基于上肢表面肌电图及神经传导速度评价新Bobath技术联合电子生物反馈疗法对脑卒中偏瘫的作用

Effect of new Bobath technology combined with electronic biofeedback therapy in hemiplegia after stroke based on upper extremity surface electromyography and nerve conduction velocity evaluation

目的 探讨新Bobath技术与电子生物反馈疗法对脑卒中偏瘫患者上肢表面肌电图、神经传导速度的影响。方法 选取2022-01—2023-02榆林市第一医院60例脑卒中偏瘫患者,采用随机数字表法分为2组各30例。对照组行电子生物反馈疗法,实验组行新Bobath技术与电子生物反馈疗法,连续干预12周。观察2组上肢功能恢复优良率及干预前后上肢表面肌电图、神经传导速度、关节运动速度、上肢功能(FMA评分)、日常活动能力(MBI评分)、肌张力(MAS评分)。结果 实验组干预12周后上肢功能恢复优良率86.67%高于对照组60.00%(P<0.05)。干预4、12周后,实验组肱二头肌及肱三头肌协同收缩率低于对照组[(30.34±2.78)%比(34.12±3.03)%,(13.78±1.66)%比(15.03±1.93)%,(20.22±2.02)%比(26.61±2.45)%,(10.01±1.02)%比(12.89±1.33)%,P<0.05],尺神经、桡神经、正中神经传导速度高于对照组[(63.83±6.45) m/s比(59.91±6.38) m/s,(64.45±6.02) m/s比(61.08±6.42) m/s,(63.92±5.56) m/s比(61.01±5.19)m/s,(70.72±8.12)m/s比(66.13±7.46)m/s,(69.68±7.59)m/s比(65.41±6.33)m/s,(68.95±7.26)m/s比(64.78±7.05)m/s,P<0.05]。实验组干预4、12周后肩关节、肘关节、腕关节运动速度高于对照组[(0.51±0.09)rad/s比(0.42±0.07)rad/s,(0.76±0.08)rad/s比(0.63±0.07)rad/s,(0.32±0.04)rad/s比(0.27±0.05)rad/s,(0.63±0.10)rad/s比(0.50±0.08)rad/s,(0.99±0.12)rad/s比(0.81±0.10)rad/s,(0.46±0.08)rad/s比(0.39±0.05)rad/s,P<0.05]。干预4、12周后实验组FMA、MBI评分高于对照组,MAS评分低于对照组(P<0.05)。结论 新Bobath技术联合电子生物反馈疗法能提高脑卒中偏瘫上肢功能恢复效果,增强神经传导速度,改善各关节运动状态,提高患者日常生活能力。

Objective To investigate the effect of new Bobath technology and electronic biofeedback therapy on upper extremity surface EMG and nerve conduction velocity in stroke patients with hemiplegia.Methods A total of 60 patients with stroke hemiplegia in Yulin First Hospital from January 2022 to February 2023were selected and divided into two groups with random number table method.The control group received electronic biofeedback therapy,and the experimental group received new Bobath technology and electronic biofeedback therapy,continuous intervention for 12 weeks.The excellent and good rate of upper limb function recovery,surface electromyography,nerve conduction velocity,joint motion velocity,upper limb function(FMA score),daily activity ability(MBI score),muscle tension(MAS score)before and after intervention were observed in the two groups.Results The excellent and good rate of upper limb function recovery in the experimental group(86.67%)was higher than 60.00%in the control group after 12 weeks of intervention(P<0.05).After 4 weeks and 12 weeks of intervention,the coordinated contraction rate of biceps and triceps in the experimental group was lower than that in the control group((30.34±2.78)%vs(34.12±3.03)%,(13.78±1.66)%vs(15.03±1.93)%,(20.22±2.02)%vs(26.61±2.45)%,(10.01±1.02)%vs(12.89±1.33)%,P<0.05).The conduction velocities of ulnar,radial,and median nerves were higher than those of the control group((63.83±6.45)m/s vs(59.91±6.38)m/s,(64.45±6.02)m/s vs(61.08±6.42)m/s,(63.92±5.56)m/s vs(61.01±5.19)m/s,(70.72±8.12)m/s vs(66.13±7.46)m/s,(69.68±7.59)m/s vs(65.41±6.33)m/s,(68.95±7.26)m/s vs(64.78±7.05)m/s,P<0.05).The shoulder,elbow,and wrist joint movement velocities of the experimental group were higher than those of the control group after 4 and12 weeks of intervention((0.51±0.09)rad/s vs(0.42±0.07)rad/s,(0.76±0.08)rad/s vs(0.63±0.07)rad/s,(0.32±0.04)rad/s vs(0.27±0.05)rad/s,(0.63±0.10)rad/s vs(0.50±0.08)rad/s,(0.99±0.12)rad/s vs(0.81±0.10)rad/s,and(0.46±0.08)rad/s vs(0.39±0.05)rad/s,P<0.05).FMA and MBI scores were higher and MAS scores were lower in the experimental group than those in the control group after 4 and 12 weeks of intervention(P<0.05).Conclusion The new Bobath technology combined with electronic biofeedback therapy can improve the function recovery effect of upper limb hemiplegia after stroke,enhance nerve conduction speed,improve the motion state of each joint,and improve the daily living ability of patients.