运动疗法结合肌电生物反馈训练对ICU不完全性颈髓损伤患者功能恢复的影响

Exercise combined with electromyographic biofeedback for functional recovery after incomplete cervical spinal cord injury in ICU

目的探讨早期运动疗法结合肌电生物反馈训练在ICU的实施及对不完全性颈髓损伤(cSCI)患者功能恢复的影响。方法选取ICU不完全性cSCI患者70例,按随机数字表法分为观察组和对照组,各35例。两组患者均给予常规治疗和运动疗法,观察组在此基础上给予肌电生物反馈训练治疗。于治疗前和治疗4周后进行ASIA运动评分量表评定、日本矫形外科学会颈椎评分量表(JOA)、改良Barthel指数(MBI),并测定患者主动肩外展、屈肘、伸肘和腕背伸时三角肌、肱二头肌、肱三头肌和桡侧腕长伸肌等长收缩时的肌电积分值(IEMG)。结果经治疗后,两组患者ASIA运动评分、JOA评分、MBI评分及三角肌、肱二头肌、肱三头肌和桡侧腕长伸肌IEMG均改善,且高于组内治疗前(均P<0.05),且观察组各项指标均高于对照组(均P<0.01)。结论运动疗法结合肌电生物反可以有效改善ICU不完全性cSCI患者的肢体功能水平,提高患者生存质量。

Objective To explore the effect of early exercise therapy combined with electromyographic（EMG） biofeedback training on functional recovery of patients with incomplete cervical spinal cord injury（cSCI） in intensive care unit（ICU）. Methods Seventy patients with incomplete cSCI were randomly divided into study group（n=35） and control group（n=35）. Patients in both groups were given conventional treatment and exercise therapy, patients in study group received additional EMG biofeedback training. American Spinal Injury Association（ASIS） motion scale, Japanese Orthopaedic Association Cervical Score（JOA）, modified Barthel Index（MBI） were used for evaluation, and the integral electromyography（IEMG） of deltoid, biceps brachii, triceps brachii and extensor carpi radialis was performed before and 4 weeks after treatment in both groups. Results The ASIA motion score,JOA score, MBI and the IEMG in both groups were significantly improved after treatment（P〈0.05）, while these parameters were more markedly improved in study group compared to control group（P〈0.01）. Conclusion Exercise therapy combined with EMG biofeedback can effectively promote the function recovery, reduce the degree of neurological impairment and improve the quality of life of patients with incomplete cSCI in ICU.