《中国康复理论与实践》

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (2): 210-216.doi: 10.3969/j.issn.1006-9771.2024.02.011

• 应用研究 • 上一篇    下一篇

前庭电刺激对脑卒中患者侧倾功能障碍的效果

龚翔1, 王梦寰1, 吴存书1, 陈珺雯1, 肖悦1,2, 杨云1,2, 孙婉婷1, 鲁俊1,2(), 许光旭1,2()   

  1. 1.南京医科大学康复医学院，江苏南京市 210029
    2.南京医科大学第一附属医院康复医学中心，江苏南京市 210029
  • 收稿日期:2023-10-29 修回日期:2024-01-12 出版日期:2024-02-25 发布日期:2024-03-01
  • 通讯作者: 鲁俊,许光旭 E-mail:lujunrehab@foxmail.com;xuguangxu@njmu.edu.cn
  • 作者简介:龚翔(1999-)，男，汉族，江苏南通市人，硕士研究生，主要研究方向：神经调控及脑功能成像。
  • 基金资助:
    1.江苏省卫生健康发展研究中心开放课题(JSHD2021003);2.江苏省研究生科研与实践创新计划项目(KYCX23_1934)

Effect of galvanic vestibular stimulation on stroke patients with lateropulsion

GONG Xiang1, WANG Menghuan1, WU Cunshu1, CHEN Junwen1, XIAO Yue1,2, YANG Yun1,2, SUN Wanting1, LU Jun1,2(), XU Guangxu1,2()   

  1. 1. Department of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, China
    2. Rehabilitation Medicine Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
  • Received:2023-10-29 Revised:2024-01-12 Published:2024-02-25 Online:2024-03-01
  • Contact: LU Jun, XU Guangxu E-mail:lujunrehab@foxmail.com;xuguangxu@njmu.edu.cn
  • Supported by:
    Jiangsu Health Development Research Center Open Project(JSHD2021003);Jiangsu Postgraduate Research & Practice Innovation Program(KYCX23_1934)

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摘要：

目的 探讨前庭电刺激对脑卒中患者侧倾功能障碍的疗效。
方法 2023年2月至10月，选取南京医科大学第一附属医院脑卒中侧倾患者30例，随机分为对照组(n = 15)和试验组(n = 15)。对照组接受常规康复训练与前庭伪电刺激，试验组接受常规康复训练与前庭电刺激，共2周。干预前后分别采用侧倾行为评估量表(SCP)、主观视觉垂直感知(SVV)、线段划消试验(LCT)、星消试验(SCT)、Berg平衡量表(BBS)、Holden功能性步行分级(FAC)和Barthel指数(BI)进行评估。
结果 干预后，除对照组SVV方向性和稳定性以及SCT外，两组其余指标均改善(|t| > 2.461, Z > 3.000, P < 0.05)，且试验组SCP、SVV稳定性、LCT和FAC均优于对照组(|t| > 2.189, Z = -2.862, P < 0.05);干预前后差值比较，除LCT外，试验组均大于对照组(|t| > 2.382, P < 0.05)。相关性分析显示，SCP与SVV方向性和稳定性、SCT、BBS、BI评分以及FAC均相关(|r| > 0.381, P < 0.05)。
结论 前庭电刺激能改善脑卒中患者的侧倾、平衡、步行功能和日常生活活动能力，可能与改善空间认知功能障碍，特别是垂直感知有关。

关键词: 脑卒中, 侧倾, 前庭电刺激, 视空间认知, 垂直感知

Abstract:

Objective To investigate the effect of galvanic vestibular stimulation on stroke patients with lateropulsion.
Methods From February to October, 2023, 30 stroke patients with lateropulsion in the First Affiliated Hospital of Nanjing Medical University were divided into control group (n = 15) and experimental group (n = 15) randomly. The control group received routine rehabilitation and sham galvanic vestibular stimulation, and the experimental group received routine rehabilitation and true galvanic vestibular stimulation, for two weeks. They were assessed with Scale for Contraversive Pushing (SCP), subjective visual vertical (SVV), Line Cancellation Test (LCT), Star Cancellation Test (SCT), Berg Balance Scale (BBS), Holden Functional Ambulation Category (FAC) and Barthel Index (BI) before and after treatment.
Results All the indexes improved in both groups after intervention (|t| > 2.461, Z > 3.000, P < 0.05), except the SVV orientation, SVV certainty and SCT in the control group; while the SCP, SVV certainty, LCT and FAC were better in the experimental group than in the control group (|t| > 2.189, Z = -2.862, P < 0.05), and the differences before and after intervention were better in the experimental group than in the control group (|t| > 2.382, P < 0.05), except LCT. SCP was correlated with SVV orientation, SVV certainty, SCT, BBS, BI and FAC (|r| > 0.381, P < 0.05).
Conclusion Galvanic vestibular stimulation can improve the lateropulsion, balance, walking function and activities of daily living in stroke patients, which may be related to improvement for spatial cognitive function, especially vertical perception.

Key words: stroke, lateropulsion, galvanic vestibular stimulation, spatial cognition, vertical perception

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