肌电生物反馈疗法联合常规康复训练对儿童发育性髋关节发育不良术后髋关节功能、平衡功能及步行能力的影响

Effects of electromyographic biofeedback therapy combined with routine rehabilitation training on hip function,balance function and walking ability of children with developmental dysplasia of the hip

目的探讨肌电生物反馈疗法联合常规康复训练对儿童发育性髋关节发育不良(DDH)术后髋关节功能、平衡功能及步行能力的影响,为肌电生物反馈疗法在儿童DDH术后康复治疗中的应用提供参考。方法选取2017年5月至2020年5月本院康复医学科收治的DDH术后患儿64例,按随机数字表法分为观察组(32例)和对照组(32例)。对照组给予常规康复训练治疗,观察组在对照组基础上联合肌电生物反馈治疗,均持续治疗12周。比较两组治疗前及治疗6周、12周后的髋关节功能(髋关节屈伸、内旋外旋、内收外展活动度及Harris功能评分)、平衡功能[Berg平衡量表(BBS)评分]、步行能力[10m步行测试(10MWT)]。结果重复测量方差分析显示,两组髋关节屈伸、内旋外旋、内收外展活动度及Harris功能评分比较的时点效应(F_(时点)=625.825、769.394、461.679、303.857)、组间效应(F_(组间)=43.842、82.323、31.581、12.881)、时点与组别的交互效应(F_(交互)=12.181、25.524、16.238、5.841)差异均有统计学意义(P<0.05);两组BBS评分、10MWT比较的时点效应(F_(时点)=548.748、304.771)、组间效应(F_(组间)=32.352、62.144)、时点与组别的交互效应(F_(交互)=14.550、14.175)差异有统计学意义(P<0.05)。治疗6周、12周后,随治疗时间增加两组髋关节屈伸、内旋外旋、内收外展活动度及10MWT较治疗前均增加,髋关节Harris功能评分、BBS评分较治疗前均提高,且观察组髋关节屈伸、内旋外旋、内收外展活动度及10MWT均大于对照组,髋关节Harris功能评分、BBS评分均显著高于对照组(P<0.05)。结论在常规康复训练基础上联合肌电生物反馈疗法可促进儿童DDH术后髋关节功能恢复,改善患儿平衡功能和步行能力。

Objective To investigate the effect of electromyographic biofeedback therapy combined with routine rehabilitation training on hip function,balance function and walking ability and provide reference for the application of electromyographic biofeedback therapy of children with developmental dysplasia of the hip(DDH).Methods 64 cases of children with DDH were randomly divided into observation group(32 cases)and control group(32 cases)from May 2017 to May 2020.The control group was treated with routine rehabilitation training,and the observation group was treated with electromyographic biofeedback on the basis of the control group,which lasted for 12 weeks.The hip function(hip flexion and extension,internal rotation and external rotation,adduction and abduction range of motion and Harris function scores),balance function[Berg balance scale(BBS)scores],walking ability[10 m walking test(10 MWT)]of the two groups were compared before treatment and after 6 and 12 weeks of treatment.Results Repeated measures analysis of variance showed that:the time point effect(F_(times)=625.825,769.394,461.679,303.857),inter group effect(F_(groups)=43.842,82.323,31.581,12.881)and interaction effect between time point and group(F_(interaction)=12.181,25.524,16.238,5.841)were statistically significant between the two groups(P<0.05).There were significant differences in BBS scores,10 MWT time point effect(F_(times)=548.748,304.771),inter group effect(F_(groups)=32.352,62.144)and interaction effect between time point and group(Finteraction=14.550,14.175)between the two groups(P<0.05).After 6 and 12 weeks of treatment,the hip flexion and extension,internal rotation and external rotation,adduction and abduction range of motion and 10 MWT of the two groups increased compared with those before treatment,Harris function score and BBS score of the hip improved compared with those before treatment,and the hip flexion and extension,internal rotation and external rotation,adduction and abduction range of motion and 10 MWT of the observation group were higher than those of the control group,Harris function score and BBS score of the hip were higher than those of the control group,significantly(P<0.05).Conclusion On the basis of routine rehabilitation training combined with electromyographic biofeedback therapy can promote the recovery of hip joint function,improve balance function and walking ability of children after DDH.