目的 观察镜像治疗结合功能性电刺激(FES)对亚急性脑卒中患者下肢运动及步行功能、日常生活活动能力的康复效果。方法 2016年7月至2017年12月,38例亚急性期脑卒中患者随机分为对照组(n=18)和治疗组(n=20)。在常规康复的基础上,对照组采用FES进行训练,治疗组同时采用下肢镜像治疗和FES进行训练,共8周。治疗前后采用简式Fugl-Meyer评定量表下肢部分(FMA-LE)、功能性步行量表(FAC)和改良Barthel指数(MBI)进行评定。结果 治疗后,两组FMA-LE、MBI评分和FAC分级均有明显改善(Z>3.002, t>7.985, P<0.01),治疗组FMA-LE评分改善更多(Z=-2.037, P<0.05),两组间FAC分级和MBI评分无显著性差异(t=-1.044, Z=-1.287, P>0.05)。结论 在FES基础上结合镜像治疗能进一步改善亚急性脑卒中患者下肢运动功能,但尚不足以影响步行和日常活动。
Objective To observe the effects of mirror therapy (MT) combined with functional electrical stimulation (FES) on motor of lower extremities, walking ability and activities of daily living for subacute stroke patients. Methods From July, 2016 to December, 2017, 38 subacute stroke patients were randomly divided into treatment group (n=20) and control group (n=18). All the patients received routine rehabilitation. The control group accepted FES, and the treatment group accepted FES and MT, for eight weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Functional Ambulation Categories (FAC) and modified Barthel Index (MBI) before and after treatment. Results Both groups improved in the scores of FMA-LE and MBI, and grade of FAC after treatment (Z>3.002, t>7.985, P<0.01), and the scores of FMA-LE improved more in the treatment group than in the control group (Z=-2.037, P<0.05). There was no difference between two groups in the scores of MBI and grade of FAC (t=-1.044, Z=-1.287, P>0.05). Conclusion The addition of MT on FES may further improve the lower extremities motor function, but not enough to improve their walking and activities of daily living in subacute stroke patients.
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