中文摘要：

目的探讨功能性电刺激（functional electrical stimulation,FES）对脑卒中偏瘫患者下肢功能的影响。方法 68例早期脑卒中患者以MINIMIZE分层后随机分为FES组23例,年龄（62.7±10.9）岁,病程（24.6±20.2）d、安慰组23例,年龄（61.6±9.7）岁,病程（23.7±16.9）d和对照组22例,年龄（64.2±8.8）岁,病程（25.2±19.4）d。3组常规治疗相同,FES组采用日本生产的低频电刺激治疗仪（KR7型）治疗,电极放在患侧胫前肌及腓骨长、短肌的运动点上;刺激参数为频率30 Hz,脉宽200μs,通电/断电比5 s/5 s,波升/波降1 s/1 s,电流以患者最大耐受强度为限;安慰组接受电刺激的部位时间和疗程与FES组相同,但每次治疗时没有电流输出,对照组不给任何电刺激,治疗1次/d,每次30 min,共3周（15次）。用综合痉挛量表（CSS）评定踝关节痉挛,Fugl-Meyer运动评定量表中下肢部分（FMA）评定下肢运动功能,脑卒中患者姿势评定量表（PASS）、Berg平衡量表（BBS）评定平衡功能。结果 3组患者一般资料及治疗前各项评定结果差异无统计学意义。治疗2周和3周后,FES组与安慰组及对照组（FES VS安慰VS对照）CSS、FMA评分差异有统计学意义（P〈0.01）,增加率分别为2周时CSS：（9.2±22.1）%VS（35.3±46.8）%VS（34.9±45.7）%,FMA：（106.5±76.8）%VS（52.5±46.1）%VS（53.6±47.4）%。3周时CSS：（10.5±18.2）%VS（49.6±54.7）%VS（50.3±51.6）%,FMA：（129.4±87.3）%VS（65.6±50.4）%VS（64.9±49.2）%。结论 FES能延缓早期脑卒中患者偏瘫下肢痉挛的发生、减轻痉挛程度,改善下肢运动能力。

英文摘要：

Objective To assess the efficacy of functional electrical stimulation（FES） in enhancing motor and functional recovery of the lower extremity in subjects with stroke.Methods In a randomized controlled trial,68 subjects with first stroke were randomly assigned into 3 groups： FES group,placebo group and control group.The electrodes of the FES group（n = 23） were applied on the motor point of the tibial muscle,peroneal muscle and peroneus brevis through square 3-cm surface electrodes.The stimulation current intensity was set to produce full ankle extension with a duty cycle of 5 seconds on and 5 seconds off.The stimulus pulse was a symmetric biphasic waveform with amplitude ranging between 0 to 90 mA,frequency 30 Hz,pulse width of 200 msec,and ramp up and down time of 2 seconds each.The current amplitude was adjusted to subject＇s comfort.It lasted for 30 minutes per day,5 days per week for 3 weeks;the time and the course of treatment of the placebo group（n = 23） as well as the FES group ＇s,but no current output for each treatment;The control group（n = 22） did not give any electrical stimulation.All subjects in the 3 groups received standard rehabilitation program.Measurements included composite spasticity score（CSS） for the spasticity of the ankle planter flexors,Fugl-Meyer motor assessment（FMA） for the lower extremity,Postural Assessment Scale for Stroke patients（PASS） and Berg Balance Scale（BBS） for balance.Measurements were recorded before treatment,after 2 and 3 weeks treatment.Results Before treatment,there were no significant differences between the three groups for age,time post-stroke,stroke severity,and the baseline of measurements.After 2 and 3 weeks of treatment,the percentage of CSS score in the FES group was（9.2 ± 22.1） % and（10.5 ± 18.2） %,significantly lower than the placebo group（35.3 ± 46.8） and（49.6 ± 54.7） % or the control group（34.9 ± 45.7） % and（50.3 ± 51.6） %.The percentage of FMA score in the FES group was（106.5 ± 76.8） % a