神经肌肉电刺激联合运动贴布对脑卒中后足下垂患者康复中应用价值

目的：探讨神经肌肉电刺激（NMES）联合运动贴布对脑卒中后足下垂的康复效果。方法：脑卒中后足下垂患者70例随机分为2组各35例，2组均接受运动训练和姿势控制训练等常规康复训练，在此基础上，NMES组接受NMES治疗，联合组接受NMES联合运动贴布治疗，疗程均为4周。比较2组治疗前后踝关节背屈角度、足内翻角度、足下垂角度；并比较2组治疗前后10m步行能力测试（10mWT）指标、起立-行走计时测试（TUGT）指标和生理耗能指数（PCI），胫前肌、腓肠肌最大积分肌电值（iMEG）、足背屈时肢体协同收缩率（CR）及治疗后临床疗效。结果：治疗4周后，2组踝关节背屈角度、10mWT及胫前肌iMEG均较治疗前增加（均P<0.01），足内翻角度、足下垂角度、TUGT时间、PCI及腓肠肌iMEG、足背屈CR均较治疗前降低（均P<0.01）；且联合组踝关节背屈角度、10mWT及胫前肌iMEG均高于NMES组（均P<0.05），足内翻角度、足下垂角度、TUGT时间、PCI及腓肠肌iMEG、足背屈CR均低于NMES组（均P<0.01）。治疗后，联合组优良率明显高于NMES组（P<0.01）。结论：NMES联合运动贴布可改善胫前肌、腓肠肌的iMEG，降低足背屈时CR，增加踝关节活动度，减小足内翻、足下垂角度，提高患肢的步行功能，治疗脑卒中后足下垂效果显著。

Applied value of neuromuscular electrical stimulation combined with kinesiology tape in rehabilitation of patients with foot drop after stroke

Objective: To investigate the rehabilitation effect of neuromuscular electrical stimulation (NMES) combined with kinesiology tape on foot drop after stroke. Methods: A total of 70 patients with foot drop after stroke from January 2019 to June 2020 were selected and randomly divided into two groups, with 35 cases in each group. Both groups received routine rehabilitation training, including exercise training and posture control training. Additionally, the NMES group received NMES treatment, and the combined group received NMES combined with kinesiology tape. The course of treatment was 4 weeks. The ankle range of motion, foot varus angle and foot drop angle were compared between the two groups before and after treatment. The 10 minute walking ability test (10mWT) index, the time up and go test (TUGT) index and the physiological energy consumption index (PCI) were compared between the two groups. The maximum integrated electromyography (iMEG) index of tibialis anterior muscle and gastrocnemius muscle, and the limb synergetic contraction rate (CR) during foot dorsiflexion were compared between the two groups. The clinical efficacy of the two groups was compared. Results: The ankle dorsiflexion angle was significantly greater, the foot varus angle and the foot drop angle were significantly smaller, the 10mWT and iMEG indexes of anterior tibial muscle were significantly higher, and the TUGT time was significantly shorter, and PCI, iMEG index of gastrocnemius muscle and CR of dorsiflexion of foot were significantly lower in the combined group than in the NMES group (all P<0.05). The clinical efficacy in the combined group was significantly better than in the control group (P<0.05). Conclusion: NMES combined with kinesiology tape can improve iMEG index of tibialis anterior muscle and gastrocnemius muscle, reduce CR during foot dorsiflexion, increase ankle joint range of motion, foot varus and foot drop angle, and improve walking function of affected limb. It has significant effect on foot drop after stroke.