肌电生物反馈配合悬吊治疗对痉挛型脑性瘫痪患儿下肢肌力和H反射的影响

Effects of electromyographic biofeedback combined with suspension therapy on the muscle strength of lower extremities and H reflex in children with spastic cerebral palsy

目的研究肌电生物反馈配合悬吊治疗对痉挛型脑性瘫痪患儿下肢肌力和H反射的影响。方法选取2016-08—2017-08河南省省立医院98例痉挛型脑性瘫痪患儿,采用单双号法随机平均分为对照组与联合组,均给予运动训练、推拿、脑循环等常规疗法,对照组加用悬吊训练,联合组加用悬吊训练+肌电生物反馈疗法,治疗12周,比较2组治疗效果。结果治疗后,2组儿童改良巴氏指数量表(ADL)评分、粗大运动功能量表(GMFM-88)D区和E区评分显著提升(P<0.05),改良Ashworth痉挛等级量表(MAS)评分、足背屈角均显著降低和综合痉挛评分量表(CSS)评分均显著降低(P<0.05),且联合组变化幅度大于对照组(P<0.05);治疗后,联合组H反射潜伏期显著长于对照组(P<0.05),波幅和最大H波/最大M波(H/M值)显著小于对照组(P<0.05)。结论肌电生物反馈联合悬吊运动治疗痉挛型脑瘫患儿,可明显改善其日常生活能力、下肢运动能力、肌痉挛症状、关节活动度、肌张力和收缩性,效果显著,值得推广。

Objectives To study the effects of electromyographic biofeedback combined with suspension therapy on the the muscle strength of lower extremities andH reflex in children with spastic cerebral palsy.Methods A total of 98 children with spastic cerebral palsy admitted to our hospital from August 2016 to August 2017 were randomly divided into the control group and the combined group by odd and even number method,and they were given routine therapies such as exercise training,massage and cerebral circulation.On the basis,the control group was additionally treated with suspension training while the combined group was additionally treated with suspension training and electromyographic biofeedback therapy.The therapy lasted for 12 weeks.The therapeutic effects were compared between the two groups.Results After treatment,scores of modified Barthel index(ADL),D area and E area of Gross Motor Function Measure(GMFM 88)in two groups were significantly improved(P<0.05),while scores of modified Ashworth asticity scale(MAS),foot dorsiflexion angle and the comprehensive spasticity scale(CSS)scores were significantly decreased(P<0.05),and changes in the combined group were greater than those in the control group(P<0.05).After treatment,the latency of H reflex in the combined group was significantly longer than that in the control group(P<0.05),and the amplitude and maximum H wave/maximum M wave(H/M value)were significantly smaller than those in the control group(P<0.05).Conclusion Electromyographic biofeedback combined with suspension can significantly improve the activities of daily living and lower limb exercise capacity,relieve muscle spasm symptoms,improve the range of motion,muscle tension and contractility of children with spastic cerebral palsy,and the effect is remarkable.