经皮电神经刺激对脑卒中偏瘫患者下肢痉挛及运动功能的影响

目的 探讨经皮电神经刺激（TENS）对脑卒中偏瘫患者下肢痉挛及运动功能的影响.方法 按纳入标准将60例偏瘫患者随机分为试验组和对照组,每组30例.对照组采用常规药物及康复治疗,试验组在此基础上增加经皮电神经刺激治疗,分别于治疗前及治疗后进行患侧下肢踝跖屈肌临床痉挛指数（CSI）评定、Fugl-Meyer运动功能评定（FMA）及最大步行速度（MWS）评定,比较两组治疗效果.结果 治疗后对照组CSI评分、FMA、MWS分别为（10.58±2.50）分、（19.01±4.67）分、（35.93±6.78） m/min,试验组CSI、FMA、MWS分别为（8.41±2.29）分、（23.41±5.45）分、（41.52±8.16） m/min.与对照组比较,试验组踝跖屈肌痉挛明显缓解（t=3.506、P〈0.05）,下肢运动功能及最大步行速度明显提高（t=3.358、t=2.886、P〈0.05）.结论 经皮电神经刺激可降低脑卒中偏瘫患者踝跖屈肌痉挛,提高下肢运功功能,改善步行能力.

The efficacy of transcutaneous electrical nerve stimulation on lower limb spasticity and movement function in stroke patients with hemiplegia

Objective To observe the efficacy of transcutaneous electrical nerve stimulation（TENS） on lower limb spasticity and movement function in stroke patients with hemiplegia. Methods Sixty patients with hemiplegia chosen by adoption criteria were randomly divided into two groups （ trail group 30 cases and control group 30 cases）. Both groups were treated by regular drug and rehabilitation therapy, the trail group was given transcutaneous electrical nerve stimulation at the same time. The clinic spastieity index of ankle plantar flexiors, Fugl-Meyer motor assessment （FMA） of lower limb and maximum walking speed （MWS） were evaluated respectively before and after treatment, and the clinical outcomes of the two groups were compared. Results After treatment, the clinical spastieity index （CSI） score, Fugl-Meyer motor assessment movement score, maximum walking speed of control group were 10.58 ± 2.50,19.01 ±4.67,35.93 ± 6.78 m/min respectively, and those of trail group were 8.41 ± 2.29,23.41 ± 5.45,41.52 ± 8.16 m/min respectively. Compared with the control group, the spasticity of ankle plantar flexiors was relieved significantly （ t = 3. 506, P 〈0. 05 ）, and the lower limb movement function and maximum walking speed improved significantly in the trail group （t = 3. 358,t = 2. 886,P 〈 0. 05）. Conclusions Transcutaneous electrical nerve stimulation can relieve the spasticity of ankle plantar flexiors, improve the lower limb movement function and walk ability of stroke patients with hemiplegia.