肌电图生物反馈疗法改善脑卒中后肢体功能：系统评价和荟萃分析。
Electromyographic biofeedback therapy for improving limb function after stroke: A systematic review and meta-analysis.
机构信息
Department of The Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China.
Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
出版信息
PLoS One. 2024 Jan 11;19(1):e0289572. doi: 10.1371/journal.pone.0289572. eCollection 2024.
BACKGROUND
Upper and lower limb impairment is common after stroke. Electromyographic biofeedback therapy is a non-invasive treatment, and its effectiveness in functional rehabilitation of the limb after stroke still remains uncertain.
OBJECTIVE
The objective of this study was to evaluate whether electromyographic biofeedback can improve upper and lower limb dysfunction in stroke patients.
METHODS
PubMed, Embase, Cochrane Library, and Physiotherapy Evidence Database (PEDro) were searched from inception to 1st May 2022. Inclusion criteria were randomized controlled clinical trials of electromyographic biofeedback therapy interventions reporting changes in upper and lower limb function in post-stroke patients. Data were extracted by two independent reviewers and pooled in random-effects models using Review manager (RevMan) software.
RESULTS
Our analyses included 10 studies enrolling a total of 303 participants. Electromyographic biofeedback therapy can effectively improve limb function after stroke (standardized mean difference [SMD], 0.44; 95% confidence interval [CI], 0.12-0.77; P = 0.008) and in subgroup analyses, the effect sizes of short-term effect (SMD, 0.33; 95% CI, 0.02-0.64; P = 0.04) was significant, but the long-term was not (SMD, 0.61; 95% CI, -0.11-1.33; P = 0.10). In addition, Electromyographic biofeedback therapy can improve the active range of motion of shoulder (SMD, 1.49; 95% CI, 2.22; P<0.0001) and wrist joints (SMD, 0.77; 95% CI, 0.13-1.42; P = 0.02) after stroke.
CONCLUSION
In this meta-analysis, electromyographic biofeedback therapy intervention can improve upper and lower limb function in patients with stroke. Short-term (less than one month) improvement after electromyographic biofeedback therapy was supported, while evidence for long-term (more than one month) benefits was lacking. Range of motion in the glenohumeral and wrist joints were improved. Stronger evidence for individualized parameters, such as optimal treatment parameters and intervention period, is needed in the future.
SYSTEMATIC REVIEW REGISTRATION
[https://www.crd.york.ac.uk/prospero/display_record.php?recordID=267596], identifier [CRD42022354363].
背景
上肢和下肢功能障碍在中风后很常见。肌电图生物反馈疗法是一种非侵入性治疗方法，但其在中风后肢体功能康复中的有效性仍不确定。
目的
本研究旨在评估肌电图生物反馈是否能改善中风患者的上下肢功能障碍。
方法
我们检索了 PubMed、Embase、Cochrane 图书馆和物理治疗证据数据库（PEDro），检索时间截至 2022 年 5 月 1 日。纳入标准为肌电图生物反馈治疗干预的随机对照临床试验，报告中风后患者上肢和下肢功能的变化。由两名独立的综述作者提取数据，并使用 Review Manager（RevMan）软件进行随机效应模型汇总。
结果
我们的分析纳入了 10 项研究，共纳入 303 名参与者。肌电图生物反馈疗法可有效改善中风后肢体功能（标准化均数差[SMD]，0.44；95%置信区间[CI]，0.12-0.77；P=0.008），且在亚组分析中，短期效应的效应量（SMD，0.33；95%CI，0.02-0.64；P=0.04）显著，但长期效应不显著（SMD，0.61；95%CI，-0.11-1.33；P=0.10）。此外，肌电图生物反馈疗法还可改善中风后肩部（SMD，1.49；95%CI，2.22；P<0.0001）和腕关节（SMD，0.77；95%CI，0.13-1.42；P=0.02）的主动活动范围。
结论
在这项荟萃分析中，肌电图生物反馈疗法干预可以改善中风患者的上下肢功能。支持短期（1 个月内）改善，而缺乏长期（1 个月以上）获益的证据。盂肱关节和腕关节的活动度得到了改善。未来需要更多针对最佳治疗参数和干预时间等个体化参数的高质量研究。
系统评价注册
[https://www.crd.york.ac.uk/prospero/display_record.php?recordID=267596]，标识符[CRD42022354363]。
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