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多通道功能性电刺激四肢联动对偏瘫后肩关节半脱位患者的康复疗效
({{custom_author.role_cn}}), {{javascript:window.custom_author_cn_index++;}}Rehabilitation efficacy of multichannel FES limb linkage on patients with shoulder subluxation after hemiplegia
({{custom_author.role_en}}), {{javascript:window.custom_author_en_index++;}}目的：观察运用多通道功能性电刺激四肢联动治疗偏瘫后肩关节半脱位患者的康复疗效。方法：将60例偏瘫后肩关节半脱位患者随机分为治疗组和对照组，各30例。对照组给予日常康复治疗和普通四肢联动训练；治疗组在日常康复治疗的同时辅以多通道功能性电刺激四肢联动。治疗4周后，采用肩峰与肱骨头间距（AHI）评定肩关节半脱位改善程度；用简化Fugl-Meyer上肢运动功能量表（FMA-UE）、改良Barthel指数（MBI）等评估肩关节功能恢复情况；比较两组治疗显效率。结果：治疗后，治疗组AHI值低于对照组；FMA-UE、MBI评分和显效率高于对照组（P<0.05）。结论：在日常康复治疗的基础上，运用多通道功能性电刺激四肢联动可改善患者肩关节半脱位症状，提高患者上肢活动能力。
Objective: To observe the rehabilitation efficacy of multichannel functional electrical stimulation (FES) combined with four limbs on patients with shoulder subluxation after hemiplegia. Methods: Sixty patients with shoulder subluxation after hemiplegia were randomly divided into a control group and a treatment group with 30 cases each. The control group was given daily rehabilitation treatment and general limb linkage training, while the treatment group was supplemented with multichannel FES limb linkage on the basis of daily rehabilitation treatment. The degree of the improvement of shoulder subluxation was assessed by the acromiohumeral interval (AHI), the recovery of shoulder function was assessed by the simplified Fugl-Meyer assessment-upper extremities (FMA-UE) and the modified Barthel index (MBI), and the significant efficacy rate was compared between the two groups four weeks after treatment. Results: After treatment, the AHI value was lower, and the FMA-UE and MBI scores and the significant efficacy rate were higher in the treatment group than the control group (P<0.05). Conclusion: Multichannel FES limb linkage can improve shoulder subluxation and upper limb mobility of patients on the basis of daily rehabilitation treatment.
功能性电刺激 / 四肢联动 / 肩关节半脱位 / 偏瘫 {{custom_keyword}} /
FES / limb linkage / shoulder subluxation / hemiplegia {{custom_keyword}} /
表1 治疗前后AHI值、FMA-UE及MBI评分比较（$\bar{x}±s$） |
| 组别 | AHI/mm | FMA-UE | MBI | |||||
|---|---|---|---|---|---|---|---|---|
| 治疗前 | 治疗后 | 治疗前 | 治疗后 | 治疗前 | 治疗后 | |||
| 治疗组（n=30） | 21.53±2.27 | 15.00±1.72a) | 7.10±2.34 | 33.53±5.51a) | 12.17±4.29 | 48.33±9.41a) | ||
| 对照组（n=30） | 21.60±2.06 | 18.10±2.04a) | 6.93±2.41 | 27.53±5.96a) | 11.83±5.00 | 38.33±9.85a) | ||
| t值 | －0.119 | －6.360 | 0.272 | 4.048 | 0.277 | 4.020 | ||
| P值 | 0.906 | <0.001 | 0.787 | <0.001 | 0.783 | <0.001 | ||
| 注：a) 与治疗前相比，P<0.001。 |
表2 临床疗效比较[n（%）] |
| 组别 | 显效 | 有效 | 无效 |
|---|---|---|---|
| 治疗组（n=30） | 11（36.6） | 19（63.3） | 0 |
| 对照组（n=30） | 1（3.3） | 27（90.0） | 2（6.7） |
| χ2值 | 11.725 | ||
| P值 | 0.003 |
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