功能电刺激治疗脑卒中足下垂合并内翻的疗效观察

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。

Efficacy of functional electrical stimulation on stroke patients with foot drop and varus ankle

Objective: To investigate the efficacy of the motion feedback functional electrical stimulation (FES) on motor function and walking ability of stroke patients with foot drop and varus ankle. Methods: Thirty-four stroke patients with foot drop and varus ankle were randomly divided into the FES group (n=17) and the control group (n=17). All patients had received the fundamental rehabilitation therapy. Additionally, the patients in the FES group were given walk training with FES for 20 min, and those in the control group were subjected to conventional walking exercise in the same time. These therapies were performed once a day, 5 days a week, totally 4 weeks. Fugl-Meyer assessment of lower extremity (FMA-LE), Timed Up and Go test (TUGT), manual muscle test (MMT) and modified Ashworth scale (MAS) were evaluated at the beginning and end of this clinical study. In addition, gait asymmetry index (GAI) and swing time variability (STV) were measured in the FES group. Results: At the beginning of the whole treatment, there was no significant difference between these two groups in terms of all the assessments (P>0.05). After 4-week treatment, all measurements in the FES group were increased significantly as compared with those before treatment (P<0.05), while only TUGT and MMT scores in the control group were improved significantly (P<0.05). Furthermore, the FMA-LE, TUGT and MAS scores in the FES group were significantly higher than those in the control group (P<0.05), while the MMT scores showed no significant difference (P>0.05). Conclusion: The motion feedback FES could significantly improve the motor function and walking ability of stroke patients; what''s more, the strength of the ankle back muscle could be increased, and the muscle spasms could be relieved.