摘要
目的:观察步态诱发功能性电刺激治疗不完全性脊髓损伤患者的疗效。方法:对40例不完全性脊髓损伤的患者,随机分为两组,对照组进行常规药物治疗、康复治疗,治疗组除常规药物治疗、康复治疗,每天佩戴步态诱发功能性电刺激进行患侧腓总神经、胫前肌电刺激同时步行训练,15—20min。每天2次,每周5—6d,共4周。分别在治疗前、治疗2周、4周行功能独立性评定(FIM)行走能力测评、10m最大步行速度测试、运动诱发电位(MEP)检测,治疗前后行胫前肌肌力评定。结果:治疗2周后,两组FIM行走能力、10m最大步行速度、胫前肌MEP潜伏期两组无明显差异(P>0.05)。治疗4周后,与对照组比较,FES治疗组FIM行走能力评分提高(P<0.01)、10m最大步行速度提高(P<0.05)、胫前肌MEP潜伏期缩短更明显(P<0.01)。胫前肌肌力治疗前两组比较无显著性意义(P>0.05),治疗4周后,两组肌力比较有显著性意义(P<0.05)。结论:功能性电刺激能显著改善不完全性脊髓损伤患者步行功能,运动诱发电位为判断脊髓运动传导功能提供了客观、定量的依据,功能性电刺激是一种安全有效的训练方法。
Objective： To observe the effect of gait triggered functional electrical stimulation on incomplete spinal cord injury（SCI）.Method： Forty patients with incomplete SCI after fractures of thoracolumbar segment were randomly divided into two groups： the treatment group（2Ocases） and the control group （20cases）. Based on routine medical treatment andrehabilitation therapy, patients of treatment group received functional electrical stimulation（FES） on common peroneal nerve and tibialis anterior muscle of affected side by using XFT-2001 low-frequency electrical pulse stimulator, and at the same time 15-20min walking training,twice a day, 5-6d per week,4 weeks in total. Scores of FIM,10m maximum walking speed and tibialis anterior muscle motor evoked potential（MED） latency were evaluatedbefore treatment, 2 weeks after treatment and 4 weeks after treatment. Tibialis anterior muscular strength was compared before treatment and 4 weeks after treatment.Result： After 2 weeks treatment,scores of FIM, 10m maximum walking speed and tibialis anterior muscle MEP latency in both groups had not significant difference （P 〉 0.05） o After 4 weeks treatment, It was shown that thescores of FIM and lOre maximum walking speed increased after treatment（P〈0.01 ,P〈0.05）, tibialis anterior muscle latency shortened（P〈0.01）,tibialis anterior muscular strength enhanced（P〈0.05） compared with control group.Conclusion： FES could improve walking function of incomplete SCI patient. MEP examination could provide objective and quantitative basis for judging the motor functional status of spinal cord. FES was considered to be asafe and effective training method. Author＇s address Dept. of Rehabilitation,the First Hospital of Yue yang,414000
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2013年第3期229-233,共5页
Chinese Journal of Rehabilitation Medicine
关键词
功能性电刺激
不完全性脊髓损伤
运动诱发电位
步行功能
functional electrical stimulation
incomplete spinal cord injury
motor evoked potential
walking function
