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1.
摘要 目的:探讨等速肌力训练联合上肢康复机器人在脑卒中恢复期偏瘫患者中的应用效果。方法:根据随机数字表法,将2020年1月-2022年12月期间合肥市第二人民医院收治的136例脑卒中恢复期偏瘫患者分为对照组(n=68,等速肌力训练)与观察组(n=68,等速肌力训练联合上肢康复机器人干预)。两组均干预3周,观察两组Fugl-Meyer上肢运动功能量表(FMA-UL)评分、改良Barthel指数(MBI)评分、偏瘫Brunnstrom分级、表面肌电图相关指标和生活质量评分变化情况。结果:观察组干预3周后FMA-UL、MBI评分高于对照组(P<0.05)。观察组干预3周后IV级患者例数多于对照组(P<0.05)。观察组干预3周后肱二头肌、肱三头肌、三角肌前束、三角肌中束的均方根值(RMS)和积分肌电值(iEMG)高于对照组(P<0.05)。观察组干预3周后生理职能、躯体疼痛、生理功能、总体健康、精神健康、活力、情感职能、社会功能各维度评分高于对照组(P<0.05)。结论:脑卒中恢复期偏瘫患者经等速肌力训练、上肢康复机器人联合干预,可促进偏瘫上肢肌肉激活和运动单位募集同步化,改善上肢肌力,提高患者的生活质量。  相似文献   

2.
摘要 目的:探讨MOTOmed下肢智能运动训练联合运动想象疗法对脑卒中偏瘫患者下肢功能、步行能力和躯干屈伸肌群肌力的影响。方法:148例脑卒中偏瘫患者来源于我院2019年5月~2021年5月期间我院接收的患者,根据随机数字表法分为对照组(n=74,常规康复训练的基础上结合MOTOmed下肢智能运动训练)和研究组(n=74,对照组的基础上结合运动想象疗法)。两组均干预12周。对比两组下肢功能、步行能力和躯干屈伸肌群肌力变化。结果:两组干预12周后Fugl-Meyer运动功能量表(FMA)、Barthel指数(BI)、功能性步行能力分级量表(FAC)评分升高,且研究组高于对照组(P<0.05)。两组干预12周后步频、步速、跨步长比率升高,且研究组高于对照组(P<0.05)。两组干预12周后健侧腹直肌、竖脊肌表面肌电信号的均方根值未见明显变化,且组间同时点对比无差异(P>0.05)。两组干预12周后患侧腹直肌、竖脊肌表面肌电信号的均方根值升高,且研究组高于对照组(P<0.05)。结论:脑卒中偏瘫患者在MOTOmed下肢智能运动训练的基础上进行运动想象疗法,可促进下肢功能改善,提高步行能力,同时还可改善患侧躯干屈伸肌群肌力。  相似文献   

3.
摘要 目的:探讨肌内效贴联合经皮神经电刺激(TENS)对脑卒中后偏瘫肩痛患者肩关节疼痛、肩关节功能和血液流变学的影响。方法:选取2019年5月~2022年1月期间江苏省人民医院收治的脑卒中后偏瘫肩痛患者100例,根据随机数字表法将其分为对照组(n=50)和研究组(n=50),在常规康复训练的基础上,对照组接受肌内效贴干预,研究组接受肌内效贴联合TENS干预。对比两组视觉模拟评分法(VAS)评分、上肢Fugl-Meyer运动功能评定量表(FMA)、改良Barthel指数(MBI)、Constant-Murley肩关节功能评分量表(CMS)评分、血液流变学指标、肩关节功能变化情况。结果:研究组干预后VAS评分低于同期对照组(P<0.05)。研究组干预后FMA、MBI、CMS评分高于同期对照组(P<0.05)。研究组干预后血浆黏度、纤维蛋白原、全血黏度、红细胞压积均低于同期对照组(P<0.05)。研究组干预后患侧肩关节的外旋、前屈、外展的主动/被动活动度(AROM/PROM)均大于对照组同期(P<0.05)。结论:肌内效贴联合TENS应用于脑卒中后偏瘫肩痛患者,可有效改善肩关节疼痛、肩关节功能和血液流变学。  相似文献   

