肌电生物反馈对脑卒中偏瘫患者上肢神经传导功能的影响

Electromyography Biofeedback Effect on Upper Limb Nerve Conduction of Stroke Patients

目的探讨肌电生物反馈对脑卒中偏瘫患者上肢神经传导功能的影响。方法选取2014年2月至2015年2月苏州明基医院收治的脑卒中偏瘫患者80例,依据抽签法分为观察组与对照组,各40例。对照组予以常规内科药物治疗与康复训练,观察组在对照组的基础上联合肌电生物反馈治疗。观察治疗后两组患者上肢神经传导速度(正中神经、尺神经与桡神经),上肢肌群(三头肌、肱三头肌与前臂肌群)肌电图(EMG)评分,上肢运动功能评定定量表(FMA)评分与腕部关节主动活动范围(AROM)。结果治疗3个月后观察组正中神经传导速度、尺神经传导速度、桡神经传导速度显著高于对照组[(65.4±4.2)m/s比(63.2±4.1)m/s,(65.6±3.2)m/s比(63.3±3.1)m/s,(65.3±2.2)m/s比(63.1±2.3)m/s](P<0.05);治疗3个月后观察组三头肌、肱三头肌、前臂肌群EMG评分显著高于对照组[(45.5±3.2)分比(42.1±3.1)分,(37.4±3.3)分比(34.3±3.1)分,(36.3±3.2)分比(32.2±3.1)分](P<0.05);两组治疗1、3个月FAM评分[观察组:(26.5±2.3)分、(31.5±3.6)分比(17.4±1.6)分;对照组:(24.3±2.2)分、(28.9±3.5)分比(17.4±1.5)分]和腕部AROM[(49±3)°、(59±5)°比(39±4)°;(45±3)°、(54±4)°比(39±3)°]均较治疗前呈上升趋势,观察组上升速度更快,两组在组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.01)。结论肌电生物反馈治疗能够明显增加脑卒偏瘫患者的上肢神经传导速度,促进上肢功能的恢复,值得推广应用。

Objective To investigate the electromyographic（ EMG） biofeedback effect on the upper extremity nerve conduction of stroke patients. Methods Total of 80 stroke patients treated in Suzhou Ben Q hospital from Feb. 2014 to Feb. 2015 were included in the study,according to the sortation method they were divided into an observation group and a control group,40 patients each. The control group received conventional medical therapy and rehabilitation,while the observation group was added with EMG biofeedback treatment on the basis of the control group＇ s regimen. After treatment,the upper limb nerve conduction velocity（ median nerve,ulnar nerve and radial nerve）,upper limb muscle（ triceps,triceps brachii and forearm muscle） electromyography（ EMG） score,Fugl Meyer Assessment（ FMA）,range of motion（ AROM） of the wrist joint of the two groups were observed. Results After 3 months of treatment,the median nerve conduction velocity,ulnar nerve conduction velocity,radial nerve conduction velocity of the observation group were significantly higher than the control group [（ 65. 4 ± 4. 2） m/s vs（ 63. 2 ± 4. 1） m / s,（ 65. 6 ± 3. 2） m / s vs（ 63. 3 ± 3. 1） m/s,（ 65. 3 ± 2. 2） m/s vs（ 63. 1 ± 2. 3） m/s]（ P〈0. 05）; after 3 months of treatment,the EMG scores of triceps,triceps brachii,forearm muscle of the observation group were significantly higher than the control group [（ 45. 5 ± 3. 2） scores vs（ 42. 1 ± 3. 1） scores,（ 37. 4 ± 3. 3） scores vs（ 34. 3 ± 3. 1）scores,（ 36. 3 ± 3. 2） scores vs（ 32. 2 ± 3. 1） scores],the differences were statistically significant（ P〈0. 05）; compared with before treatment,FAM score of the two groups after 1,3 months of treatment saw an upward trend[observation group：（ 26. 5 ± 2. 3） scores,（ 31. 5 ± 3. 6） scores,and（ 17. 4 ± 1. 6） scores; the control group：（ 24. 3 ± 2. 2） scores,（ 28. 9 ± 3. 5） scores and（ 17. 4 ± 1. 5） scores] and wrist AROM were on the rise [（ 49 ± 3） °,（ 59 ± 5） ° vs（ 39 ± 4） °;（ 45 ± 3） °,（ 54 ± 4） vs（ 39 ± 3） ° ],and the observation group increased faster,the differences between the two groups,time points,and interaction of groups· time points were statistically significant（ P〈0. 01）. Conclusion EMG biofeedback can significantly increase the hemiplegia nerve conduction velocity,and promote the recovery of upper limb function of the stroke patients,thus is worthy of promotion in clinical.