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肌电图生物反馈治疗对改善偏瘫中风患者上肢功能的影响。

The effect of electromyographic biofeedback treatment in improving upper extremity functioning of patients with hemiplegic stroke.

机构信息

Department of 5th Physical Medicine and Rehabilitation Clinic, Ankara Physical Medicine Rehabilitation Education and Research Hospital, Ankara, Turkey.

出版信息

J Stroke Cerebrovasc Dis. 2012 Apr;21(3):187-92. doi: 10.1016/j.jstrokecerebrovasdis.2010.06.006. Epub 2010 Sep 29.

Abstract

This study evaluated the effect of electromyographic biofeedback (EMG-BF) treatment on wrist flexor muscle spasticity, upper extremity motor function, and ability to perform activities of daily living in patients with hemiplegia following stroke. A total of 40 patients were enrolled and were randomly assigned to two groups: a group treated with EMG-BF (study group) and a untreated (control) group. Both groups participated in a hemiplegia rehabilitation program consisting of neurodevelopmental and conventional methods and verbal encouragement to "relax" spastic wrist flexor muscles. In addition, the study group received 3 weeks of EMG-BF treatment, 5 times a week, for 20 minutes per session at hemiplegic side wrist flexors. Clinical findings were assessed before and after rehabilitation using the Ashworth scale (AS), Brunnstrom's stage (BS) of recovery for hemiplegic arm and hand, the upper extremity function test (UEFT), the wrist and hand portion of the Fugl-Meyer scale (FMS), goniometric measurements of wrist extension, surface EMG potentials, and the Barthel Index (BI). There was no statistically significant difference between the two groups in terms of age, sex, systemic disease, and the etiology, side, and duration of hemiplegia. There also was no statistically significant difference in the pretreatment values between two groups. We found statistically significant improvements posttreatment in the AS, BS, UEFT, goniometric measurements of wrist extension, and surface EMG potentials in the study group. We also noted statistically significant differences in the wrist and hand portion of the FMS and the BI in both groups, but with significantly greater improvements in the study group. Our findings indicate a positive effect of EMG-BF treatment in conjunction with neurodevelopmental and conventional methods in hemiplegia rehabilitation.

摘要

本研究评估了肌电图生物反馈(EMG-BF)治疗对中风后偏瘫患者腕屈肌痉挛、上肢运动功能和日常生活活动能力的影响。共纳入 40 例患者,随机分为两组:接受 EMG-BF 治疗的组(研究组)和未治疗组(对照组)。两组均参加偏瘫康复计划,包括神经发育和常规方法以及口头鼓励“放松”痉挛的腕屈肌。此外,研究组在偏瘫侧腕屈肌接受 3 周的 EMG-BF 治疗,每周 5 次,每次 20 分钟。使用 Ashworth 量表(AS)、偏瘫上肢和手的 Brunnstrom 恢复阶段(BS)、上肢功能测试(UEFT)、Fugl-Meyer 量表的腕和手部分(FMS)、腕关节伸展的角度测量、表面肌电图电位和 Barthel 指数(BI)在康复前后评估临床发现。两组在年龄、性别、系统性疾病以及偏瘫的病因、侧别和持续时间方面无统计学差异。两组治疗前的数值也无统计学差异。我们发现研究组在 AS、BS、UEFT、腕关节伸展角度测量和表面肌电图电位方面治疗后有统计学显著改善。我们还注意到两组的 FMS 腕和手部分以及 BI 均有统计学显著差异,但研究组的改善更为显著。我们的发现表明,EMG-BF 治疗与神经发育和常规方法联合应用于偏瘫康复具有积极作用。

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