肌电生物反馈对脑卒中偏瘫患者步行能力的影响

The effects of electromyography biofeedback on walking ability of stroke hemiplegic patients

目的:探讨肌电生物反馈治疗(EMGBF)对脑卒中偏瘫患者胫前肌肌力、下肢运动功能及步行能力的影响。方法:选取病程小于6个月的首次脑卒中偏瘫患者35例,随机分成EMGBF组和对照组。EMGBF组患者共17例,年龄(61.90±10.35)岁,采用常规康复训练结合EMGBF;对照组患者共18例,年龄(55.12±9.92)岁,进行常规康复训练,治疗4周。分别于治疗前后采用踝背屈主动关节活动度(AROM)、改良Ashworth量表、胫前肌肌力、Berg平衡量表(BBS)、简化Fugl-Meyer运动量表下肢功能评分(FMA-L)和10m步行速度测定,评估患者的步行能力。结果:两组患者治疗前,各评估方法之间的差异均无显著性意义(P>0.05),具有可比性。治疗4周后,EMGBF组和对照组各评估结果均有明显改善,与治疗前比较差异均有显著性意义(P<0.05);但EMGBF组患者的踝背屈AROM、前肌肌力、BBS、FMA-L和步速改善情况优于对照组(P<0.05);两组肌张力变化差异无显著性意义(P>0.05)。结论:在常规康复训练的基础上,加用EMGBF能更有效地改善脑卒中偏瘫患者踝背屈障碍,促进偏瘫侧下肢功能及步行能力的恢复。

Objective：To assess the effects of electromyography biofeedback （EMGBF） therapy on the lower extremity motor function and walking ability of stroke hemiplegic patients.Method：Thirty-five patients suffered from stroke with foot-drop less than six months were enrolled in the study.The EMGBF group （17 patients） received EMGBF treatment combined with physical therapy.The control group （18 patients） was treated with physical therapy only.Clinical and functional evaluations before and after treatment were performed using ankle dorsiflexion active range of motion （AROM）, modified Ashworth scale, modified Lovett muscle test, Berg balance scale （BBS）, the lower limb part of Fugl-Meyer assessment （FMA-L） and 10m walking speed measurement.Result：There was no significant difference between two groups before treatment（P0.05）.After treatment, two groups showed significantly increasing of scores on ankle dorsiflexion AROM, Ashworth scale, BBS, FMA-L and 10m walking speed （P0.05） and anterior tibial muscle strength（P0.01）.Ankle dorsiflexion AROM, anterior tibial muscle strength, BBS, FMA-L and 10m walking speed improved significantly in EMGBF group compared with control group （P0.05）.No difference were found in muscle tonic between two groups（P0.05）.Conclusion：EMGBF technique could increase ankle dorsiflexion AROM, anterior tibial muscle strength and improve recovery of functional locomotion, walking ability and drop-foot in patients with hemiplegia and foot-drop after stroke.