镜像疗法同步结合肌电生物反馈疗法对老年脑卒中偏瘫患者上肢、手运动功能的改善效果观察

Observation on the Improvement Effect of Mirror Therapy Combined with Electromyography Biofeedback Therapy on Upper Limb and Hand Motor Function in Elderly Stroke Patients with Hemiplegia

目的分析镜像疗法(MT)同步结合肌电生物反馈疗法(EMGBFT)对老年脑卒中偏瘫患者上肢、手运动功能的改善效果.方法选取2019年1月-2020年12月上海市金山区众仁老年护理医院收治的62例老年脑卒中偏瘫患者为研究对象,按照随机数字表法分为观察组和对照组,每组31例.两组均接受常规康复治疗,在此基础上,对照组采用普通箱训练同步结合EMGBFT,观察组采用MT同步结合EMGBFT.于治疗前、治疗4周、治疗8周分别采用简化Fugl-Meyer运动功能评定量表上肢部分(FMA-UE)、Brunnstrom偏瘫运动功能评定标准及改良Barthel指数评定量表(MBI)对两组患者的上肢运动功能、上肢和手Brunnstrom分期、日常生活活动能力进行评估.结果治疗4周、治疗8周,两组上肢和手Brunnstrom分期比较,差异无统计学意义(P>0.05);观察组FMA-UE、MBI评分均高于对照组,组间差异有统计学意义(P<0.05).观察组、对照组组内各时间点FMA-UE评分、MBI评分、上肢和手Brunnstrom分期比较,差异有统计学意义(P<0.05).结论在常规康复治疗的基础上采用MT同步结合EMGBFT治疗老年脑卒中偏瘫患者,可有效促进其上肢和手运动功能恢复,提高其日常生活活动能力,并可能对其上肢和手的分离运动具有一定的促进作用.

Objective To analyze the improvement effect of mirror therapy(MT)combined with electromyographic biofeedback therapy(EMGBFT)on upper limb and hand motor function in elderly stroke patients with hemiplegia.Methods 62 elderly stroke patients with hemiplegia who were admitted to Shanghai Jinshan Zhongren Aged Care Hospital from January 2019 to December 2020 were selected as the research objects,and divided into an observation group and a control group according to the random number table method,with 31 cases in each group.Both groups received conventional rehabilitation therapy.On this basis,the control group received ordinary box training synchronously combined with EMGBFT,and the observation group received MT synchronously combined with EMGBFT.Before treatment,4 weeks of treatment and 8 weeks of treatment,Fugl-Meyer assessment-Upper Extremity(FMA-UE),Brunnstrom hemiplegic motor function evaluation criteria and modified Barthel index(MBI)were used to evaluate the motor function of the upper limbs,the Brunnstrom stages of upper limbs and hands,and activities of daily living of the two groups of patients.Results After 4 weeks of treatment and 8 weeks of treatment,there was no significant difference in Brunnstrom staging of upper limbs and hands between the two groups(P>0.05);the FMA-UE and MBI scores of the observation group were higher than those of the control group,and the differences between the groups were statistically significant(P<0.05).There were statistically significant differences in FMA-UE score,MBI score,Brunnstrom staging of upper limbs and hands between the observation group and the control group at each time point(P<0.05).Conclusion On the basis of conventional rehabilitation therapy,MT combined with EMGBFT in the treatment of elderly stroke patients with hemiplegia can effectively promote the recovery of upper limb and hand motor function,improve the activities of daily living,and may have a certain promotion effect on the separation movement of the upper limbs and hands.