太极拳和八段锦对脑卒中患者偏瘫下肢运动功能和表面肌电的效果

Effects of Taiji Quan and Baduanjin on Motor Function of Lower Limbs for Stroke Patients using Surface Electromyography

目的探讨太极拳等中国传统运动疗法对脑卒中患者偏瘫下肢的干预效果。方法 2014年3月至2016年3月,105例脑卒中患者分为对照组、气功组和太极组,各35例。三组均行常规康复,太极组行改良的24式太极拳,气功组行健身气功八段锦干预。干预前,干预4周末和8周末,采用Fugel-Meyer评定量表下肢部分(FMA-LE)进行评定,记录患侧胫骨前肌和腓肠肌积分肌电(iEMG),以及踝跖屈和背屈时协同收缩率(CR)。结果对照组21例、气功组23例、太极组28例完成研究。干预8周末,太极组FMA-LE评分高于对照组(P <0.05)。踝背屈时,太极组和气功组胫骨前肌i EMG高于对照组(P <0.05);太极组胫骨前肌CR低于对照组和气功组(P <0.05)。结论太极拳和气功锻炼可增强主动肌肌力,太极拳锻炼更有助于患者偏瘫下肢主动肌与拮抗肌之间的协同。

Objective To explore the effects of traditional exercise therapy, such as Taiji Quan, on motor function of lower limbs in stroke patients.Methods From March, 2014 to March, 2016, 105 stroke patients were divided into control group(n = 35), Qigong group(n = 35) and Taiji group(n = 35). All the patients received routine rehabilitation. In addition, the Taiji group exercised with modified 24 type Taiji Quan, while the Qigong group exercised with Baduanjin. They were assessed with Fugel-Meyer Assessment-lower extremities(FMA-LE), and integral electromyography(iEMG) and co-contraction ratio(CR) of tibialis anterior muscle and gastrocnemius were recorded with surface electromyography,before, four weeks and eight weeks after treatment.Results There were 21 cases in the control group, 23 in the Qigong group and 28 in the Taiji group finishing the exercise. At the end of the 8th week, the score of FMA-LE was more in the Taiji group than in the control group(P <0.05). The i EMG of tibialis anterior muscle as dorsiflexsion was more in both the Taiji group and the Qigong group than in the control group(P < 0.05). The CR of tibialis anterior muscle was less in the Taiji group than in both the control group and the Qigong group(P < 0.05).Conclusion Both Taiji Quan and Qigong exercise may promote the activities of muscle of legs in the patients with stroke, while Taiji Quan seems to be better in the coordination between active muscles and antagonistic muscles.