4.
摘要 目的:研究运动想象训练联合三维旋进式振动疗法对脑卒中偏瘫患者平衡能力、上肢功能及日常生活活动能力的影响。方法:研究对象来源于苏州市立医院康复医学科2019年4月~2022年4月期间收治的80例脑卒中偏瘫患者。入院后按照计算机产生随机数进行随机分配为对照组和研究组,每组各40例。对照组患者接受运动想象训练,研究组患者接受三维旋进式振动疗法联合运动想象训练。对比两组疗效、上肢功能、平衡能力及日常生活活动能力。结果:两组患者干预2周后、干预4周后Fugl-Meyer上肢运动功能量表(FM-uL)、上肢动作研究量表(ARAT)评分均升高,且研究组均高于对照组同期;改良Ashworth痉挛量表(MAS)评分均下降,且研究组低于对照组同期(P<0.05)。两组患者干预2周后、干预4周后Berg平衡量表(BBS)评分均升高,且研究组高于对照组同期(P<0.05)。两组患者干预2周后、干预4周后Barthel指数(BI)评分均升高,且研究组高于对照组同期(P<0.05)。结论:运动想象训练联合三维旋进式振动疗法干预脑卒中偏瘫患者,可有效改善患者的平衡能力、上肢功能及日常生活活动能力。  相似文献   

5.
摘要 目的:探讨脑卒中痉挛性患者经颅磁刺激联合物理治疗后上肢功能改善状况的临床观察。方法:选取我院2018年1月到2020年1月共收治的80例脑卒中患者,所有患者均出现不同部位痉挛现象,将患者随机分为观察组与对照组,每组40例。给予对照组患者常规治疗与康复训练,观察组患者在常规治疗基础上应用低频重复经颅刺激联合肌电生物反馈模式下的康复训练。对比两组患者的治疗效果与上肢功能改善情况。结果:观察组治疗总有效率95.00 %,高于对照组72.50 %(P<0.05);治疗前两组患者的NIHSS评分应用神经功能缺损量表(Neurological deficit scale,NIHSS)、MMSE评分应用认知功能量表(Cognitive function scale,MMSE)、ADL评分应用日常生活能力量表(Activities of daily living scale,ADL)评分对比无显著差异(P>0.05),治疗后,观察组的NIHSS评分低于对照组,ADL评分高于对照组(P<0.05);治疗前两组患者的肱二头肌和肱三头肌均方根值(Root mean square,RMS)对比无显著差异(P>0.05),治疗后,观察组患者的肱二头肌RMS低于对照组,肱三头肌RMS高于对照组(P<0.05);治疗前两组患者的运动功能评估表中的上肢功能部分(Upper limb function in motor function assessment table,FMA-UE)、手部精细化动作及上肢功能测量表(Measurement table of hand fine movement and upper limb function,Carroll)评分对比无显著差异(P>0.05),治疗后,观察组患者的FMA-UE、Carroll评分高于对照组(P<0.05)。结论:对脑卒中上肢痉挛患者在常规治疗与康复训练的基础上应用低频重复经颅刺激联合肌电生物反馈模式下的康复训练,虽然对患者的认知功能无明显影响,但是能提升患者上肢痉挛的治疗效果,促进患者上肢功能恢复,提高生活能力,值得临床应用推广。  相似文献   

6.
摘要 目的:探讨三维旋进式振动疗法联合常规康复训练对脑卒中偏瘫患者上下肢痉挛状态、步行能力及生活质量的影响。方法:按照随机数字表法,将南京医科大学附属苏州医院2020年4月~2022年4月期间收治的80例脑卒中偏瘫患者分为对照组(常规康复训练)和实验组(三维旋进式振动疗法联合常规康复训练),每组各40例。对比两组偏瘫侧上下肢痉挛状态、步行能力及生活质量情况。结果:两组干预4周后、干预8周后Fugl-Meyer运动功能评分(FMA)上肢、下肢评分均较干预前升高,且实验组高于对照组(P<0.05)。两组干预4周后、干预8周后步长、步速、6 min步行试验(6MWT)均较干预前升高,且实验组高于对照组(P<0.05)。两组干预8周后,生理职能(RP)、活力(VT)、生理功能(PF)、总体健康(GH)、社会功能(SF)、躯体疼痛(BP)、情感职能(RE)、精神健康(MH)均较干预前升高,且实验组高于对照组(P<0.05)。结论:三维旋进式振动疗法联合常规康复训练应用于脑卒中偏瘫患者,可有效改善上下肢痉挛状态,提高步行能力,促进生活质量提高。  相似文献   

