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结合功能性电刺激的运动再学习方案用于颈腰椎脊髓病继发四肢瘫的步态训练

Gait Training With Motor Relearning Program in Conjunction With Functional Electrical Stimulation in Quadriparesis Secondary to Cervical and Lumbar Myelopathy.

作者信息

Akhuj Aditi, Deodhe Nishigandha P, Jachak Shrushti

机构信息

Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Feb 19;16(2):e54449. doi: 10.7759/cureus.54449. eCollection 2024 Feb.

Abstract

Degenerative cervical myelopathy is a frequently encountered age-related pathology following compression of the spinal cord. This case report delineates the clinical manifestation of cervical and lumbar myelopathy in a 78-year-old male patient, characterised by chief complaints of difficulty in moving bilateral upper and lower extremities and difficulty in bed mobility. Motor impairment can manifest in three different presentations, which are paraparesis, hemiparesis, or quadriparesis. The motor relearning program incorporating functional electrical stimulation constitutes a rehabilitative approach used for the restoration of motor function. This study outlines the protocol for the physiotherapy intervention protocol, mainly focusing on gait training. Along with it, balance training, proprioceptive neuromuscular facilitation, etc., were also included. The goal of physiotherapy rehabilitation was to improve the patient's ability to do tasks related to daily living. The outcome measures used were the dynamic gait index, functional independence measure, and Modified Japanese Orthopaedic Association score. We document significant increases in muscular tone and power, improved active range of motion, enhancements in gait parameters, and notable advancements in the individual's functional independence through the implementation of a physiotherapeutic regimen.

摘要

退行性颈椎脊髓病是脊髓受压后常见的与年龄相关的病理状况。本病例报告描述了一名78岁男性患者的颈髓病和腰髓病的临床表现,主要症状为双侧上下肢活动困难和床上活动困难。运动障碍可表现为三种不同形式,即双侧轻瘫、偏瘫或四肢瘫。结合功能性电刺激的运动再学习计划是一种用于恢复运动功能的康复方法。本研究概述了物理治疗干预方案,主要侧重于步态训练。同时,还包括平衡训练、本体感觉神经肌肉促进法等。物理治疗康复的目标是提高患者完成日常生活相关任务的能力。所使用的结果指标为动态步态指数、功能独立性测量和改良日本矫形外科学会评分。我们记录了通过实施物理治疗方案,肌肉张力和力量显著增加、主动活动范围改善、步态参数提高以及个体功能独立性取得显著进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b589/10951938/1f4b3892b338/cureus-0016-00000054449-i01.jpg

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