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步态同步的臀中肌神经肌肉电刺激治疗右侧偏瘫患者:病例报告。

Gait synchronized neuromuscular electrical stimulation to the gluteus medius on a patient with right hemiparesis: a case report.

机构信息

Michigan Medicine, Department of Physical Medicine and Rehabilitation, University Hospital, MI, USA.

Physical Therapy, Mayo Clinic, College of Medicine and Science, Rochester, MN, USA.

出版信息

Physiother Theory Pract. 2022 Nov;38(13):3180-3186. doi: 10.1080/09593985.2021.1946874. Epub 2021 Jul 14.

Abstract

BACKGROUND AND PURPOSE

Although the use of neuromuscular electrical stimulation (NMES) to return gait speed and function in patients poststroke is well documented, the use of NMES to the gluteus medius in patients with hemiparesis is not well described. The purpose of this case report is to describe the use of gait synchronized NMES to the right gluteus medius of a patient with right hemiparesis who had poor hip abduction control during the stance phase of the gait cycle and impaired balance.

CASE DESCRIPTION

A 72-year-old female presented to the emergency department with right-sided hemiparesis. During her fifteen day stay in in-patient rehabilitation she demonstrated a Trendelenburg gait pattern, indicating the use of functional NMES to the gluteus medius to help improve her hip abduction control during the stance phase of gait.

OUTCOMES

After intervention which included traditional rehabilitation as well as functional NMES, the patient's gait speed increased from 0.22 m/s to 0.69 m/s and her Berg Balance Scale (BBS) increased from a 14/56 to 32/56 over a 14 day period indicating an improvement in dynamic balance and community ambulation.

DISCUSSION

This case report outlines the novel use of NMES to the gluteus medius during the stance phase of the gait cycle in a patient with poor hip abductor control.

摘要

背景与目的

尽管神经肌肉电刺激(NMES)在脑卒中后患者中恢复步态速度和功能的应用已有充分记录,但在偏瘫患者中使用 NMES 刺激臀中肌的应用却描述甚少。本病例报告的目的是描述对一名右侧偏瘫患者使用步态同步 NMES 刺激右侧臀中肌的应用,该患者在步态周期的站立相存在髋关节外展控制不良和平衡受损的情况。

病例描述

一名 72 岁女性因右侧偏瘫急诊就诊。在她 15 天的住院康复期间,她出现了特伦德伦堡步态模式,表明使用功能性 NMES 刺激臀中肌有助于改善其在步态站立相的髋关节外展控制。

结果

经过包括传统康复和功能性 NMES 在内的干预后,患者的步态速度从 0.22m/s 增加到 0.69m/s,Berg 平衡量表(BBS)从 14/56 增加到 32/56,这表明其动态平衡和社区步行能力得到了改善。

讨论

本病例报告概述了在髋关节外展肌控制不良的患者中,在步态周期的站立相使用 NMES 刺激臀中肌的新方法。

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