發(fā)布時間：2018-03-10 05:19

  本文選題：功能性電刺激　切入點：肌電生物反饋　出處：《復旦大學》2014年碩士論文　論文類型：學位論文

【摘要】：[目的]1、比較FES與肌電生物反饋療法治療腦卒中患者足下垂內(nèi)翻的臨床療效。2、為FES對腦卒中患者足下垂內(nèi)翻的臨床治療提供客觀依據(jù)。[方法]篩選21例符合入組標準的腦卒中患者通過微軟Excel軟件中的Rand函數(shù)隨機分為功能性電刺激(Functional electrical stimulation, FES)組和肌電生物反饋(Electromyographic Biofeedback, EMG-BF)組。21例患者中3例由于某些原因未能完成本研究,最終18例患者完成本研究。FES組9例(年齡60.18±15.82歲,病程83.56±55.51天,其中男7例,女2例；梗塞4例,出血5例),EMG-BF組9例(年齡63.21±19.73歲,病程78.78±59.43天,其中男6例,女3例,梗塞3例,出血6例)。兩組常規(guī)治療相同,包括藥物和基本的康復訓練。此外,FES組給予功能性電刺激治療,EMG-BF組給予肌電生物反饋療法；入選患者分別于治療前、治療后2周、治療后4周接受以下量表評定：改良Ashworth肌張力分級(踝背伸)(Modified Ashworth Spasticity Scale, MAS)、下肢簡化Fugl-Meyer運動功能評分(Fugl-Meyer Assessment of Motor Function,FMA)、下肢Brunnstrom運動恢復分期(Recovery Stage of Brunn strom, RSB)、步行功能評定(Functional Ambulation Classification, FAC)以及10米步行能力測試(10-meter Walk Test,10m WT)。采用SPSS17.0對結果進行統(tǒng)計分析,設定P0.05為差異有統(tǒng)計學意義。[結果]1.一般資料比較：FES組和EMG-BF組在年齡、性別、腦卒中性質(zhì)、病程等方面差異無統(tǒng)計學意義(P0.05),兩組資料具有可比性。2.治療前比較：治療前兩組在MAS、FMA、RSB、FAC以及10mWT等方面差異無統(tǒng)計學意義(P0.05),兩組資料具有可比性。3.治療后組內(nèi)比較：治療2周后、4周后評分與治療前評分相比,兩組在FMA、RSB、FAC以及10mWT等方面差異均有統(tǒng)計學意義(P0.05)。FES組在治療2周后MAS評分與治療前比較有統(tǒng)計學差異(P0.05),在治療4周后與治療前比較無統(tǒng)計學差異(P0.05)。EMG-BF組在治療2周、4周后MAS評分與治療前評分相比,差異均有統(tǒng)計學意義(P0.05)。4.治療后組間比較治療2周后兩組在FMA、10mWT結果之間差異有統(tǒng)計學意義(P0.05),在MAS、RSB、FAC之間差異無統(tǒng)計學意義(P0.05)。治療4周后兩組在FMA、10mWT結果之間差異有統(tǒng)計學意義(P0.05),在MAS、RSB、FAC評分差異無統(tǒng)計學意義(P0.05)。[結論]1.FES可以延緩腦卒中后足下垂內(nèi)翻患者下肢痙攣加重的趨勢和程度。2.FES可以改善腦卒中后足下垂內(nèi)翻患者的運動功能及步行速度,且療效較EMG-BF療法更顯著。
[Abstract]:[objective] 1. To compare the clinical efficacy of FES and electromyoelectric biofeedback therapy in the treatment of foot ptosis varus in stroke patients. [methods] to provide objective basis for the clinical treatment of foot ptosis varus with FES. [methods] 21 patients with stroke were selected. Standard stroke patients were randomly divided into functional electrical stimulation (FESs) group and electromyographic biofeedback (EMG-BF) group through Rand function in Microsoft Excel software. FES group (age 60.18 鹵15.82 years, course 83.56 鹵55.51 days, male 7 cases, female 2 cases, infarction 4 cases, bleeding 5 cases EMG-BF 9 cases (age 63.21 鹵19.73 years, course 78.78 鹵59.43 days), male 6 cases, female 3 cases, infarction 3 cases, infarction 3 cases, the course of disease 78.78 鹵59.43 days. The two groups received the same routine treatment, including drugs and basic rehabilitation training. In addition, the FES group was treated with functional electrical stimulation and EMG-BF group was given myoelectric biofeedback therapy, the patients were enrolled before treatment and 2 weeks after treatment. Four weeks after treatment, the following scales were assessed: modified Ashworth Spasticity scale (MASE), lower extremity simplified Fugl-Meyer Assessment of Motor function scale, lower extremity Brunnstrom recovery stage, recovery Stage of Brunnstrom, and functional Ambulation evaluation. Classification (FAC) and 10-meter Walk test (10m WTT). The results were statistically analyzed by SPSS17.0. The differences were statistically significant. [results] 1.General data were compared between the EMG-BF group and the two groups in age, sex, stroke nature, There was no significant difference in course of disease between the two groups (P 0.05), and the data of the two groups were comparable. 2. Comparison before treatment: there was no significant difference between the two groups in MASFMARSBFAC and 10mWT before treatment (P 0.05). The data of the two groups were comparable. 3. After treatment, there was no significant difference between the two groups in terms of MASFMA-RSB-FAC and 10mWT. The scores after 2 weeks and 4 weeks after treatment were compared with those before treatment. There were significant differences in FMA-RSB-FAC and 10mWT between the two groups. The MAS scores in the FES group after 2 weeks of treatment were significantly different from those before treatment, and there was no significant difference between the two groups after 4 weeks of treatment and before treatment (P0.05U. EMG-BF group at 2 weeks and 4 weeks after treatment). Post MAS scores were compared with pre-treatment scores, After 2 weeks of treatment, there was a significant difference between the two groups in the FMA10mWT results. There was no significant difference between the two groups in the FMA10mWT results. There was no significant difference between the two groups in the FMA10mWT results after 4 weeks of treatment, and there was no significant difference between the two groups in the FMA10mWT results after 4 weeks of treatment. There was no significant difference in the scores of FAC between the two groups. [conclusion] 1. FES can delay the tendency and degree of spasticity of lower extremities in patients with stroke. 2. FES can improve the motor function and walking speed of patients with prolapsed foot varus after stroke. The curative effect was more significant than that of EMG-BF therapy.
【學位授予單位】：復旦大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R743.3

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相關期刊論文 前1條

1 單莎瑞;黃國志;曾慶;汪孝紅;;步態(tài)誘發(fā)功能性電刺激對腦卒中后足下垂患者步態(tài)時空參數(shù)的影響[J];中國康復醫(yī)學雜志;2013年06期

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本文編號：1591941