康复学报 (Aug 2024)
Effect of Multi-Joint Functional Electrical Stimulation Combined with Conventional Rehabilitation Therapy on Lower Limb Motor Function of Patients with Stroke
Abstract
ObjectiveTo investigate the effect of multi-joint functional electrical stimulation (FES) combined with conventional rehabilitation therapy on lower limb motor function of patients with stroke.MethodsA total of 35 patients with lower limb motor dysfunction after stroke were admitted to the Department of Rehabilitation Medicine in the Huashan Hospital, Fudan University from January to December 2023. The patients were randomly divided into control group and experimental group by SPSS 25.0 statistical software, with 16 and 19 cases in each group, respectively. During the course of the treatment, one case in the control group dropped out due to early discharge, four cases in the experimental group discontinued or dropped out for various reasons, and finally 15 cases were included in each group. The control group received routine rehabilitation treatment and routine walking training. Routine rehabilitation treatment included stretching training, muscle strength training, joint mobility training, motor control training and functional mobility training for transfer, 40 minutes a time, once a day, five times a week for four weeks; routine walking training included pelvic control training, knee joint stability training, balance training, up and down stairs training, 20 minutes a time, once a day, five times a week for four weeks. The experimental group received multi-joint FES treatment in addition to the conventional rehabilitation treatment received in the control group, 20 minutes a time, once a day, five times a week for four weeks. Before treatment, two and four weeks after treatment, Fugl-Meyer assessment lower extremity (FMA-LE) was used to assess lower limb motor function; the JiBuEn three-dimensional gait analysis system was used to assess the walking speed, stride length, double support phase (the stage of the gait cycle in which both feet landed simultaneously), and average knee flexion and extension angles (the average of the maximum knee flexion and extension angles); the modified Barthel index (MBI) was used to assess the activities of daily living.Results(1) FMA-LE and MBI scores: compared with that before treatment, the FMA-LE and MBI scores of both groups increased significantly after two and four weeks of treatment, with statistically significant differences (P<0.05). Compared with two weeks after treatment, the FMA-LE and MBI scores of both groups increased significantly after four weeks of treatment, with statistically significant differences (P<0.05). Compared with the control group at the same time, the FMA-LE scores of the experimental group after two and four weeks of treatment and the MBI scores after four weeks of treatment increased significantly, with statistically significant differences (P<0.05). (2) Gait parameters: compared with that before treatment, the walking speed, stride length, and the average knee flexion and extension angles in the experimental group increased significantly after two and four weeks of treatment, while the double support phase decreased significantly, with statistically significant differences (P<0.05). Compared with two weeks after treatment, the walking speed, stride length, and the average knee flexion and extension angles in the experimental group increased significantly after four weeks of treatment, while the double support phase decreased significantly, with statistically significant differences (P<0.05). Compared with the control group at the same time, the walking speed and the average knee flexion and extension angles in the experimental group increased significantly after two weeks of treatment, while the stride length and the average knee flexion and extension angles increased significantly after four weeks of treatment, and the double support phase decreased significantly, with statistically significant differences (P<0.05).ConclusionMulti-joint FES combined with conventional rehabilitation therapy can effectively improve the lower limb motor function, walking ability and activities of daily living of hemiplegic patients after stroke.
