究组治疗后上述指标的iEMG均高于对照组(均P<0.05)。2组治疗后股四头肌、腓肠肌、胫骨前肌的方根振幅(RMS)均低于治疗前(均P<0.05),且研究组治疗后上述指标的RMS均低于对照组(均P<0.05)。2组治疗后步速、步频、跨步长比率均高于治疗前(均P<0.05),且研究组治疗后上述指标均高于对照组(均P<0.05)。结论:踝足矫形器辅助本体感觉训练脑卒中后偏瘫患者可明显改善其运动功能、平衡功能,促进股四头肌、腓肠肌、胫骨前肌功能的恢复。

Effect of Ankle-Foot Orthosis Assisted Proprioceptive Training on Motor Function and Surface Electromyography Stroke Patients with hemiplegia

Objective: To investigate the effect of ankle-foot orthosis assisted proprioceptive training on motor function and surface electromyography Stroke Patients with hemiplegia. Methods: 116 cases of hemiplegic stroke treated in our hospital from January 2016 to February 2018 were selected and divided into two groups by the random number table method, each with 58 cases. The control group received the dynamic ankle-foot orthosis, and the study group received the dynamic ankle-foot orthosis assisted proprioceptive training. The motor function, balance function, surface electromyography, time and phase parameters of three-dimensional gait were compared between the two groups. Results: The scores of simplified Fugl-Meyer assessment (FMA) and Berg balance scale (BBS) in both groups were higher than those before treatment, and higher in the study group than those in the control group (P<0.05). The integrated electromyograph (iEMG) score of quadriceps femoris, tibialis anterior muscle and gastrocnemius muscle was significantly increased in both groups after treatment, and significantly higher in the study group than in the control group (P<0.05). The root mean square amplitude (RMS) of quadriceps femoris, tibialis anterior muscle and gastrocnemius muscle was decreased in both groups after treatment, and lower in the study group than in the control group (P<0.05). The leg speed, stride frequency, stride length ratio (affected limb/healthy limbs) in both groups after treatment were increased, more significant in the study group than in the control group (P<0.05). Conclusion: The application of ankle-foot orthosis assisted proprioceptive training can significantly ameliorate the motor function and balance function, and promote the recovery of quadriceps femoris, tibialis anterior muscle and gastrocnemius muscle for patients with hemiplegic stroke.