Mathieu P A, Sullivan S J
Biomedical Engineering Institute, Université de Montréal, Canada.
Electromyogr Clin Neurophysiol. 1995 Dec;35(8):491-502.
The study concerns eleven patients who had suffered from a cerebro-vascular accident (CVA) less than 6 months previously and who were hospitalized for treatment. In addition to their multidisciplinary rehabilitation treatments, the patients consented to participate in an electromyographic (EMG) biofeedback program designed to increase their shoulder activity. From blocks of five individual isometric contractions, curves of both the mean torque and of its standard deviation (SD) were generated and from each of these, a mean value was obtained. These two measures were used to analyze the effects on the biofeedback training had induced on shoulder activity. The training induced negligible changes on the contralateral (CL) side. The mean torque value for the group was 31.02 post vs 30.99 Nm pre-training. However, for the hemiplegic (HEMI) limbs, some patients showed improvement while others did not. The treatment was considered a success when the mean torque values obtained in the last 2/3 of the training or at the post-training session were > or = 1.5 the values obtained during the pre-training session. Based on this criteria, it was found that six out of eleven patients did improve their muscular activity through the training. Among these, the improvement of four was greater during the 2/3 session than that observed at the post-training session. The six successful patients were found to have a pre-training upper extremity Fugl-Meyer score < or = 13. Two patients had a similar pre-training score of 11, and met the criteria of success, but the younger patient performed better than the older one. Patients with scores of 20 and higher did not meet the 1.5 criteria. A correlation (r = 0.80) was found between post/pre ratios of Fugl-Meyer scores and those of the mean torque: the test thus seems to have a limited usefulness for assessing local changes such as the effects of the biofeedback treatment on the shoulder.
该研究涉及11名患者，他们在不到6个月前发生了脑血管意外（CVA）并住院治疗。除了接受多学科康复治疗外，患者还同意参加一项旨在增加肩部活动的肌电图（EMG）生物反馈计划。从每组5次单独的等长收缩中，生成平均扭矩及其标准差（SD）的曲线，并从每条曲线中获得一个平均值。这两个指标用于分析生物反馈训练对肩部活动的影响。训练对健侧（CL）的影响可忽略不计。该组的平均扭矩值训练后为31.02 Nm，训练前为30.99 Nm。然而，对于偏瘫（HEMI）肢体，一些患者有所改善，而另一些患者则没有。当在训练的最后2/3阶段或训练后阶段获得的平均扭矩值≥训练前阶段获得的值的1.5倍时，该治疗被认为是成功的。基于这一标准，发现11名患者中有6名通过训练改善了肌肉活动。其中，4名患者在2/3阶段的改善比训练后阶段观察到的更大。发现6名成功的患者训练前上肢Fugl-Meyer评分≤13分。两名患者训练前评分为11分，符合成功标准，但年轻患者比年长患者表现更好。评分20分及以上的患者未达到1.5倍的标准。Fugl-Meyer评分的训练后/训练前比值与平均扭矩的比值之间存在相关性（r = 0.80）：因此，该测试对于评估局部变化（如生物反馈治疗对肩部的影响）似乎用处有限。
