肌电生物反馈联合早期功能训练对出血性脑卒中患者运动功能恢复及血清肌肉生成抑制素水平的影响

Effects of electromyographic biofeedback combined with early functional training on motor function recovery and serum myostatin level in patients with hemorrhagic stroke

目的观察肌电生物反馈联合早期功能训练对出血性脑卒中患者运动功能恢复及血清肌肉生成抑制素水平的影响。方法选取2018年1月至2019年1月期间在上海中医药大学附属第七人民医院神经内科治疗的160例出血性脑卒中患者为研究对象,依据随机数表法将其分为对照组和观察组各80例,对照组患者接受常规康复干预方案,观察组在对照组基础上接受肌电生物反馈联合早期功能训练,干预时间均为4周。比较两组患者干预前后的运动功能恢复情况、血清肌肉生成抑制素水平、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力(ADL)评分以及血肿吸收情况。结果干预后两组患者的上肢、下肢运动功能评分较干预前明显提高,且干预后观察组患者的上肢、下肢运动功能评分分别为(40.41±13.22)分、(24.81±8.19)分,明显大于对照组的(32.72±10.09)分、(21.26±6.95)分,差异均有统计学意义(P<0.05);干预后观察组与对照组患者的血清肌肉生成抑制素水平分别为(7.55±1.25)μg/L、(9.02±1.46)μg/L,较干预前的(11.33±2.63)μg/L、(11.29±2.58)μg/L明显下降,且干预后观察组患者的血清肌肉生成抑制素水平明显低于对照组,差异均有统计学意义(P<0.05);干预后观察组与对照组患者的NIHSS评分分别为(3.84±1.13)分、(8.76±1.55)分,较干预前的(20.42±3.22)分、(20.33±3.16)分明显减小,ADL评分分别为(68.13±17.68)分、(53.45±14.26)分,较干预前的(30.22±9.97)分、(30.28±10.02)分明显增大,且干预后观察组患者的NIHSS评分明显小于对照组,ADL评分明显大于对照组,差异均有统计学意义(P<0.05);两组患者的血肿吸收情况比较差异无统计学意义(P>0.05)。结论肌电生物反馈联合早期功能训练可促进出血性脑卒中患者运动功能恢复,减轻神经缺损程度,提高日常生活活动能力,并能促进血肿吸收。

Objective To observe the effects of electromyographic biofeedback combined with early functional training on motor function recovery and serum myostatin level in patients with hemorrhagic stroke. Methods A total of160 patients with hemorrhagic stroke who were treated in the Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine from January 2018 to January 2019 were divided into two groups according to random number table method. Eighty patients in the control group received routine rehabilitation intervention schemes, and 80 patients in the study group received electromyographic biofeedback combined with early functional training on the basis of the control group, both for 4 weeks. After intervention, the recovery of motor function was evaluated, and serum myostatin level was measured. National Institutes of Health Stroke Scale(NIHSS) and Activity of Daily Life(ADL) scores were counted, and the absorption of hematoma was compared. Results After intervention, the motor function scores of upper limbs and lower limbs in the two groups were significantly higher than those before intervention, and the motor function scores of upper limbs and lower limbs in the study group were 40.41±13.22, 24.81±8.19, significantly higher than 32.72±10.09, 21.26±6.95 in the control group(P<0.05). The serum myostatin levels after intervention in the study group and the control group were(7.55±1.25) μg/L and(9.02±1.46) μg/L respectively, which were significantly lower than(11.33±2.63) μg/L and(11.29±2.58) μg/L before intervention, and the serum myostatin levels in the study group were significantly lower than those in the control group(P<0.05). After intervention, the NIHSS scores of the study group and the control group were 3.84±1.13, 8.76±1.55, significantly lower than 20.42±3.22, 20.33±3.16 before intervention;the ADL scores were 68.13±17.68, 53.45±14.26, significantly higher than 30.22±9.97, 30.28±10.02 before intervention;the NIHSS score of the study group was significantly lower than that of the control group;the ADL score was significantly higher than that of the control group;the differences were statistically significant(P<0.05). There was no significant difference in hematoma absorption between the two groups(P>0.05). Conclusion Electromygraphic biofeedback combined with early functional training can promote the recovery of motor function in patients with hemorrhagic stroke, reduce the degree of neurological deficit, improve the ability of daily living, and promote hematoma absorption.