7.
摘要 目的:观察脑卒中偏瘫患者经肌内效贴联合平衡功能训练治疗后,其步行功能、生活质量及平衡功能的变化。方法:于2018年6月~2020年8月期间,选取我院收治的300例脑卒中偏瘫患者,根据随机数字表法分为对照组(150例,常规康复训练和平衡功能训练)和研究组(150例,常规康复训练、平衡功能训练联合肌内效贴),均治疗4周。对比两组平衡功能、步行功能、生活质量、睁眼站立、脚前后站立、闭眼站立的重心摆动速度及动态稳定时间。结果:治疗4周后,两组Fugl-Meyer下肢运动功能评定量表(FMA)、Berg平衡量表(BBS)评分较治疗前升高,且研究组高于对照组(P<0.05)。治疗4周后,两组步行功能指标:步频、步长、步速、步幅较治疗前升高,且研究组高于对照组(P<0.05)。治疗4周后,两组SF-36各维度评分较治疗前升高,且研究组高于对照组(P<0.05)。治疗4周后,两组睁眼站立、脚前后站立、闭眼站立的重心摆动速度和动态稳定时间较治疗前降低,且研究组低于对照组(P<0.05)。结论:脑卒中偏瘫患者经肌内效贴联合平衡功能训练治疗后,平衡功能得到较好的恢复,步行能力提高,其生活质量得到改善。  相似文献   

8.
摘要 目的:探讨虚拟现实平衡训练联合神经肌肉电刺激(NMES)对前交叉韧带重建术(ACLR)后患者膝关节功能、腘绳肌肌力和步行功能的影响。方法:选择2019年8月~2021年12月期间我院收治的前交叉韧带(ACL)损伤患者96例,并成功实施ACLR,采用随机数字表法分为对照组(n=48,常规康复训练、虚拟现实平衡训练)和研究组(n=48,常规康复训练、虚拟现实平衡训练联合NMES干预)。对比两组膝关节功能优良率、膝关节功能、腘绳肌肌力和步行功能。结果:研究组的临床膝关节功能优良率93.75%(45/48)高于对照组68.75%(33/48),差异有统计学意义(P<0.05)。两组干预后膝关节功能评分、膝关节活动度对均升高,且研究组高于对照组(P<0.05)。两组干预后患侧腘绳肌等长肌力升高,且研究组高于对照组(P<0.05),两组干预后健侧腘绳肌等长肌力对比无明显差异(P>0.05)。两组干预后步长、步速升高,且研究组高于对照组,患侧摆动相降低,且研究组低于对照组(P<0.05)。两组干预后被动活动察觉阀值、进行被动角度再生试验降低,且研究组低于对照组(P<0.05)。结论:虚拟现实平衡训练联合NMES应用于ACLR术后患者的疗效显著,有助于其膝关节功能恢复,提高腘绳肌肌力,改善步行功能。  相似文献   

