基于床旁康复干预的上肢强制性运动疗法对脑梗死患者神经功能和表面肌电信号的影响

The effect of upper limb compulsory exercise therapy based on bedside rehabilitation intervention on neural function and surface electromyographic signals in patients with cerebral infarction

目的探讨基于床旁康复干预的上肢强制性运动疗法在脑梗死患者中的应用效果及对神经功能和表面肌电信号的影响。方法回顾性选取2019年3月~2022年10月首都医科大学附属北京友谊医院医保神经内科收治的脑梗死患者126例,根据干预方法不同分为对照组和观察组各63例。对照组采用常规方法干预,观察组联合基于床旁康复干预的上肢强制性运动疗法干预,3个月康复干预后评估患者效果,比较两组有效率、运动功能、神经功能恢复、认知功能、日常生活能力及表面肌电信号。结果观察组干预3个月有效率为95.23%,高于对照组80.95%,差异有统计学意义(χ^(2)=6.130,P=0.013)。观察组康复训练3个月后肢体运动功能Fugel-Meyer(FMA)、简易智能精神状态检查量表(MMSE)及改良Barthel指数(MBI)高于对照组,NIHSS低于对照组,差异有统计学意义(t=8.561、2.321、4.568、5.112,P=0.000);两组干预3个月后表面肌电信号得到改善,且观察组上肢肱二头肌、肱三头肌、桡侧腕伸肌及桡侧腕屈肌肌群的表面肌电信号高于对照组,差异有统计学意义(t=20.572、14.747、29.192、17.054,P=0.000)。结论基于床旁康复干预的上肢强制性运动疗法用于脑梗死患者中,有助于提高患者治疗效果,能增强患者运动及日常生活能力,改善患者认知功能,减轻神经功能,亦可改善患者上肢肌电信号,值得临床应用。

Objective To explore the application effect of upper limb compulsory motor therapy based on bedside rehabilitation intervention in patients with cerebral infarction and its impact on neural function and surface electromyography signals.Methods A retrospective study was conducted on 126 patients with cerebral infarction admitted to the Neurology Department of Beijing Friendship Hospital Affiliated to Capital Medical University from March 2019 to October 2022.They were divided into a control group and an observation group,with 63 patients in each group,based on different intervention method.The control group received routine intervention,while the observation group received upper limb mandatory motor therapy intervention based on bedside rehabilitation intervention.After 3 months of rehabilitation intervention,the patient′s effectiveness was evaluated,and the effectiveness,motor function,neurological function recovery,cognitive function,daily living ability,and surface electromyographic signals were compared between the two groups.Results The 3-month intervention effective rate of 95.23%in the observation group was higher than 80.95%in the control group(χ^(2)=6.130,P=0.013);After 3 months of rehabilitation training,the FMA,MMSE,and MBI in the observation group were higher than those in the control group,NIHSS was lower than that of the control group(t=8.561,2.321,4.568,5.112,P=0.000);After 3 months of intervention,the surface electromyographic signals of both groups improved;The surface electromyographic signals of the biceps brachii,triceps brachii,extensor carpi radialis,and flexor carpi radialis muscle groups in the observation group were higher than those in the control group(t=20.572,14.747,29.191,17.053,P=0.000).Conclusion The use of bedside rehabilitation intervention for upper limb compulsory motor therapy in patients with cerebral infarction can improve the treatment effect,enhance their motor and daily life abilities,improve their cognitive function,reduce neurological function,and improve their upper limb electromyography signals.It is worth promoting and applying.