表面肌电生物反馈联合减重平板训练在脑卒中后偏瘫患者中的应用效果分析

Effect Analysis of Surface EMG Biofeedback Combined with Body Weight Support Treadmill Training in Application of Patients with Hemiplegia after Stroke

目的分析表面肌电生物反馈联合减重平板训练在脑卒中后偏瘫患者中的应用效果。方法收集2017年12月—2020年12月收治的185例脑卒中后偏瘫的临床资料。按治疗方法不同分为单一组(表面肌电生物反馈治疗)91例与联合组(表面肌电生物反馈联合减重平板训练治疗)94例。比较两组治疗前后胫前肌和腓肠肌的积分肌电值、踝关节主动背伸活动度、Fugl-Meyer运动功能量表(FMA)、临床痉挛指数(CSI)、美国国立卫生研究院卒中量表(NIHSS)及Barthel指数(BI)评分。结果治疗前后,两组胫前肌、腓肠肌静息状态积分肌电值比较差异无统计学意义(P>0.05)。治疗后,两组胫前肌主动运动状态积分肌电值、FMA评分、踝关节主动背伸活动度及BI评分均较治疗前升高,腓肠肌主动运动状态积分肌电值、CSI及NIHSS评分均较治疗前降低,且联合组改善程度优于单一组(P<0.05)。结论表面肌电生物反馈联合减重平板训练可改善脑卒中后偏瘫患者的运动功能,增强患者下肢肌力,提高康复效果。

Objective To analyze the effect of surface electromyographic biofeedback(sEMGBF)combined with body weight support treadmill training(BWSTT)in application of patients with hemiplegia after stroke.Methods Clinical data of 185 patients with hemiplegia after stroke admitted between December 2017 and December 2020 was collected.The patients were divided into single group(n=91,sEMGBF treatment)and combination group(n=94,sEMGBF combined with BWSTT treatment)according to different therapeutic methods.The integral electromyographic(EMG)values of the tibialis anterior and gastrocnemius muscles,active dorsal expansion range of motion(ROM)of ankle joint,scores of Fugl-Meyer Motor Function Scale(FMA),Clinical Spasticity Index(CSI),National Institutes of Health Stroke Scale(NIHSS)and Barthel Index(BI)before and after treatment were compared between two groups Results There were no significant differences in integral EMG values of tibialis anterior muscle and gastrocnemius muscle in quiescent condition before and after treatment between two groups(P>0.05).After treatment,the integral EMG values in active exercise,FMA score,active dorsal expansion ROM of ankle joint and BI score of tibialis anterior muscles were significantly higher,while integral EMG values,CSI and NIHSS scores of the active gastrocnemius muscle were significantly lower than those before treatment in two groups,and the improvement conditions in combination group were better than those in single group(P<0.05).Conclusion The sEMGBF combined with BWSTT may improve the motor function of patients with hemiplegia after stroke,enhance the muscle strength of the patients'lower limbs and improve the rehabilitation effect.