肌电生物反馈对急性期脑卒中偏瘫患者上肢功能的影响被引量：23

Effect of Electromyogram Biofeedback Stimulation on Upper Extremity Function with Acute Stroke Hemiplegia

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摘要目的:评价肌电生物反馈联合常规康复训练对急性期脑卒中偏瘫患者上肢功能的影响,为脑卒中后急性期上肢运动功能障碍的康复治疗探寻更有效的方法。方法:将35例生命体征平稳、无意识障碍的急性期脑卒中偏瘫患者分为观察组18例和对照组17例。两组患者均给予神经内科药物治疗和常规康复训练,观察组患者偏瘫侧上肢加以肌电生物反馈治疗。两组均于治疗前和治疗2个月后对偏瘫侧上肢进行Brunnstrom运动功能分级、简式Fugl-Meyer(FMA)上肢运动功能评定和腕背伸时肌肉最大收缩时肌电(EMG)幅值的测定。结果:经2个月治疗后,两组患者偏瘫侧上肢的Brunnstrom分级、FMA及EMG幅值较治疗前均有提高(P<0.05),且观察组各项评分均优于对照组(P<0.05)。结论:本文中观察组和对照组的患者经康复治疗后,偏瘫侧上肢的运动功能均较治疗前提高。但在脑卒中患者的急性期应用肌电生物反馈治疗联合常规康复训练,较单独使用常规运动疗法和作业疗法治疗,能更好地改善急性期脑卒中偏瘫患者上肢的功能,更显著地促进偏瘫上肢的运动功能恢复及分离运动的产生,同时对促进腕关节背伸肌力的恢复方面提供了电生理学依据。总之,在常规康复训练的基础上加用肌电生物反馈治疗,可更显著地促进急性期脑卒中偏瘫患者的上肢功能,为脑卒中急性期肢体运动障碍的康复治疗提供了更有效的方法。 Objective： To evaluate the effect of electromyogram biofeedback stimulation on upper limb function of acute stroke hemiplegic patients,and explore more effective ways for the rehabilitation of the upper limb motor dysfunction after acute stroke.Methods： 35 acute stroke patients following hemiplegia who with stable vital signs,unconscious barriers were divided into observation group（n=18） and control group（n=17）.Two groups were given clinical treatment and conventional rehabilitation training.The observation group patients＇ hemiplegic upper limb added surface electromyogram biofeedback stimulation training.Brunnstrom＇s recovery stages,the Fugl-Meyer Assessment（FMA） and electromyography amplitude of wrist dorsiflexion on hemiplegic upper limb were assessed before and 2 months after the treatment.Results： Both groups had significantly higher Brunnstrom＇s and FMA scores and better electromyography amplitude（P0.05）,and the observation group was significantly better than the control group after the treatment（P0.05）.Conclusion： In this article,the hemiplegic upper limb motor function of observation group and control group patients were improved after rehabilitation compared with before treatment.It can better improve the upper extremity function of hemiplegic patients after acute stoke that electromyogram biofeedback stimulation training combined with conventional rehabilitation comparing to use PT and OT alone.More significantly,it promoted the motor function recovery and the generation of separatist movement of the hemiplegic upper limb,and provided the electrophysiological basis on the recovery of wrist dorsiflexion muscle strength.In short,on the basis of conventional rehabilitation with EMG bio-feedback therapy,may be more significant in promoting hemiplegia upper limb function of acute stroke patients,and provide a more effective method for the rehabilitation of patients with acute stroke limb movement disorder.