任务导向性训练结合肌电生物反馈治疗对脑卒中患者上肢腕背伸功能的影响

The effects of task-oriented training combined with electromyographic biofeedback on wrist/finger extension after stroke

目的探讨任务导向性训练结合肌电生物反馈治疗对脑卒中偏瘫患者上肢手背伸功能的影响。方法将36例脑卒中偏瘫患者按随机数字表法分为对照组和实验组，每组18例。对照组进行常规康复治疗和肌电生物反馈疗法治疗，实验组在上述治疗的同时增加患侧上肢任务导向训练，即训练时结合日常实物并完成明确指令动作，如手背伸抓握及够物等训练。由不知分组的同一治疗师分别于治疗前和治疗8周后（治疗后）评定2组患者的患侧腕关节背伸主动活动度（AROM）、手腕Fugl—Meyers运动功能评定（FMA）和腕背伸表面肌电图（sEMG）值，并进行统计学分析比较。结果治疗前，实验组和对照组患者腕关节AROM、手腕FMA评分和腕背伸sEMG值分别为（4．17±2．68）°和（3．11±2．85）°、（11．11±3．69）分和（13．72±4．46）分、（42．83±16．48）μV和（37．28±18．48）μV，组间差异无统计学意义（P〉0．05），具有可比性。治疗后，实验组和对照组患者上述指标分别为（6．39±4．22）°和（3．83±4．02）°、（27．72±8．84）分和（22．05±7．81）分、（102．5±53．11）μV和（72．17±32．65）μV，均较治疗前有所改善（P〈0．05），且实验组明显优于对照组（P〈0．05）。结论任务导向性训练结合肌电生物反馈治疗能明显促进偏瘫患者E肢腕背伸功能改善。

Objective To study the effects of task-oriented training combined with electromyographic biofeedback on wrist and finger extension after stroke. Methods Thirty-eight stroke patients were assigned randomly into either an experimental group （ 18 cases） or a control group （ 18 cases）. Both groups received routine rehabilitation treatment and electromyographie biofeedback training. In addition, the experimental group was given task-oriented training in wrist and finger extensionl Myoelectricity values, the active range of wrist dorsiflexion and the Fugl- Meyer upper extremity assessment （FMA） were assessed before and after 8 weeks of training. Results All of the patients showed significant improvements after 8 weeks of training, but compared with the controls, the patients in the experimental group improved significantly more in terms of all of the measures. Conclusion Task-oriented training with electromyographic biofeedback can improve upper extremity function, particularly wrist extension, among hemiplegic stroke survivors.