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目的探讨步态诱发功能性电刺激与减重平板训练同步治疗对脑卒中患者偏瘫下肢表面肌电信号的影响。方法选择90例脑卒中后偏瘫患者,随机分为同步组(A组)、分离组(B组)和减重平板组(C组),每组各30例患者。A组采用步态诱发功能性电刺激与减重平板训练同步进行治疗,B组采用步态诱发功能性电刺激与减重平板训练分离进行治疗,C组仅单纯采用减重平板治疗,共治疗3周,观察对比3组治疗前后患侧胫骨前肌和腓肠肌外侧头的积分肌电值(iEMG)及协同收缩率(CR)、步速、左右步幅差、踝关节活动度(AROM)、Fugl-Meyer运动功能量表(FMA)下肢部分、改良Barthel指数(MBI)和功能性步行分级(FAC)评分。结果治疗后,3组患者胫骨前肌和腓肠肌i EMG值、踝背伸及跖屈CR、步速、左右步幅差、踝关节活动度、FMA评分、MBI评分、FAC评分均较治疗前改善(P均<0.05),治疗后A、B组前述各项指标均优于C组(P均<0.05),A组胫骨前肌iEMG、踝关节背伸CR及AROM优于B组(P均<0.05)。结论诱发功能性电刺激与减重平板训练同步治疗可以调节脑卒中偏瘫患者患侧下肢表面肌电信号,两者同步治疗改善表面肌电信号的作用明显优于两者分离治疗及单用减重平板训练治疗。
Objective To investigate the effect of synchronized gait-induced electrical stimulation and weight-loss plate training on the EMG of lower extremities in patients with stroke. Methods Ninety patients with post-stroke hemiplegia were randomly divided into three groups: control group (group A), group B (group B) and weight reduction group (group C), 30 patients in each group. Group A was treated with gait-induced functional electrical stimulation and weight-loss plate training simultaneously. Group B was treated with gait-induced functional electrical stimulation and weight-loss plate training. Group C was treated with weight-loss plate alone 3 weeks before and after treatment, the iEMG and CR of the anterior tibialis anterior muscle and gastrocnemius muscle were observed and compared before and after treatment. The pace, left and right gait amplitude, ankle mobility (AROM) Fugl-Meyer Motor Function Scale (FMA) lower limbs, Modified Barthel Index (MBI), and Functional Walk Score (FAC) scores. Results After treatment, i EMG value, ankle dorsiflexion and plantar flexion, gait velocity, left and right gait width, ankle joint mobility, FMA score, MBI score and FAC score of tibialis anterior muscle and gastrocnemius muscle in the three groups were all better than those before treatment (All P <0.05). The above indexes of group A and group B were better than group C after treatment (all P <0.05), and the AEMG and AROM of AEM in group A were better than those in group B <0.05). Conclusions Simultaneous treatment of functional electrical stimulation and weight-loss plate training can modulate the EMG signal on the ipsilateral lower limb in patients with hemiplegia due to stroke. The simultaneous treatment of both of them can obviously improve the EMG of the lower limbs, Flatbed training treatment.