镜像视觉反馈和肌电生物反馈对脑卒中偏瘫患者上肢功能的影响

Effects of Mirror Visual Feedback and Electromyographic Biofeedback on Upper Extremity Function in Hemiplegics after Stroke

目的研究镜像视觉反馈(MVF)、任务导向训练和肌电生物反馈(EMGBF)对脑卒中偏瘫患者上肢功能的恢复的作用。方法 90例脑卒中偏瘫患者采用随机数字表法分为对照组(n=30)、EMGBF组(n=30)和MVF组(n=30)。所有患者均接受常规康复治疗和任务导向性训练,EMGBF组在此基础上加EMGBF,MVF组在EMGBF组的基础上加MVF,共8周。治疗前后进行Fugl-Meyer运动功能评定(FMA)、Carroll手功能评定(UEFT),并测定偏瘫上肢相关肌电积分。结果治疗后,所有患者上肢FMA评分,UEFT评级和上肢肌肉肌电积分均较治疗前改善(P<0.05)。组间比较,EMGBF组各项指标均优于对照组(P<0.05),MVF组优于其他两组(P<0.05)。结论镜像视觉反馈结合肌电生物反馈可以更有效地促进脑卒中偏瘫患者上肢功能的改善。

Objective To investigate the effects of mirror visual feedback（MVF） and electromyographic biofeedback（EMGBF） on upper extremity function in hemiplegic patients after stroke based on task-oriented training. Methods 90 patients with hempiplegia after stroke were randomly divided into control group（n=30）, EMGBF group（n=30） and MVF group（n=30）. All patients accepted routine rehabilitation and task-oriented training once a day for 8 weeks. The EMGBF group also accepted EMGBF, and the MVF group accepted MVF in addition. They were assessed with Fugl-Meyer Assessment（FMA） and the Upper Extremity Function Test（UEFT）, and their integrated electromyogram（i EMG） of affected upper extremities were recorded before and after treatment. Results All the groups improved in scores of FMA and UEFT, as well as the i EMG after treatment（P〈0.05）, and ranked as the MVF group, the EMGBF group and the control group from improving more to less（P〈0.05）. Conclusion Mirror visual feedback combined with electromyographic biofeedback may further promote the recovery of upper limb function in patients with hemiplegia after stroke based on task-oriented training.