强制性运动疗法结合神经肌肉电刺激在脑卒中偏瘫患者上肢功能康复中的临床疗效

李启金　林洁玲　罗超敏

【摘要】 目的：觀察脑卒中偏瘫患者临床行神经肌肉电刺激、强制性运动疗法治疗，患者上肢功能恢复的效果。方法：选取本院2014年10月-2016年2月期间收治的86例脑卒中偏瘫患者为研究对象，按入院时间先后将其分为对照组和观察组，每组各43例。对照组采用常规康复训练、神经肌肉电刺激治疗，观察组在对照组基础上加用强制性运动疗法。比较治疗后两组日常生活能力、上肢能力改善情况，评估疾病治疗效果，同时对两组上肢动作恢复情况进行评测。结果：入院时，两组患肢运动能力、生活能力以及上肢动作能力评分比较，差异均无统计学意义（P>0.05）；治疗后，观察组上肢运动功能评分明显高于对照组，上肢功能恢复率为95.3%明显高于对照组86.0%，差异均有统计学意义（P<0.05）。结论：临床对脑卒中偏瘫患者行神经肌肉电刺激、强制性运动疗法治疗，患者上肢运动、动作能力明显改善，生活能力明显提高。

【关键词】 上肢功能； 脑卒中； 神经肌肉电刺激； 疗效； 偏瘫； 强制性运动

The Clinical Effect of the Combination of Compulsory Exercise Therapy and Neuromuscular Electrical Stimulation on the Rehabilitation of Upper Limb Function in Stroke Patients with Hemiplegia/LI Qi-jin，LIN Jie-ling，LUO Chao-min.//Medical Innovation of China，2017，14（16）：038-041

【Abstract】 Objective：To observe the effect of neuromuscular electrical stimulation and mandatory exercise therapy on the recovery of upper limb function in stroke patients with hemiplegia.Method：A total of 86 cases stroke with hemiptegic admitted to our hospital from October 2014 to February 2016 were selected as research objects and were divided into the control group and the observation group by admission time，43 cases in each group.The control group was treated with conventional rehabilitation training and neuromuscular electrical stimulation，the observation group was treated with added compulsory exercise on the basis of the control group.The daily living ability and the improvement of upper limb ability of two groups were compared，and the postoperative disease treatment effect and the recovery of upper limb movements of two groups were evaluated at the same time.Result：There was no significant difference in the limb exercise ability，life ability and upper limb movement ability of two group before treatment（P>0.05）.After treatment，the functional score of the observation group was significantly higher than that of the contrast group，the recovery rate of upper limb function of the observation group was 95.3%，which was significantly higher than 86.0% of the control group（P<0.05）.Conclusion：When applying neuromuscular electrical stimulation and mandatory exercise therapy for stroke patients with hemiplegia clinically，the living ability，upper limb function and movement ability of patients are significantly improved.

【Key words】 Upper limb function； Stroke； Neuromuscular electrical stimulation； Efficacy； Hemiplegia； Mandatory exercise

First-authors address：Xinyi Peoples Hospital，Xinyi 525300，China

doi：10.3969/j.issn.1674-4985.2017.16.011

随着近些年医疗水平的发展，临床在脑卒中治疗方面取得了极大的进步，患者死亡率明显降低，但脑卒中致残率仍居高不下，其中偏瘫是最常见的后遗症，偏瘫发生是由于疾病造成脑组织供血障碍，组织病变、坏死，脑神经功能性损伤所致[1]。有研究表明约60%患者会因疾病出现一侧上肢功能障碍，若不及时治疗会严重影响患者日常生活，导致患者逐渐丧失自理能力，致使其与社会脱节，因此为提高患者生活质量，临床多行早期康复训练[2]。大量研究表明对偏瘫患者进行早期康复训练能促进身体各项功能恢复，但传统康复训练恢复较慢，近几年临床较为推崇使用强制性运动疗法进行治疗，其通过限制患者健侧上肢，迫使患者使用患肢，从而通过反复密集再塑训练，促进患肢功能恢复[3]。同……