针刺联合肌电生物反馈疗法对脑卒中患者下肢功能的影响

Effects of electromyographic biofeedback combined with acupuncture on lower limb function of patients after stroke

目的:观察针刺联合肌电生物反馈疗法对脑卒中偏瘫患者下肢功能康复的影响。方法:将60例脑卒中偏瘫患者随机分为对照组和治疗组,各30例;两组患者均以偏瘫肢体训练为常规康复,对照组采用针刺治疗,治疗组在对照组基础上加用肌电生物反馈治疗,共治疗4周。分别于治疗前、治疗后,测定患者偏瘫侧踝关节主动背屈活动范围(AROM),采用Fugl-Meyer运动功能量表(FMA)评定下肢运动功能,采用Barthel指数量表(BI)评定日常生活活动能力。结果:治疗前,两组患者踝关节AROM平均差值(0.21±0.09)、下肢FMA平均差值(0.66±0.28)、BI平均差值(0.73±1.27),评分相比差异均无显著性(P>0.05);治疗后,两组患者踝关节AROM平均差值(3.19±0.78)、下肢FMA平均差值(7.36±0.64)、Barthel平均差值(19.54±2.07),评分均比治疗前明显增加(P<0.01)且治疗组改善程度优于对照组(P<0.05)。结论:针刺联合肌电生物反馈疗法可以进一步促进脑卒中患者下肢功能的康复,显著提高偏瘫患者的关节活动度和日常生活活动能力。

Objective： To observe the effects of electromyographic biofeedback combined with acupuncture on lower limb function of patients with hemiplegia after stroke.Method： Sixty patients with stroke were divided into control group and treatment group with 30 patients in each group. Two groups treated with conventional rehabilitation, and in addition, control group with acupuncture treatment, treatment group with acupuncture and electromyographic biofeedback treatment. All treatments lasted for 4 weeks. Active range of motion（AROM） of ankle dorsiflexion, Fugl- Meyer assessment（FMA） and Barthel index（BI） were adopted to evaluate relative motor functions of patients before and after treatment.Result： There was no significant difference between two groups in the scores of average AROM（0.21±0.09）,FMA（0.66±0.28）, and BI（0.73±1.27） before treatments（P〈0.05）. The scores of average AROM（3.65±0.78）,FMA（7.36±0.64）, and BI（19.54±2.07） improved significantly after treatments in both groups（P〈0.01）, and improved better in the treatment group than those in the control group（P〈0.05）.Conclusion： The electromyographic biofeedback combined with acupuncture could significantly improve the low-er limb motor function, the severity of ankle spasticity and recovery of activities of daily living in stroke patients with hemiplegia.