早期康复训练联合肌电生物反馈对动脉瘤所致脑卒中偏瘫患者的疗效及体感诱发电位的影响

Effect of early rehabilitation training combined with electromyographic biofeedback on the efficacy and somatosensory evoked potential in patients with stroke associated hemiplegia

目的探讨早期康复训练联合肌电生物反馈对动脉瘤所致脑卒中偏瘫患者的疗效及体感诱发电位的影响。方法选取2015年1月至2017年1月间上海市养志康复医院神经康复病区收治的150例脑卒中偏瘫患者,采用随机数表法分为观察组和对照组,每组75例。观察组患者在早期康复治疗基础上采用肌电生物反馈,对照组患者采用早期康复治疗方法进行康复治疗,在康复治疗前后采用Fugl-Meyer评定量表(FMA)、改良Barthel指数(MBI)、脑卒中专门化生活质量表(SS-QOL)、神经功能缺损(NFD)评分及体感诱发电位(SEP)对患者恢复情况进行评价。结果康复治疗前,两组患者FMA评分和MBI指数比较,差异无统计学意义(P>0.05)。康复治疗后,两组患者FMA评分和MBI指数均升高,且观察组高于对照组,差异均有统计学意义(均P<0.05)。康复治疗前,两组患者SS-QOL和NFD评分比较,差异无统计学意义。康复治疗后,两组患者SS-QOL评分均升高,NFD评分均下降,且观察组改变更明显,差异均有统计学意义(均P<0.05)。康复治疗前,两组患者患肢SEP潜伏期差异无统计学意义(P>0.05)。康复治疗3个月后,两组患者患肢SEP潜伏期均明显缩短,且观察组变化更明显,差异均有统计学意义(均P<0.05)。结论早期康复治疗联合肌电生物反馈可提高脑卒中患者的临床疗效,促进脑神经的恢复与重建,改善生活质量和不良预后。

Objective To explore the effect of early rehabilitation training combined with electro- myographic biofeedback on the efficacy and somatosensory evoked potential in patients with stroke associated hemiplegia. Methods A total of 150 patients with stroke associated hemiplegia who were treated at Shang- hai Yangzhi Rehabilitation Hospital from January 2015 to January 2017 were selected and divided into an observation group and a control group according to random digital table method, with 75 patients in each group. The observation group was given electromyographic biofeedback on the basis of early rehabilitation therapy and the control group was only treated with early rehabilitation therapy. The recovery of patients was evaluated by Fugl-Meyer rating scale （FMA）, modified barthel index （MBI）, Stroke-specific quality life scale （SS-QOL）, nerve function defect （NFD） score and somatosensory evoked potential （SEP） before and after nursing. Results There was no significant difference in FMA score and MBI level between the two groups before nursing （ P 〉 0. 05 ）, but FMA score and MBI level increased in both groups after nursing with the increase higher in the observation group than in the control group （ all P 〈 0. 05 ）. Before rehabilitation,there was no significant difference in SS-QOL and NFD scores between the two groups （ P 〉 O. 05 ） but after rehabilitation, SS-QOL scores increased in both groups and NFD scores decreased in both groups with the changes more significant in the observation group than in the control group （ all P 〈 0.05 ）. Before rehabili- tation, there was no significant difference in the latency of SEP between the two groups and at 3 months after the rehabilitation, SEP decreased in both groups with changes more significant in the observation group than in the control group （ all P 〈 0. 05）. Conclusion Early rehabilitation training combined with electromyographic biofeedback can improve the clinical efficacy in patients with stroke associated hemiplegia, effectively promote the recovery and reconstruction of brain nerve, and improve the quality of life and poor prognosis.