MOTOmed智能训练治疗脊髓损伤下肢痉挛的疗效观察及肌电图分析

Effects of MOTOmed intelligent training on lower limb spasm of spinal cord injury and electromyography analysis

目的主要观察MOTOmed智能训练系统对脊髓损伤患者下肢肌痉挛的治疗疗效。方法采用随机对照设计,选择2012年1月至2013年12月常熟市第二人民医院不完全脊髓损伤患者60例为脊髓损伤组,其中男性31例,女性29例;年龄35~62岁,平均年龄47.45岁。同时选取同年龄段的非截瘫肌电图受检者30例为正常对照组,其中男性15例,女性15例;年龄30~68岁,平均年龄46.30岁。分别记录双下肢胫神经的F波的最小潜伏期、最大潜伏期和F波的出现率,计算F波的时间离散度（即F波的最小潜伏期与F波的最大潜伏期的差值）及F波的平均出现率,比较F波的时间离散度及F波的平均出现率在不完全性脊髓损伤患者及非截瘫患者之间的差异。将不完全脊髓损伤患者随机分为MOTOmed组（MOTOmed＋常规康复训练）30例和常规治疗组（常规康复训练）30例,进行了MOTOmed智能训练治疗的临床对比分析。结果脊髓损伤患者F波的时间离散度值比正常对照者高,分别为（9.0±1.8）ms vs（5.5±1.0）ms（P〈0.01）。脊髓损伤患者F波的平均出现率比正常对照者低[（84.5±6.2）%vs（89.5±5.7）%;P〈0.01]。脊髓损伤MOTOmed组与常规治疗组治疗有效率差异有统计学意义。MOTOmed组F波的时间离散度值比常规治疗组低[（8.9±2.1）ms vs（10.4±2.2）ms;P〈0.01]。MOTOmed组F波的平均出现率比常规治疗组高[（84.2±7.1）%vs（80.4±6.8）%;P〈0.05]。结论 MOTOmed智能训练治疗脊髓损伤下肢痉挛的临床对比研究发现,采用智能训练的患者疗效明显好于常规治疗的患者,提示MOTOmed智能训练治疗脊髓损伤下肢痉挛值得在临床广泛应用。

Objective To study the treatment effects of MOTOmed intelligent training on lower limb spasm of spinal cord injury patients. Methods A total of 60 patients with incomplete spinal cord injury from January 2012 to December 2013 were enrolled,which included 31 males and 29 females, aged 35- 62 years old with mean age of 47.45 years old. Thirty cases of non-spinal cord injury were set as normal control group, which included 15 males and 15 females, aged 30- 68 years old with mean age of46.30 years old. The minimum incubation period, the maximum incubation period and occurrence rate of F wave of tibial nerve of2 lower limbs were respectively recorded. Time discrete degree of F wave and average occurrence rate of F wave were calculated and the differences were compared between incomplete spinal cord injury patients and non-spinal cord injury patients. In addition, 60 incomplete spinal cord injury patients were randomly divided into 2 groups, MOTOmed group（MOTOmed ＋conventional rehabilitation training） and conventional treatment group（conventional rehabilitation training）, and the differences were compared between 2 groups. Results The time discrete degree of F wave of patients in spinal cord injury group[（9.0 ± 1.8） ms]was longer than that in normal control group[（5.5 ± 1.0） ms; P〈0.01]. Average occurrence rate of F wave of patients in spinal cord injury group（84.5 % ± 6.2 %） was lower than that in normal control group（89.5 % ± 5.7 %; P〈0.01）. There was significant difference about treatment effect between MOTOmed group and conventional treatment group. Time discrete degree of F wave in MOTOmed group（8.9 ms ± 2.1 ms） was lower than that in conventional treatment group [（10.4 ± 2.2） ms; P〈0.01]. Average occurrence rate of F wave in MOTOmed group（84.2 % ± 7.1 %） was higher than that in conventional treatment group（80.4 % ± 6.8 %; P〈0.05）. Conclusion It is demonstrated that MOTOmed intelligence training could provide the better therapeutic effect on lower limb spasm of spinal cord injury than conventional treatment, and is worth being used widely in clinical practice.