肌电生物反馈治疗对不同Brunnstrom分期脑梗死患者腕背伸功能的改善作用

doi:10.13481/j.1671-587x.20160526

吉林大学学报(医学版) ›› 2016, Vol. 42 ›› Issue (05): 975-979.doi: 10.13481/j.1671-587x.20160526

肌电生物反馈治疗对不同Brunnstrom分期脑梗死患者腕背伸功能的改善作用

常永霞¹, 李姣¹, 马秋云¹, 侯文丽¹, 戈雷¹, 孟海超¹, 胡瑾², 马崇¹, 王正田¹

1. 河北北方学院附属第一医院康复医学科, 河北张家口 075000;
2. 河北北方学院附属第一医院神经内科, 河北张家口 075000

收稿日期:2016-05-05 出版日期:2016-09-28 发布日期:2016-09-29
作者简介:常永霞(1974-),女,河北省蔚县人,副主任技师,医学硕士,主要从事康复治疗方面的研究。
基金资助:
河北省卫生厅科学技术研究与发展指导计划项目资助课题（1421130D）

Improvement effect of electromyographic biofeedback on wrist dorsiflexion function of patients with cerebral infarction at different Brunnstrom stages

CHANG Yongxia¹, LI Jiao¹, MA Qiuyun¹, HOU Wenli¹, GE Lei¹, MENG Haichao¹, HU Jin², MA Chong¹, WANG Zhengtian¹

1. Department of Rehabilitation Medicine, First Affiliated Hospital, Hebei North University, Zhangjiakou 075000, China;
2. Department of Neurology, First Affiliated Hospital, Hebei North University, Zhangjiakou 075000, China

Received:2016-05-05 Online:2016-09-28 Published:2016-09-29

摘要/Abstract

摘要：

目的：探讨肌电生物反馈治疗对不同Brunnstrom分期脑梗死患者腕背伸功能的影响，阐明肌电生物反馈治疗作用，为其临床应用提供依据。方法：选取脑梗死患者100例，BrunnstromⅠ-Ⅱ期54例，采用随机数字表法将该期患者分为对照组22例和治疗组32例；Brunnstrom Ⅲ期46例，采用随机数字表法将该期患者分为对照组23例和治疗组23例。4组患者均进行常规卒中康复治疗，治疗组加做肌电生物反馈治疗。分别于治疗前、治疗4和8周评估各组患者腕背伸肌最大表面肌电值和主动活动度（AROM），并进行上肢Fugl-Meyers运动功能评定（FMA）。结果：BrunnstromⅠ-Ⅱ治疗组和对照组患者腕背伸肌表面最大肌电值治疗8周均较治疗前明显提高（P<0.05），且BrunnstromⅠ-Ⅱ治疗组高于同期BrunnstromⅠ-Ⅱ对照组（P<0.05）；与治疗前比较，Brunnstrom Ⅲ治疗组腕背伸肌表面最大肌电值治疗4周时开始提高（P<0.05），且明显高于同期Brunnstrom Ⅲ对照组（P<0.05），对照组治疗8周开始提高（P<0.05）；BrunnstromⅠ-Ⅱ治疗组腕背伸肌AROM治疗8周开始增加（P<0.05），BrunnstromⅠ-Ⅱ对照组无明显变化（P>0.05），BrunnstromⅠ-Ⅱ治疗组腕背伸肌AROM明显高于BrunnstromⅠ-Ⅱ对照组（P<0.05）；Brunnstrom Ⅲ治疗组和对照组腕背伸肌AROM治疗4周时均明显提高（P<0.01，P<0.05），且治疗组明显高于对照组（P<0.05）；BrunnstromⅠ-Ⅱ治疗组和对照组FMA评分治疗8周时明显提高（P<0.05），且高于同期BrunnstromⅠ-Ⅱ对照组（P<0.05）；BrunnstromⅢ治疗组FMA评分治疗4周开始提高（P<0.05），BrunnstromⅢ对照组治疗8周时FMA评分较治疗前明显提高（P<0.05），且Brunnstrom Ⅲ治疗组明显高于Brunnstrom Ⅲ对照组（P<0.05）。结论：肌电生物反馈能增加脑梗死患者腕背伸肌肌力，改善肢体功能。

