低频穴位电刺激对中风后踝背屈障碍患者步行能力的影响

发布时间：2018-07-20 21:50

【摘要】：目的：观察不同低频穴位电刺激方法对中风后踝背屈障碍患者步行能力的影响,并对踝关节主动背屈活动度与步行能力之间的关系进行探讨,优化治疗方案,为提高临床疗效提供有力依据。方法：选择符合纳入标准的中风后踝背屈障碍患者60例,随机分为对照组与治疗组,每组各30例。两组患者均接受常规治疗。对照组接受常规低频穴位电刺激治疗,选取患侧足三里、阳陵泉,采用断续波(断续比1：1),频率为50Hz,每次20分钟,每日1次,治疗6天,休息1天,共治疗4周；治疗组接受屈伸肌交替低频穴位电刺激治疗,选取患侧足三里、阳陵泉、飞扬、昆仑,电刺激的波形、频率、治疗时间、治疗频率、疗程均与对照组相同。分别在疗前与疗后使用RM Gait步态分析系统对两组患者的步行能力进行评价,并对踝关节最大主动背屈角度及下肢Fulg-Meyer评分进行测定。利用SPSS 230统计软件对数据进行处理与分析。结果：1.两组患者疗后的步速、步频、患侧步长较疗前差异均非常显著(P0.01),两组患者步速、步频、患侧步长的差值组间差异有显著性意义(P0.05),治疗组优于对照组。2.两组患者疗后患侧单支撑相占步态周期百分比、双支撑相占步态周期百分比较疗前差异均非常显著(P0.01),两组患者患侧单支撑相占步态周期百分比、双支撑相占步态周期百分比的差值组间差异有显著性意义(P0.05),治疗组优于对照组。3.两组患者疗后患侧踝关节最大主动背屈角度、下肢Fulg-Meyer评分较疗前差异均非常显著(P0.01),两组患者患侧踝关节最大主动背屈角度的差值组间差异有显著性意义(P0.05),两组患者下肢Fulg-Meyer评分的差值组间差异非常显著(P0.01),治疗组优于对照组。4.两组患者患侧踝关节最大主动背屈角度的差值与步速、步频、患侧步长、患侧单支撑相占步态周期百分比、双支撑相占步态周期百分比的差值的相关性分析P值均小于0.01,提示患侧踝关节最大主动背屈角度的差值与步速、步频、患侧步长、患侧单支撑相占步态周期百分比、双支撑相占步态周期百分比的差值相关。结论：1.屈伸肌交替低频穴位电刺激与常规低频穴位电刺激均能改善中风后踝背屈障碍,对中风后踝背屈障碍患者步行能力的提升疗效显著；2.屈伸肌交替低频穴位电刺激对改善中风后踝背屈障碍疗效优于常规低频穴位电刺激；3.踝背屈功能在维持下肢负重、步行的平衡与稳定性方面有着重要的作用,是影响步行能力的重要因素。
[Abstract]:Objective: to observe the effect of different low frequency acupoint electrical stimulation on walking ability of patients with ankle dorsoflexion disorder after stroke, and to explore the relationship between active dorsiflexion activity and walking ability of ankle joint, and to optimize the treatment scheme. In order to improve the clinical efficacy to provide a strong basis. Methods: 60 patients with malleolus dorsiflexion were randomly divided into control group and treatment group with 30 cases in each group. Both groups received routine treatment. The control group was treated with conventional low frequency acupoint electrical stimulation. Zusanli and Yanglingquan of affected side were treated with intermittent wave (intermittent ratio of 1:1), frequency was 50 Hz, every time was 20 minutes, once a day, treatment for 6 days, rest for 1 day, a total of 4 weeks; The treatment group was treated with alternating low frequency electric stimulation of flexor and extensor muscle. The waveform, frequency, treatment time, treatment frequency and course of treatment were the same as those of the control group in Zusanli, Yanglingquan, Feiyang, Kunlun and electric stimulation groups. The walking ability of the two groups was evaluated by RMGait gait analysis system before and after treatment, and the maximum active dorsiflexion angle of ankle joint and the Fulg-Meyer score of lower extremity were measured. SPSS 230 statistical software was used to process and analyze the data. The result is 1: 1. There were significant differences in step speed, frequency and length of the affected side between the two groups (P0.01). There were significant differences between the two groups (P0.05), the treatment group was better than the control group. 2. There were significant differences between the two groups in the percentage of gait cycle and the percentage of double support phase in gait cycle after treatment (P0.01), and the percentage of the affected unilateral support phase in gait cycle was significant (P0.01). There was significant difference in the percentage of double support phase in gait cycle between groups (P0.05), the treatment group was better than the control group. 3. The maximum active dorsiflexion angle of ankle joint of the two groups after treatment, Fulg-Meyer score of lower extremity was significantly different from that before treatment (P0.01). There was significant difference in the difference of the maximal active dorsiflexion angle between the two groups (P0.05). The difference of Fulg-Meyer score between the two groups was very significant (P0.01). The treatment group was better than the control group (P0.01). The difference between the maximum active dorsiflexion angle of the ankle joint of the two groups and the step speed, step frequency, the length of the affected side, the percentage of the affected side single bracing phase to the gait cycle, Correlation Analysis of the percentage of double bracing Phase in gait cycle P < 0.01, indicating that the difference between the maximum active dorsiflexion angle of the affected ankle joint and the step speed, step frequency, step length of the affected side, and the percentage of the single bracing phase of the affected side to the gait cycle, the ratio of the maximum active dorsiflexion angle of the affected ankle to the gait cycle. The difference between double bracing phase and gait cycle percentage is correlated. Conclusion 1. Alternately low frequency acupoint electrical stimulation of flexion and extensor muscle and conventional low frequency acupoint electrical stimulation can improve the ankle dorsoflexion disorder after stroke, and the effect on walking ability of patients with ankle dorsoflexion disorder after stroke is significant. 2. The effect of alternating low frequency acupoint electrical stimulation of flexion and extensor muscle on improving ankle dorsal flexion disorder after apoplexy was better than that of conventional low frequency acupoint electrical stimulation. The function of ankle dorsiflexion plays an important role in maintaining the weight bearing of lower limbs, balance and stability of walking, and is an important factor affecting walking ability.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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