摘要
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。
Objective： To investigate the reliability of functional electrical stimulation（FES） on somatosensory evoked potentials （SEP） on stroke subjects. Method： Nine stroke subjects were randomly divided into two groups, the upper limb group and the lower limb group. They were 7 males and 2 females, 60.3±11.8years old and 1.2±0.5 months post stroke. Subjects in the upper limb group received FES treatment on the affected upper limb for 30 min. The parameters were 30Hz with the pulse width 0.2ms, on/off at 5s/8s, rise and fall time at 1s/1s. Those who were in the lower limb group received FES treatment on the affected lower limb for 30min with the same stimulating parameters as those in the upper limb group. SEP were examined before and after FES treatment with an average of repetition 150×2 at each session. The amplitude and latency of N9 and N20 of the upper limb were recorded for subjects in the upper limb group, while the same parameters of No and P40 of the lower limb were recorded for subjects in the lower limb group. The interclass correlation coefficient （ICC） was used to analyze the reproducibility of SEP and the difference between 2 sessions before and after 30min stimulation were also analyzed within each group. Result： The SEP for both sessions was highly reproducible and ICCs were between 0.899-1.000 in the upper limb group while it was between 0.193-1.000 in the lower limb group. There were significant changes in the amplitude and latency of N9 and N20 in the upper limb group after FES treatment. But no significant changes were found in the latency of the N9 and P40 in the lower limb group. Conclusion： SEP is reliable to observe the effects of FES on subject with stroke and the reliability in the upper limb group was better than that in the lower limb group.
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2007年第10期874-876,共3页
Chinese Journal of Rehabilitation Medicine
关键词
功能性电刺激
体感诱发电位
脑卒中
functional electrical stimulation
somatosensory evoked potential
stroke