关键词: 脑梗死, Brunnstrom分期, 腕背伸, 本体感觉, 肌电生物反馈

Abstract:

Objective: To observe the effect of electromyographic biofeedback on the wrist dirsiflexion function of the patients with cerebral infarction at different Brunnstrom stages, and to clarify the treatment of electromyographic biofeedback,and to provide basis for its clinical application. Methods: A total of 100 cerebral infarction patients were selected.Among them 54 BrunnstromⅠ-Ⅱpatients were randomly divided into treatment group (n=32) and control group (n=22),and another 46 Brunnstrom Ⅲ patients were randomly divided into treatment group (n=23) and control group (n=23). The patients in four groups were treated with the same routine stroke rehabilitation therapy while the patients in treatment groups still received the electromyographic biofeedback therapy additionally. The maximum electromyographic contraction of muscle, active range of movement (AROM)and Fugl-Meyers Assessment (FMA) of the extension of wrist joint were evaluated before treatment and 4 and 8 weeks after treatment, respectively. Results: The maximum electromyographic contraction values of muscle of the patients in BrunnstromⅠ-Ⅱ treatment group and control group were significantly improved 8 weeks after treatment(P<0.05),and the value in treatment group was higher than that in control group(P<0.05).The maximum electromyographic contraction value of muscle in Brunnstrom Ⅲ treatment group began to improve 4 weeks after treatment compared with before treatment (P<0.05) and it was significantly higher than that in control group(P<0.05).The maximum electromyographic contraction value of muscle in Brunnstrom Ⅲ control group began to improve 8 weeks after treatment (P<0.05).The AROM in Brunnstrom Ⅰ-Ⅱ treatment group began to improve 8 weeks after treatment (P<0.05) and it was significantly higher than that in control group(P<0.05) while the AROM in control group had no significant change(P>0.05).The AROM in Brunnstrom Ⅲ treatment group and control group were significantly improved 4 weeks after treatment(P<0.05 or P<0.01),and the value in treatment group was significantly higher than that in control group(P<0.05).The FMA in BrunnstromⅠ-Ⅱtreatment group and control group were significantly improved 8 weeks after treatment(P<0.05),while the value in treatment group was higher than that in control group(P<0.05); the FMA in Brunnstrom Ⅲ treatment group began to improve 4 weeks after treatment (P<0.05) and it was significantly higher than that in control group(P<0.05).The FMA in control group began to improve 8 weeks after treatment (P<0.05). Conclusion: Electromyographic biofeedback can increase the strength and improve the body function of the patients with cerebral infaction.

Key words: cerebral infarction, Brunnstrom stage, wrist extension, proprioception, electromyographic biofeedback

中图分类号:

R493

常永霞, 李姣, 马秋云, 侯文丽, 戈雷, 孟海超, 胡瑾, 马崇, 王正田. 肌电生物反馈治疗对不同Brunnstrom分期脑梗死患者腕背伸功能的改善作用[J]. 吉林大学学报(医学版), 2016, 42(05): 975-979.

CHANG Yongxia, LI Jiao, MA Qiuyun, HOU Wenli, GE Lei, MENG Haichao, HU Jin, MA Chong, WANG Zhengtian. Improvement effect of electromyographic biofeedback on wrist dorsiflexion function of patients with cerebral infarction at different Brunnstrom stages[J]. Journal of Jilin University Medicine Edition, 2016, 42(05): 975-979.

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肌电生物反馈治疗对不同Brunnstrom分期脑梗死患者腕背伸功能的改善作用

Improvement effect of electromyographic biofeedback on wrist dorsiflexion function of patients with cerebral infarction at different Brunnstrom stages

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