9.
摘要 目的:研究智能化人机交互和场景模拟对脑卒中患者上肢运动功能的影响,探索其在康复训练中的作用,为脑卒中患者康复提供新的治疗方法和方向。方法:选取2019年1月-2022年12月在我院接收治疗的80例脑卒中患者,按随机数字表法分为对照组和实验,每组40人,对照组接受常规康复治疗,实验组在常规康复治疗基础上增加智能化人机交互和场景模拟训练。比较两组Fugl-Meyer上肢运动功能量表评分(UE-FMA)、患者的生活自理能力Barthel指数、上肢功能测试(UEFT),患侧上肢腕背伸肌的改良Ashworh评分(MAS)以及徒手肌力评估(MMT)。比较两组患者满意度评分。结果:治疗后,两组患者UE-FMA评分与治疗前相比均提高,且实验组显著高于对照组(P<0.05);治疗后,两组患者MBI评分与治疗前相比均提高,且实验组显著高于对照组(P<0.05);治疗后,两组患者UEFT评分与治疗前相比均提高,且实验组显著高于对照组(P<0.05);治疗后,两组患者MMT评分与治疗前相比均提高,且实验组显著高于对照组(P<0.05)治疗后,两组患者MAS评分与治疗前相比均降低,且实验组显著低于对照组(P<0.05);与对照组相比,实验组满意度95%,高于对照组80%(P<0.05)。结论:智能化人机交互和场景模拟训练对脑卒中患者的上肢运动功能有积极的影响,可以有效改善患者的康复效果。  相似文献   

10.
目的:探讨优秀赛艇运动员不同部位肌肉微循环血流灌注量(MB)的变化特点,为无创微循环相关指标更好的应用于运动员机能监控提供参考和借鉴。方法:运用PeriFlux System5000系列激光多普勒血流仪对12名优秀男子赛艇运动员不同部位肌肉微循环血流灌注量进行无创测试,测试环境为室内,温度(25±3)℃,湿度45.O%~65.O%。结果:①基础值:肱二头肌〉肱桡肌〉股四头肌〉腓肠肌,且肱二头肌显著高于肱桡肌(P〈0.05),极显著高于股四头肌和腓肠肌(P〈0.01);②加热后值及加热前后差值:肱桡肌〉肱二头肌〉股四头肌〉腓肠肌,且肱二头肌、肱桡肌显著高于腓肠肌(P〈0.05)。结论:优秀男子赛艇运动员上肢肌肉值MBF值要明显高于下肢肌肉,尤其加热后值上肢肌肉明显高于下肢肌,而上肢肌肉或下肢肌肉之间则不存在明显差异,因此为了使监测结果更具有代表性,赛艇运动员进行微循环血流灌注量及其相关指标监测时应选取上肢相同肌肉上同一空间的解剖位点。  相似文献   

11.
Stroke survivors routinely experience long-term motor and sensory impairments. In parallel with neurological changes, material properties of muscles in the impaired limbs, such as muscle stiffness, may also change progressively. However, these stiffness measures are routinely derived from individual joint stiffness, representing whole muscle groups. Here, we use shear wave (SW) ultrasound elastography to measure SW velocity, as a surrogate measure of stiffness, to quantify material properties in individual muscles. Accordingly, the purpose of this study was to compare muscle material properties of the bicep brachii in stroke survivors and in age-matched control subjects by measuring SW velocity at rest and different voluntary activation levels. Our main findings show that at rest, the SW velocity was on average 41% greater in the paretic muscle compared the contralateral non-paretic muscle. The mean passive SW velocity across all subjects were 2.34 ± 0.41 m/s for the non-paretic side, 3.30 ± 1.20 m/s for the paretic side, and 2.24 ± 0.18 for controls. SW velocity was significantly different in muscles of the paretic and non-paretic side (p < 0.001), but not between muscles of the non-paretic and controls (p = 0.47). As voluntary activation increased, SW velocity increased non-linearly, with an average power fit of r2 = 0.83 ± 0.09 for the non-paretic side, r2 = 0.61 ± 0.24 for the paretic side, and r2 = 0.24 ± 0.15 for the healthy age-matched controls. In active muscle (10, 25, 50, 75, 100% maximum voluntary contraction), there was no significant difference in SW velocity between the non-paretic, paretic, and control muscles.These findings suggest that stroke-impaired muscles have potentially altered muscle material properties, specifically stiffness, and that passive and active stiffness may contribute differently to total muscle stiffness.  相似文献   

