肌电反馈体感游戏治疗分娩性臂丛神经麻痹儿童上肢功能的效果

Effect of Electromyographic Biofeedback Motion Sensing Game on Upper Limb Function in Children with Obstetric Brachial Plexus Injury

目的探讨采用肌电反馈体感游戏治疗分娩性臂丛麻痹（OBPP）患儿上肢功能的效果。方法 2013年3月~2014年2月,本院41例患儿随机分为常规治疗组（n=21）和体感游戏组（n=20）。两组均进行运动疗法治疗,体感游戏组还进行肌电体感游戏的上肢作业疗法,共4周。两组均在治疗前后进行Mallet评定和患儿肩部外展时三角肌电生理学评定。结果治疗前,两组Mallet评分无显著性差异（t=0.730,P〉0.05）。治疗后两组Mallet评分均较治疗前提高（t〉5.085,P〈0.05）,体感游戏组Mallet评分及治疗前后差值明显高于常规治疗组（t〉3.195,P〈0.01）。治疗后,体感游戏组三角肌的肌电积分值（i EMG）、平均肌电值（a EMG）和最大随意收缩值（EMGmax）均较治疗前升高（t〉4.420,P〈0.05）,而常规治疗组仅a EMG、i EMG高于治疗前（t〉2.282,P〈0.05）。治疗后体感游戏组各项肌电指标及治疗前后差值均高于常规治疗组（t〉2.155,P〈0.05）。结论肌电反馈体感游戏治疗对提高分娩性臂丛神经麻痹患儿上肢功能及力量有一定作用。

Objective To investigate the effect of electromyographic biofeedback motion sensing game on upper limb function in children with obstetric brachial plexus palsy（OBPP）. Methods From March, 2013 to February, 2014, 41 children with OBPP were randomly assigned into conventional rehabilitation group（n=21） and motion sensing game group（n=20）. Both groups underwent a comprehensive course of rehabilitation, and the motion sensing game group received upper limb occupational therapy in the motion sensing game, for four weeks. They were assessed with Mallet shoulder function scale and the surface electromyogram（EMG） of the deltoid muscle when abducting the shoulder before and after treatment. Results Before treatment, there was no significant difference in the Mallet scores between two groups（t=0.730, P〈0.05）, the scores improved after treatment in both groups（t〉5.085, P〈0.05）, and the scores after treatment and the D-value scores before and after treatment were higher in the motion sensing game group than in the conventional rehabilitation group（t〉3.195, P〈0.01）. The integral EMG（i EMG） value, average EMG（a EMG） value and maximum EMG（EMGmax） value of the deltoid muscle improved in the motion sensing game group after treatment（t〉4.420, P〈0.05）, however, only a EMG and i EMG improved in the conventional rehabilitation group（t〉2.282, P〈0.05）. All of them after treatment and the D-value were higher in the motion sensing game group than in the conventional rehabilitation group（t〉2.155, P〈0.05）. Conclusion Electromyographic biofeedback motion sensing game therapy plays a role in the rehabilitation of upper limb function and muscle strength in children with OBPP.