| 摘要: |
| ［摘要］ 目的 观察整合性神经肌肉训练治疗脑卒中后下肢痉挛性偏瘫患者的疗效。方法 选择2021年1月至2024年12月中国人民解放军海军陆战队医院收治的100例脑卒中后下肢痉挛性偏瘫患者。采用随机数字表法将患者分为对照组和观察组，各50例。对照组采用常规康复训练，观察组采用整合性神经肌肉训练，两组训练周期均为12周。分别于治疗前后观察下肢表面肌电图指标、神经功能、下肢运动功能、心理状态和生活质量，检测血清γ-氨基丁酸（GABA）、神经元特异性烯醇化酶（NSE）、谷氨酸（Glu）水平，对比两组临床疗效。结果 治疗后两组肌电图肌肉活动信号的均方根（RMS）、美国国立卫生研究院卒中量表（NIHSS）评分、临床痉挛指数（CSI）、医院焦虑抑郁量表（HADS）评分、GABA水平、NSE水平、Glu水平较治疗前显著降低，且观察组显著低于对照组（P<0.05）；治疗后两组10 m步行时间较治疗前显著缩短，且观察组显著短于对照组（P<0.05）；治疗后两组积分肌电（iEMG）、中位频率（MF）、平均功率频率（MPF）、Berg平衡量表（BBS）评分、Fugl-Meyer运动功能评定（FMA）量表评分、功能独立性测量（FIM）评分和改良Barthel指数（MBI）较治疗前显著升高，且观察组显著高于对照组（P<0.05）。观察组总有效率高于对照组（96.00% vs 82.00%， χ2=5.005，P=0.025）。结论 整合性神经肌肉训练治疗脑卒中后下肢痉挛性偏瘫患者的疗效显著，能够有效改善患者神经功能、下肢运动功能以及心理状态。 |
| 关键词: 整合性神经肌肉训练 脑卒中 下肢痉挛性偏瘫 表面肌电图 γ-氨基丁酸 神经元特异性烯醇化酶 谷氨酸 |
| DOI：10.3969/j.issn.1674-3806.2025.10.09 |
| 分类号:R 741 |
| 基金项目: |
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| Observation on efficacy of integrated neuromuscular training in treatment of patients with spastic hemiplegia of lower limbs after stroke |
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JING Xingquan, CHEN Wanchao, XIE Zhuopeng
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Department of Rehabilitation Medicine and Physical Therapy, Chinese People′s Liberation Army Marine Corps Hospital, Chaozhou 521000, China
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| Abstract: |
| ［Abstract］ Objective To observe the efficacy of integrated neuromuscular training(INT) in treatment of patients with spastic hemiplegia of lower limbs after stroke. Methods One hundred patients with spastic hemiplegia of lower limbs after stroke who were admitted to Chinese People′s Liberation Army Marine Corps Hospital from January 2021 to December 2024 were selected. The patients were divided into control group and observation group by using random number table method, with 50 patients in each group. The control group received conventional rehabilitation training, while the observation group received INT. The training period was 12 weeks in both groups. The surface electromyography(sEMG) indicators of lower limbs, neurological function, lower limb motor function, psychological state and quality of life were observed, and the levels of serum gamma-aminobutyric acid(GABA), neuron-specific enolase(NSE) and glutamate(Glu) were detected before and after treatment. The clinical effects were compared between the two groups. Results After treatment, the root mean square(RMS) of electrical activity signals of muscles in electromyography, the National Institutes of Health Stroke Scale(NIHSS) scores, the Clinical Spasticity Index(CSI) scores, the Hospital Anxiety and Depression Scale(HADS) scores, GABA levels, NSE levels and Glu levels in both groups were significantly lower than those before treatment, and these indicators in the observation group were significantly lower than those in the control group after treatment(P<0.05). After treatment, the time of 10-meter walk test in both groups was significantly shortened compared with that before treatment, and the time of 10-meter walk test in the observation group was significantly shorter than that in the control group after treatment(P<0.05). After treatment, the intramuscular electromyography(iEMG), median frequency(MF), mean power frequency(MPF), Berg Balance Scale(BBS) scores, Fugl-Meyer Assessment(FMA) scale scores, Functional Independence Measure(FIM) scores and modified Barthel Index(MBI) in the two groups were significantly elevated than those before treatment, and these indicators in the observation group were significantly higher than those in the control group after treatment(P<0.05). The total effective rate of the observation group was higher than that of the control group(96.00% vs 82.00%, χ2=5.005, P=0.025). Conclusion INT is significantly effective in treatment of patients with spastic hemiplegia of lower limbs after stroke. INT can effectively improve the neurological function, lower limb motor function and psychological state of the patients. |
| Key words: Integrated neuromuscular training(INT) Stroke Spastic hemiplegia of lower limbs Surface electromyography(sEMG) Gamma-aminobutyric acid(GABA) Neuron-specific enolase(NSE) Glutamate(Glu) |