12.
The study compared changes in intramuscular and surface recordings of EMG amplitude with ultrasound measures of muscle architecture of the elbow flexors during a submaximal isometric contraction. Ten subjects performed a fatiguing contraction to task failure at 20% of maximal voluntary contraction force. EMG activity was recorded in biceps brachii, brachialis, and brachioradialis muscles using intramuscular and surface electrodes. The rates of increase in the amplitude of the surface EMG for the long and short heads of biceps brachii and brachioradialis were greater than those for the intramuscular recordings measured at different depths. The amplitude of the intramuscular recordings from three muscles increased at a similar rate (P = 0.13), as did the amplitude of the three surface recordings from two muscles (P = 0.83). The increases in brachialis thickness (27.7 +/- 5.7 to 30.9 +/- 3.5 mm; P < 0.05) and pennation angle (10.9 +/- 3.5 to 16.5 +/- 4.8 degrees ; P = 0.003) were not associated with the increase in intramuscular EMG amplitude (P > 0.58). The increase in brachioradialis thickness (22.8 +/- 4.8 to 25.5 +/- 3.4 mm; P = 0.0075) was associated with the increase in the amplitude for one of two intramuscular EMG signals (P = 0.007, r = 0.79). The time to failure was more strongly associated with the rate of increase in the amplitude of the surface EMG than that for the intramuscular EMG, which suggests that the surface measurement provides a more appropriate measure of the change in muscle activation during a fatiguing contraction.  相似文献   

13.
Recent works have demonstrated a linear relationship between muscle activation and shear modulus in various superficial muscles. As such, it may be possible to overcome limitations of traditional electromyography (EMG) methods by assessing activation using shear wave elastography. However, the relationship has not been wholly validated in deep muscles. This study measured the association between squared shear wave velocity, which is related to shear modulus, and activation within superficial and deep muscles. This relationship was also compared between surface and intramuscular EMG electrodes. We simultaneously recorded EMG and shear wave velocity in one deep (brachialis) and one superficial (brachioradialis) muscle in ten healthy individuals during isometric elbow flexion across a wide range of contraction intensities. Muscle activation and squared shear wave velocity demonstrated good reliability (ICC > 0.75) and showed a linear relationship (P < 0.05) for all muscle/EMG electrode type combinations (study conditions) after down-sampling. Study condition was not a significant within-subject factor to the slope or intercept of the relationship (P > 0.05). This work demonstrates that activation of both superficial and deep muscles can be assessed noninvasively using ultrasound shear wave elastography and is a critical step toward demonstrating elastography’s utility as an alternative to EMG.  相似文献   

14.
The aim of this preliminary study was to examine the validity of a recently-introduced tool (MyotonPRO) for the assessment of mechanical parameters of the main lower extremity muscles in patients with chronic stroke. Thigh and shank muscles of 20 stroke patients with limited hypertonia (11 men and 9 women; mean age: 52 ± 11 yrs) and 20 healthy controls (11 men and 9 women; mean age: 53 ± 10 yrs) were bilaterally evaluated with (i) MyotonPRO for muscle stiffness, tone and elasticity, (ii) ultrasonography for muscle and subcutaneous thickness, and (iii) dynamometry for isometric muscle strength. MyotonPRO parameters of stroke patients were reassessed a week later (inter-day test-retest design). For all the investigated muscles, MyotonPRO variables did not differ between the more affected and the less affected side of patients (P > 0.05 for main side effect), and neither differed between patients and controls (P > 0.05 for main group effect), except for gastrocnemius medialis stiffness that was higher in patients (300 ± 51 N/m) than in controls (281 ± 29 N/m; P < 0.05). Thigh muscle stiffness was negatively correlated to subcutaneous thickness (r = −0.84 for the vastus lateralis; P < 0.001), while only tibialis anterior stiffness and tone correlated positively with muscle thickness (both r = 0.46; P < 0.01). Test-retest reliability of MyotonPRO parameters was adequate, except for muscle elasticity. The validity of MyotonPRO for the evaluation of thigh muscles in chronic stroke patients is partially challenged by the poor discriminant ability and by the considerable impact of subcutaneous tissue thickness (sex-dependent) on mechanical parameters. The potential validity of MyotonPRO for the assessment of shank muscles requires further investigation.  相似文献   

