摘要
目的探究经颅直流电刺激(tDCS)联合高压氧(HBO)治疗对脑卒中偏瘫患者运动功能障碍的疗效。方法选取山西医科大学第一医院康复科2019年3月至2021年3月收治的脑卒中偏瘫患者90例, 按照随机数字表法分为观察组和对照组, 每组45例。所有患者均进行常规康复治疗, 对照组给予tDCS治疗, 观察组在接受HBO治疗的基础上给予tDCS治疗, 比较2组患者治疗前后的下肢运动能力、平衡能力、日常生活能力、神经缺损情况及表面肌电参数。结果 2组患者治疗后运动功能评定量表(FMA-L)和Berg平衡量表(BBS)评分均较治疗前提高, 且观察组高于对照组, 差异均有统计学意义(P<0.05)。2组患者治疗后睁眼和闭眼时的重心移动轨迹椭圆面积减小, 且观察组小于对照组, 差异均有统计学意义(P<0.05)。2组患者治疗后的美国国立卫生研究院卒中量表(NIHSS)评分降低, 且观察组低于对照组;巴氏指数评分提高, 且观察组高于对照组;差异均有统计学意义(P<0.05)。2组患者治疗后积分肌电值(iEMG)均升高, 且观察组高于对照组;协同收缩率(CR)降低, 且观察组低于对照组;差异均有统计学意义(P<0.05)。结论 tDCS联合HBO治疗可有效提高脑卒中偏瘫患者的运动能力, 在恢复机体平衡能力、肌肉活性方面效果显著, 有利于神经功能恢复及生活质量改善。
Objective To study the therapeutic effects of transcranial direct current stimulation(tDCS)combined with hyperbaric oxygen(HBO)in the treatment of dyskinesia in stroke patients with hemiplegia.Methods A total of 90 stroke patients with hemiplegia admitted to the Department of Rehabilitation of the First Hospital of Shanxi Medical University between March 2019 and March 2021 were selected.They were divided into observation group and control group according to the random number table method,with 45 patients in each group.All patients underwent conventional rehabilitation treatment.The control group was treated with tDCS,and the observation group was treated with tDCS on the basis of HBO therapy.The lower limb motor ability,balance ability,activity of daily living,nerve defects and surface electromyography parameters were compared between the two groups.Results After treatment,the Fugl-Meyer Assessment Scale(FMA-L)scores and Berg Balance Scale(BBS)scores of the two groups were significantly increased,and the observation group had significantly higher scores than the control group.The differences were statistically significant(P<0.05).After treatment,the ellipse area of the center of gravity trajectory when eyes opened and closed was significantly reduced in the two groups,and the ellipse area of the observation group was significantly smaller than that of the control group.The differences were statistically significant(P<0.05).After treatment,the National Institutes of Health Stroke Scale(NIHSS)scores of the two groups were significantly reduced,and the observation group had significantly lower scores than the control group.Barthel Index scores of the two groups were significantly increased,and the observation group had significantly higher scores than the control group.The differences were statistically significant(P<0.05).After treatment,the integrated electromyogram(iEMG)was significantly increased in the two groups,and the observation group had significantly higher iEMG than the control group.The synergistic contraction rate(CR)was significantly reduced,and it was significantly lower in the observation group than in the control group.The differences were statistically significant(P<0.05).Conclusion The combined treatment of tDCS and HBO can effectively improve the motor ability of stroke patients with hemiplegia,restore their balance ability and muscle activity,and promote the nerve function recovery and quality of life.
作者
孙静
武俊英
刘惠灵
王聪
Sun Jing;Wu Junying;Liu Huiling;Wang Cong(Department of Rehabilitation,The First Hospital of Shanxi Medical University,Taiyuan 030001,China;Sports Medical Rehabilitation Center,Hebei Institute of Sports Science,Shijiazhuang 050011,China)
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2022年第2期188-192,共5页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
基金
河北省重点研发计划项目(21375701D)。
关键词
脑卒中偏瘫
经颅直流电刺激
高压氧
运动功能
Stroke hemiplegia
Transcranial direct current stimulation
Hyperbaric oxygen
Motor function
作者简介
通信作者:武俊英,Email:353997497@qq.com。
