椅面前倾对脑卒中偏瘫患者坐-站转移的影响

doi:10.3969/j.issn.1006-9771.2020.07.017

《中国康复理论与实践》 ›› 2020, Vol. 26 ›› Issue (7): 825-829.doi: 10.3969/j.issn.1006-9771.2020.07.017

椅面前倾对脑卒中偏瘫患者坐-站转移的影响

周哲^1a,沈夏锋^1b(),沈小花^1c,吴雪娇^1c,王凤爽^1a,荣积峰^1c,吴毅²

1.上海市第一康复医院,a.综合康复科;b. 神经康复科;c. 康复治疗中心,上海市 200090
2.复旦大学附属华山医院康复医学科,上海市 200040

收稿日期:2019-12-22 修回日期:2020-03-30 出版日期:2020-07-25 发布日期:2020-07-24
通讯作者: 沈夏锋 E-mail:shenxiafeng@aliyun.com
作者简介:周哲(1984-),女,汉族,陕西安康市人,硕士研究生,主治医师,主要研究方向：神经康复。|沈夏锋(1970-),男,汉族,浙江温州市人,博士,主任医师,主要研究方向：神经康复。
基金资助:
上海市残疾人联合会科研项目(K2018012);上海市卫生健康委员会科研项目(201940392);上海市卫生和计划生育委员会科研项目(201840237)

Effect of Chair Inclination Forward on Sit-to-Stand for Hemiplegics after Stroke

ZHOU Zhe^1a,SHEN Xia-feng^1b(),SHEN Xiao-hua^1c,WU Xue-jiao^1c,WANG Feng-shuang^1a,RONG Ji-feng^1c,WU Yi²

1. a. Department of Rehabilitation Medicine, b. Department of Neurological Rehabilitation; c. Rehabilitation Treatment Center, the First Rehabilitation Hospital of Shanghai, Shanghai 200090, China
2. Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai 200040, China

Received:2019-12-22 Revised:2020-03-30 Published:2020-07-25 Online:2020-07-24
Contact: SHEN Xia-feng E-mail:shenxiafeng@aliyun.com
Supported by:
Shanghai Disabled Persons' Federation Scientific Research Project(K2018012);Shanghai Municipal Health Commission Scientific Research Project(201940392);Shanghai Municipal Commission of Health and Family Planning Scientific Research Project(201840237)

摘要/Abstract

摘要：

目的探讨不同椅面前倾角度对脑卒中偏瘫患者坐-站转移时间及下肢肌肉激活的影响。方法 2019年1月至8月,脑卒中偏瘫患者15例,采用高强度海绵楔形垫调整座椅前倾角度,患者在平椅(0°)、前倾10°和前倾20°下分别完成5次坐-站转移,记录坐-站转移时间,双下肢股直肌、腘绳肌、胫骨前肌和腓肠肌内侧头表面肌电(sEMG)信号。结果前倾10°和20°时,各肌肉总肌电峰值、均方根(RMS)值和积分肌电(iEMG)值均比0°时降低(F > 4.530, P < 0.05),前倾20°时坐-站转移时间短于0°时( P < 0.05)。结论椅面前倾特定角度可改善脑卒中偏瘫患者坐-站转移表现。

关键词: 脑卒中, 偏瘫, 坐-站转移, 座椅, 前倾, 表面肌电图, 康复

Abstract:

Objective To study the effect of chair inclination angles forward on sit-to-stand time and muscle activation of lower extremities in stroke patients with hemiplegia. Methods From January to August, 2019, 15 stroke patients with hemiplegia finished five times sit-to-stand at seat slope 0°, 10° and 20° forward. The time, and surface electromyogram (sEMG) signals of rectus femoris, hamstrings, anterior tibialis and peroneus muscle were recorded.Results The total EMG peak, root mean square and integrated electromyography (iEMG) of all the muscles decreased at seat slope 10° and 20° forward compared with those at 0° (F > 4.530, P < 0.05). The time decreased at seat slope 20° forward compared with that at 0° ( P < 0.05). Conclusion Seat inclination forward at some angles may improve the sit-to-stand performance in stroke patients with hemiplegia.

Key words: stroke, hemiplegia, sit-to-stand, chair, inclination, surface electromyography, rehabilitation

中图分类号:

R743.3

周哲,沈夏锋,沈小花,吴雪娇,王凤爽,荣积峰,吴毅. 椅面前倾对脑卒中偏瘫患者坐-站转移的影响[J]. 《中国康复理论与实践》, 2020, 26(7): 825-829.

ZHOU Zhe,SHEN Xia-feng,SHEN Xiao-hua,WU Xue-jiao,WANG Feng-shuang,RONG Ji-feng,WU Yi. Effect of Chair Inclination Forward on Sit-to-Stand for Hemiplegics after Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(7): 825-829.

图/表 3

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参考文献 25

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项目	统计值
年龄(岁)	59.60±9.36
性别(男/女, n)	10/5
身高(m)	1.68±0.03
体质量(kg)	72.27±7.09
卒中类型(梗死/出血,n)	12/3
偏瘫侧(左/右,n)	10/5
发病时间(月)	7.26±8.10
下肢Brunnstrom分期(Ⅳ/Ⅴ,n)	11/4
简化Fugl-Meyer评定量表下肢运动评分	29.83±3.09
Berg平衡量表评分	48.69±3.01
改良Barthel指数评分	89±12.15

座椅前倾角	n	坐-站转移时间(s)	肌电峰值(μV)	RMS(μV)	iEMG(V·s)
0°	15	4.14±2.89	634.28±536.64	81.85±61.49	56.61±40.51
10°	15	3.33±1.49	544.91±483.41^a	75.45±57.03^a	52.36±37.11^a
20°	15	3.13±1.20^a	519.61±435.05^a	76.31±58.68^a	53.01±39.89^a
F值		6.620	9.862	7.229	4.530
P值		0.007	0.001	0.002	0.013

椅面前倾对脑卒中偏瘫患者坐-站转移的影响

Effect of Chair Inclination Forward on Sit-to-Stand for Hemiplegics after Stroke

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肌肉	解剖位置
股直肌	大腿前侧中段肌腹最隆起处
腘绳肌	大腿后侧中部
胫骨前肌	膝关节与踝关节上1/4~1/3,胫骨旁开
腓肠肌内侧头	膝关节远端,中线旁开内侧2 cm

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