15.
摘要 目的:探讨老年男性腹股沟疝与肌肉质量、肌力及腹内压力(IAP)的相关性。方法:选取2021年1月-2023年1月在眉山市人民医院普外一科就诊的 86例老年男性腹股沟疝患者作为研究组,选取同期100名老年体检者作为对照组,对两组研究对象的腹部肌肉质量、肌力及IAP进行检测,并探讨其与腹股沟疝发病风险的相关性。结果:研究组患者腹部骨骼肌肉面积值(SMA)、骨骼肌指数(SMI)水平及右手握力、左手握力均低于对照组,腹内脂肪面积、SMI异常比例及直立加压时腹内压(OVIAP)、直立加压前后腹内压差(OVIAPD)、平卧与直立加压时腹内压差(OSVIAPD)均高于对照组,差异均有统计学意义(P<0.05)。Logistic多元回归模型分析结果显示,老年腹股沟疝的发生与SMI水平、SMI异常、右手握力、OVIAPD、OSVIAPD具有相关性(P<0.05)。结论:老年男性腹股沟疝患者存在腹部肌肉质量和肌力的下降,患者在直立做加压动作时可出现IAP水平的升高,上述指标均与腹股沟疝的发生具有相关性,临床可采用针对性的综合干预措施以降低老年男性人群腹股沟疝的发病风险。  相似文献   

16.
This study was to investigate the properties of mechanomyography (MMG), or muscle sound, of the paretic muscle in the affected side of hemiplegic subjects after stroke during isometric voluntary contractions, in comparison with those from the muscle in the unaffected side of the hemiplegic subjects and from the healthy muscle of unimpaired subjects. MMG and electromyography (EMG) signals were recorded simultaneously from the biceps brachii muscles of the dominant arm of unimpaired subjects (n=5) and the unaffected and affected arms of subjects after stroke (n=8), when performing a fatiguing maximal voluntary contraction (MVC) associated with the decrease in elbow flexion torque, and then submaximal elbow flexions at 20%, 40%, 60% and 80% MVCs. The root mean squared (RMS) values, the mean power frequencies (MPF, in the power density spectrum, PDS) of the EMG and MMG, and the high frequency rate (HF-rate, the ratio of the power above 15Hz in the MMG PDS) were used for the analysis. The MMG RMS decreased more slowly during the MVC in the affected muscle compared to the healthy and unaffected muscles. A transient increase could be observed in the MMG MPFs from the unaffected and healthy muscles during the MVC, associated with the decrease in their simultaneous EMG MPFs due to the muscular fatigue. No significant variation could be seen in the EMG and MMG MPFs in the affected muscles during the MVC. The values in the MPF and HF-rate of MMG from the affected muscles were significantly lower than those from the healthy and unaffected muscles (P<0.05) at the high contraction level (80% MVC). Both the MMG and EMG RMS values in the healthy and unaffected groups were found to be significantly higher than the affected group (P<0.05) at 60% and 80% MVCs. These observations were related to an atrophy of the fast-twitch fibers and a reduction of the neural input in the affected muscles of the hemiplegic subjects. The results in this study suggested MMG could be used as a complementary to EMG for the analysis on muscular characteristics in subjects after stroke.  相似文献   

17.
目的:研究强制性运动疗法(CIMT)在脑卒中偏瘫康复治疗中的应用效果。方法:将100例脑卒中偏瘫患者随机分为两组,对照组50例予常规运动疗法,实验组50例予CIMT。治疗后,比较两组患者的临床总有效率、步行速度评分、日常生活活动能力评分、运动功能评分及患者满意度。结果:治疗后,试验组的总有效率显著高于对照组(90%vs.68%),步行速度评分[(61.25±7.94)vs.46.12±8.56]、日常生活活动能力评分[(58.76±8.92)vs.47.95 9.16]、运动功能评分[(85.14±4.68)vs.52.39 9.64]、患者满意度(94%vs.78%)较对照组均明显升高(94%vs.78%),差异具有统计学意义(P0.05)。结论:强制性运动疗法用于脑卒中偏瘫患者康复治疗的临床效果明显提升,可有效改善患者的运动功能。  相似文献   

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