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中风偏瘫患者腹部和背部肌肉神经肌肉电刺激对姿势平衡的比较

Comparison Between Neuromuscular Electrical Stimulation to Abdominal and Back Muscles on Postural Balance in Post-stroke Hemiplegic Patients.

作者信息

Park Mingeun, Seok Hyun, Kim Sang-Hyun, Noh Kyudong, Lee Seung Yeol

机构信息

Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

出版信息

Ann Rehabil Med. 2018 Oct;42(5):652-659. doi: 10.5535/arm.2018.42.5.652. Epub 2018 Oct 31.

Abstract

OBJECTIVE

To compare the effects of neuromuscular electrical stimulation (NMES) to abdominal muscles and back muscles on postural balance in post-stroke hemiplegic patients.

METHODS

Thirty post-stroke hemiplegic patients were prospectively enrolled and randomly assigned to one of the three groups: core muscle-strengthening exercise (CME) with NMES to abdominal muscles (group A), CME with NMES to back muscles (group B), and CME alone (group C). All subjects underwent their targeted interventions for 30 minutes each day, 5 days per week for 3 weeks under a conventional stroke rehabilitation program. Subjects were evaluated using Korean version of Berg Balance Scale (K-BBS), Trunk Impairment Scale (TIS), Korean version of Modified Barthel Index (K-MBI), Weight Distribution Index (WDI), and Stability Index (SI) just before and 3 weeks after intervention.

RESULTS

Changes in K-BBS (p<0.05) and TIS (p<0.05) were significantly higher in group A (18.5±8.10, 6.6±1.90) and group B (19.9±5.44, 7.0±2.26) than in group C (8.4±4.14, 3.1±0.99). However, K-MBI, WDI, and SI failed to show any significant difference. No significant difference in all outcomes was observed between groups A and B.

CONCLUSION

The effect of NMES to the abdominal muscles was similar to the effect on back muscles in terms of postural balance. This finding indicated that the NMES to the abdominal muscles may be an alternative for post-stroke hemiplegic patients contraindicated for NMES to the back muscles. Additional studies investigating the effects of NMES on abdominal and back muscles are needed.

摘要

目的

比较神经肌肉电刺激(NMES)作用于腹部肌肉和背部肌肉对脑卒中偏瘫患者姿势平衡的影响。

方法

前瞻性纳入30例脑卒中偏瘫患者,并随机分为三组:对腹部肌肉进行神经肌肉电刺激的核心肌肉强化训练(CME)组(A组)、对背部肌肉进行神经肌肉电刺激的CME组(B组)和单纯CME组(C组)。所有受试者在常规脑卒中康复计划下,每天接受30分钟的目标干预,每周5天,共3周。在干预前和干预3周后,使用韩国版Berg平衡量表(K-BBS)、躯干功能障碍量表(TIS)、韩国版改良Barthel指数(K-MBI)、体重分布指数(WDI)和稳定性指数(SI)对受试者进行评估。

结果

A组(18.5±8.10,6.6±1.90)和B组(19.9±5.44,7.0±2.26)的K-BBS(p<0.05)和TIS(p<0.05)变化显著高于C组(8.4±4.14,3.1±0.99)。然而,K-MBI、WDI和SI未显示出任何显著差异。A组和B组在所有结果上均未观察到显著差异。

结论

就姿势平衡而言,NMES作用于腹部肌肉的效果与作用于背部肌肉的效果相似。这一发现表明,对于禁忌对背部肌肉进行NMES治疗的脑卒中偏瘫患者,对腹部肌肉进行NMES可能是一种替代方法。需要进一步研究NMES对腹部和背部肌肉的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6aea/6246866/0a9a8e7aebc2/arm-2018-42-5-652f1.jpg

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