交叉迁移联合肌电生物反馈干预对亚急性期脑卒中患者腕背伸功能的影响

Effects of cross-education combined with electromyography biofeedback intervention on wrist dorsal extension function in patients with subacute stroke

目的:观察交叉迁移联合肌电生物反馈干预对亚急性期脑卒中患者腕背伸功能的影响。方法:将45例亚急性期脑卒中患者随机分为交叉迁移组、肌电生物反馈组、联合组,每组各15例。3组患者均接受常规康复训练,交叉迁移组在此基础上进行交叉迁移治疗,肌电生物反馈组在此基础上进行肌电生物反馈治疗,联合组在此基础上进行交叉迁移联合肌电生物反馈治疗。以上每组治疗需持续6周,并于治疗前、治疗后采用主动关节活动度(active joint range of motion,AROM)、徒手肌力评定(manual muscle test,MMT)、上肢Fugl-Meyer评分(FMA-UE)、改良Barthel指数(modified Barthel index,MBI)对患者腕背伸功能、上肢运动功能及日常生活活动能力进行评定。结果:治疗前,3组患者的FMA-UE评分、腕背伸AROM及肌力评分、MBI评分比较均无显著性差异(P>0.05)。治疗6周后,3组患者的FMA-UE评分、腕背伸AROM及肌力评分、MBI评分与治疗前相比均明显提高(P<0.05)。其中,联合组与交叉迁移组、肌电生物反馈组相比,除MBI评分比较无显著性差异(P>0.05)外,其他指标评分比较均有显著性差异(P<0.05),而交叉迁移组和肌电生物反馈组各项指标评分比较均无显著性差异(P>0.05)。结论:交叉迁移联合肌电生物反馈干预在改善亚急性期脑卒中患者腕背伸功能、上肢运动功能及日常生活活动能力方面优于单一的交叉迁移或肌电生物反馈疗法。

Objective:To observe the effect of cross-education combined with electromyography(EMG)biofeedback intervention on the wrist dorsal extension function of patients with subacute stroke.Method:Forty-five patients with subacute stroke were randomly divided into cross-education group,EMG biofeedback group,and combined group,with 15 cases in each group.The patients of three groups received routine rehabilitation training.The cross-education group performed additional cross-education training on this basis,the EMG biofeedback group performed additional EMG biofeedback training,and the combined group performed additional cross-education combined with EMG biofeedback.The above treatment lasted for 6 weeks,and before and after treatment,active joint range of motion(AROM),manual muscle test(MMT),simplified Fugl-Meyer motor function score:upper extremity(FMA-UE),modified Barthel index(MBI)were used to assess the patient's wrist extension function,upper limb motor function and activities of daily living.Result:Before treatment,the three groups had no significant difference in FMA-UE score,wrist dorsiflexion AROM,muscle strength score,and MBI score(P>0.05).Afer 6 weeks treatment,the FMA-UE score,wrist dorsiflexion AROM,muscle strength score,and MBI score of the three groups were significantly improved compared with those before treatment(P<0.05).When comparison among the groups,there was no significant difference in MBI score(P>0.05),and other index score comparisons showed significant differences(P<0.05),and there was no significant difference in the comparison of the cross-education group and the EMG biofeedback group(P>0.05).Conclusion:Cross-education combined with EMG biofeedback is better than single cross-education or EMG biofeedback intervention in improving the wrist extension function,upper limb motor function and activities of daily living in patients with subacute stroke.