肌电生物反馈训练对脊髓损伤患者心理功能及运动功能的影响

Effects of electromyographic biofeedback training on psychological and motor functioning in patients with spinal cord injury

目的观察肌电生物反馈训练对脊髓损伤（SCI）患者心理功能及肢体运动功能的影响。方法共选取SCI患者70例，采用随机数字表法将其分为治疗组及对照组。2组患者均给予常规处理，治疗组在此基础上辅以肌电生物反馈训练，对照组则辅以中频电治疗。于治疗前、治疗6周后分别采用罗森伯格自信心量表（RSES）、美国脊柱损伤协会（ASIA）运动评分对2组患者自信心及瘫痪肢体运动功能进行评定，并对2组患者股四头肌、胭绳肌及胫骨前肌最大收缩时肌电信号值进行检测比较。结果治疗前2组患者RSES、ASIA运动评分组间差异均无统计学意义（P〉0．05）；治疗后2组患者ASIA运动评分均显著提高（P〈0．05），并且治疗组改善幅度明显优于对照组（P〈0．01）；另外治疗组RSES评分在治疗后亦有明显改善（P〈0．05），并且该组患者RSES评分与ASIA运动评分间具有显著正相关性（P〈0．05），而对照组RSES运动评分治疗前、后无明显变化（P〉0．05）。通过肌电检测发现，治疗组患者治疗后股四头肌、胭绳肌及胫骨前肌最大收缩时肌电信号值均较治疗前及对照组显著提高（P〈0．01）。结论肌电生物反馈训练能提高SCI患者自信心，有助于患者瘫痪肢体运动功能进一步改善。

Objective To investigate the therapeutic effects of electromyography biofeedback （EMGBF） on motor and psychological function in patients with spinal cord injury （ SCI）. Methods Seventy SCI patients were randomly divided into research and control groups with 35 patients in each. In addition to conventional rehabilitation, the patients in the research group received EMGBF training while those in the control group were treated with medium frequency electrotherapy. To evaluate the patients＇ self confidence and motor function of their paralyzed limbs, Rosenberg＇s self-esteem scale （RSES） and American Spinai Injury Association （ASIA） locomotor function scoring were performed before and six weeks after the interventions in both groups of patients. The changes of EMG of the quadriceps, hamstring and anterior tibial muscles of both groups in maximum contraction were also observed before and six weeks after the interventions. Results There were no significant differences in the RSES scores or ASIA locomotor function results between the groups before the interventions. ASIA locomotor function evaluation scores increased significantly in both groups after the interventions, with significantly better results in the research group. The RSES scores in the research group also improved significantly after the interventions, and RSES scoring and ASIA scoring were positively correlated in those patients. But no significant improvement in average RSES scores was found in the control group. The muscle contraction EMG amplitudes also increased significantly in patients of the research group after the interventions. Conclusions EMGBF training can enhance patients＇ self-confidence, which helps patients with SCI improve their motor functions.