功能强化训练结合肌电生物反馈对急性脑卒中患者上肢功能的影响

Intensive training combined with electromyographic biofeedback for motor recovery of upper extremities after acute stroke

目的:观察肌电生物反馈电刺激联合上肢功能强化训练对急性脑卒中患者上肢功能障碍的疗效。方法:将60例脑卒中偏瘫患者随机分为观察组和对照组各30例。2组均给予常规康复治疗和上肢功能强化训练,观察组在此基础上给予肌电生物反馈电刺激治疗。2组患者于治疗前和治疗4周后进行Brunnstrom分级上肢评定、简化Fugl-Meyer上肢功能评定(FMA)、功能独立性评定(FIM)、肩外展及腕背伸主动活动范围(AROM)测定、主动肩外展和腕背伸时三角肌和桡侧腕长伸肌等长收缩的肌电积分值(IEMG)测定。结果:经治疗后,2组患者Brunnstrom分级、FMA评分、FIM评分,肩外展AROM、腕背伸AROM、IEMG值均高于组内治疗前(P<0.05),其中观察组各项评分均更高于对照组(P<0.01)。结论:肌电生物反馈电刺激结合功能强化训练能有效改善急性脑卒中偏瘫患者上肢运动功能,降低患者神经缺损程度,提高日常生活活动能力。

Objective：To observe the effects of electromyographic （EMG） biofeedback electrical stimulation com‐bined with intensive training on upper limb motor function in patients with stroke in acute stage .Methods：Hemiple‐gic stroke patients were randomly divided into observation group （n=30） and routine treatment group （n=30） .The two groups were given routine treatment and rehabilitation of upper limb function training .Patients in observation group received EMG biofeedback electrical stimulation .Two groups of patients were assessed with Brunnstrom scale of upper extremity assessment ,Simple Fugl‐Meyer Assessment （FMA） ,Function Independent Measure （FIM） , active range of movement of shoulder and wrist ,and the integrated electromyogram （IEMG） before and 4 weeks af‐ter treatment .Results：After treatment ,significant improvements were revealed in both two groups according to Brunnstrom scale of upper extremity assessment ,FMA ,FIM ,active range of movement of shoulder and wrist ,and the IEMG （P〈0 .05） ,more significantly in observation group （P〈0 .01） .Conclusions：EMG biofeedback electrical stimulation combined with intensive training can improve the upper limb motor function and activities of daily living , and reduce neurologic deficits in patients with hemiplegia after acute stroke .