摘要
目的评价经颅直流电刺激(tDCS)联合下肢智能反馈训练在急性脑卒中(ACS)后下肢运动功能障碍患者康复中的应用效果。方法回顾性选取2020年1月至2022年12月青岛市中医医院收治的ACS后下肢运动功能障碍患者84例作为研究对象,根据康复方案不同分为tDCS组和联合组,各42例。tDCS组给予常规药物治疗及功能锻炼+tDCS治疗,联合组在tDCS组基础上联合下肢智能反馈训练。评价两组的临床疗效,采用中国人卒中量表(CSS)评定神经功能,采用Fugl-Meyer运动功能量表下肢部分(FMA-L)评定运动功能,采用Berg平衡量表(BBS)、计时起立-行走测试(TUGT)评定平衡功能,采用巴氏指数(BI)评定日常生活能力(ADL),采用脑卒中专用生活质量量表(SS-QOL)评估生存质量,并比较两组的患者满意度。结果联合组治疗总有效率为90.48%,显著高于tDCS组(69.05%),差异有统计学意义(χ^(2)=5.974,P<0.05)。治疗后,两组FMA-L、BBS、BI和SS-QOL评分均较治疗前明显增加,CSS、TUGT均较治疗前显著减少,而联合组FMA-L、BBS、BI和SS-QOL量表评分分别为(28.86±3.47)、(44.84±6.31)、(72.26±8.67)、(183.34±25.06)分,均高于tDCS组[(23.10±5.11)、(39.06±7.28)、(61.80±8.31)、(161.25±33.84)分],CSS、TUGT分别为(9.75±2.16)、(19.29±8.50)分,均低于tDCS组[(15.08±2.71)、(26.13±11.52)分],差异均有统计学意义(P<0.05)。联合组患者满意度为92.86%,明显高于tDCS组(64.29%),差异有统计学意义(χ^(2)=10.182,P<0.05)。结论tDCS联合下肢智能反馈训练治疗ACS后下肢运动功能障碍疗效较好,可有效改善神经、运动、平衡功能,提高日常生活能力及生存,满意度高。
Objective To evaluate the effect of transcranial direct current stimulation(tDCS)combined with lower limb intelligent feedback training in the rehabilitation of patients with lower limb motor dysfunction after acute cerebral stroke(ACS).Methods A total of 84 patients with lower limb motor dysfunction after ACS admitted to Qingdao Traditional Chinese Medicine Hospital from January 2020 to December 2022 were retrospectively selected as research subjects.They were divided into tDCS group and combination group according to different rehabilitation plans,with 42 patients in each group.The clinical efficacy of both groups was evaluated,with neurological function evaluated using the Chinese Stroke Scale(CSS),motor function evaluated by the Fugl Meyer Motor Function Scale Lower Limb(FMA-L),balance function evaluated by the Berg balance scale(BBS),time"up and go"test(TUGT),and daily living ability(ADL)evaluated by Barthel index(BI),the quality of life was evaluated by the Stroke Specific Quality of Life Scale(SS-QOL),and the patient satisfaction of the two groups was compared.Results The total effective rate of the combined group was 90.48%,which was significantly higher than that of the tDCS group(69.05%),the difference was statistically significant(χ^(2)=5.974,P<0.05).After treatment,the scores of FMA-L,BBS,BI,and SS-QOL scales in both groups were significantly higher than those before treatment,while CSS and TUGT were significantly lower than those before treatment.However,the scores of FMA-L,BBS,BI,and SS-QOL scales in the combination group were(28.86±3.47),(44.84±6.31),(72.26±8.67),(183.34±25.06)points,respectively,which were higher than those in the tDCS group[(23.10±5.11),(39.06±7.28),(61.80±8.31),(161.25±33.84)points],while CSS and TUGT were (9.75±2.16),(19.29±8.50)points,respectively,which were lower than those in the tDCS group[(15.08±2.71),(26.13±11.52)points],the differences were statistically significant(P<0.05).The satisfaction rate of patients in the combined group was 92.86%,which was significantly higher than that in the tDCS group(64.29%),the difference was statistically significant(χ^(2)=10.182,P<0.05).Conclusion tDCS combined with lower limb intelligent feedback training has a positive effect on the treatment of lower limb motor dysfunction after ACS,which can effectively improve the patient's neurological function,motor function,balance function,improve the patient's ability of daily life and survival treatment,with high satisfaction.
作者
王楠
刘绪涛
谢豪娜
WANG Nan;LIU Xu-tao;XIE Hao-na(Department of Needle Push Rehabilitation,Qingdao Traditional Chinese Medicine Hospital,Qingdao Shandong 266000,China)
出处
《临床和实验医学杂志》
2023年第16期1755-1758,共4页
Journal of Clinical and Experimental Medicine
基金
2021年山东省中医药科技项目(编号:2021Q055)。
关键词
急性脑卒中
下肢运动功能障碍
经颅直流电刺激
下肢智能反馈训练系统
疗效
Acute cerebral stroke
Lower limb motor dysfunction
Transcranial direct current stimulation
Lower limb intelligent feedback training system
Curative effect
作者简介
通讯作者:谢豪娜,E-mail:wangnan199504@163.com。
