摘要
目的 探索Bobath康复技术联合神经肌肉电刺激对老年脑卒中偏瘫患者平衡功能及神经功能的影响。方法 选取2022年1月至2024年1月连云港市第一人民医院收治的老年脑卒中偏瘫患者197例,根据随机数字表法分为2组,对照组99例采用Bobath康复技术,观察组98例采用Bobath康复技术联合神经肌肉电刺激治疗。治疗后4周、8周记录并比较2组Berg平衡量表(Berg balance scale, BBS)评分、Fugl-Meyer运动功能评估量表下肢部分(Fugl-Meyer assessment of lower extremity, FMA-LE)评分、Barthel指数量表(Barthel index, BI)评分、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale, NIHSS)评分、中国临床神经功能缺损评分量表(China stroke scale, CSS)、步行时空参数、运动神经元兴奋性和肌肉肌电值。结果 2组治疗后4周、8周BBS评分、FMA-LE评分、BI评分均高于治疗前,NIHSS评分、CSS评分均低于治疗前(P<0.05);观察组治疗后4周、8周BBS评分、FMA-LE评分、BI评分均高于对照组,NIHSS评分、CSS评分均低于对照组(P<0.01)。2组治疗后8周肌肉静态肌电值、肌肉收缩肌电值步宽、步频、步速、步长均大于治疗前,M波最大波幅、H波最大波幅小于治疗前(P<0.05);观察组治疗后8周肌肉静态肌电值、肌肉收缩肌电值步宽、步频、步速、步长均大于对照组(P<0.05,P<0.01),M波最大波幅、H波最大波幅小于对照组[(1.13±0.18)mV vs(1.59±0.23)mV,(1.22±0.21)mV vs(1.93±0.19)mV,P<0.01]。结论 对老年脑卒中偏瘫患者实施Bobath康复技术联合神经肌肉电刺激治疗能更好改善平衡功能和神经功能,提高下肢能力,恢复步行能力。
Objective To explore the effects of Bobath rehabilitation technology(BRT)combined with neuromuscular electrical stimulation(NMES)on balance and neurological function in elderly stroke patients with hemiplegia.Methods A total of 197 elderly stroke patients with hemiplegia admitted to our hospital from January 2022 to January 2024 were enrolled,and randomly divided into control group(BRT,99 cases)and observation group(BRT+NMES,98 cases).At 4 and 8 weeks after treatment,Berg Balance Scale(BBS),Fugl-Meyer Assessment of Lower Extremity(FMA-LE),Barthel index(BI),National Institutes of Health Stroke Scale(NIHSS),China stroke scale(CSS)were performed,and temporal and spatial parameters of walking,motor neuron excitability and electromyographic indicators were collected.The obtained scores and parameters were compared between the two groups.Results At 4 and 8 weeks after treatment,BBS score,FMA-LE score and BI score were significantly increased,and NIHSS score and CSS score were obviously decreased in both groups when compared with their baseline levels(P<0.05).The scores of BBS,FMA-LE and BI were notably higher,while those of NIHSS and CSS were remarkably lower in the observation group than the control group at 4 and 8 weeks after treatment(P<0.01).At 8 weeks after treatment,the static and contraction electromyographic values,and step width,frequency,speed and length of the two groups were significantly higher,and the maximum amplitude of M wave and H wave were lower than before treatment(P<0.05).At 8 weeks after treatment,the observation group had statistically higher static and contraction electromyographic values,and step width,frequency,speed and length(P<0.05,P<0.01),and lower maximum amplitude of M wave and H wave(1.13±0.18 mV vs 1.59±0.23 mV,1.22±0.21 mV vs 1.93±0.19 mV,P<0.01)when compared with the control group.Conclusion The implementation of BRT+NMES can better improve balance and neurological function,enhance lower limb ability,and restore walking ability in elderly stroke patients with hemiplegia.
作者
韦静
王霞
Wei Jing;Wang Xia(Department of Neurology,Lianyungang First People's Hospital,Lianyungang 222000,Jiangsu Province,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2024年第11期1329-1333,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
江苏省第五期“333工程”培养资金资助项目(BRA2020265)。
关键词
卒中
偏瘫
电刺激
平衡
神经功能
Bobath康复技术
stroke
hemiplegia
electricstimulation
balance
neurologicalfunction
Bobathrehabili-tationtechnology
