Bradley L, Hart B B, Mandana S, Flowers K, Riches M, Sanderson P
Physiotherapy Service, Scunthorpe General Hospital, North Lincolnshire, UK.
Clin Rehabil. 1998 Feb;12(1):11-22. doi: 10.1191/026921598677671932.
To examine the effects of electromyographic (EMG) biofeedback training on the recovery of gait in the acute phase post stroke.
Patients were randomly assigned to EMG biofeedback or control groups. They received treatment three times a week for six weeks. All patients were assessed prior to treatment, after 18 treatment sessions, and at three months follow-up.
The study was carried out at Scunthorpe General Hospital in North Lincolnshire. The subjects were acute stroke patients who had been admitted on to the medical and elderly wards.
The EMG biofeedback group were treated using EMG as an adjunct to physiotherapy. The patients were encouraged to facilitate or inhibit abnormal muscle tone via auditory or visual signals transmitted from electrodes placed over the appropriate muscles. The control group were treated using the same techniques, electrodes were used with this group of patients, but the EMG machine was turned off and faced away from the patient and the therapist to control the placebo effect.
A large battery of outcome measures was used for physical and psychological assessment. The physical measures consisted of active movement, muscle tone, sensation, proprioception, mobility and activities of daily living (ADL). The psychological measures included orientation, memory, spatial performance, language and IQ.
Twenty-one patients were included in the study. Scores were combined into four groups: mild EMG, severe EMG, mild control and severe control. Results showed that there was an improvement in physical scores for active movement, mobility and ADL over time, but there was no significant difference between the EMG and control groups. Scores on the psychological tests were within normal limits, and there was no difference in performance between the EMG and control groups.
This study showed no significant differences in the rate of improvement after stroke between the two groups. Although EMG biofeedback was used as an adjunct to physiotherapy and represented clinical practice, the results provide little evidence to support the clinical significance of using EMG biofeedback to improve gait in the acute phase after stroke.
探讨肌电图（EMG）生物反馈训练对脑卒中急性期步态恢复的影响。
患者被随机分为EMG生物反馈组或对照组。他们每周接受三次治疗，共六周。所有患者在治疗前、18次治疗后以及三个月随访时均接受评估。
该研究在北林肯郡的斯肯索普总医院进行。受试者为入住内科和老年病房的急性脑卒中患者。
EMG生物反馈组采用EMG作为物理治疗的辅助手段。鼓励患者通过放置在相应肌肉上的电极传输的听觉或视觉信号来促进或抑制异常肌张力。对照组采用相同技术，该组患者使用电极，但EMG机器关闭并背对患者和治疗师，以控制安慰剂效应。
使用大量结果测量指标进行身体和心理评估。身体测量指标包括主动运动、肌张力、感觉、本体感觉、活动能力和日常生活活动（ADL）。心理测量指标包括定向、记忆、空间表现、语言和智商。
21名患者纳入研究。分数分为四组：轻度EMG、重度EMG、轻度对照和重度对照。结果显示，随着时间推移，主动运动、活动能力和ADL的身体分数有所改善，但EMG组和对照组之间无显著差异。心理测试分数在正常范围内，EMG组和对照组在表现上无差异。
本研究表明两组脑卒中后改善率无显著差异。尽管EMG生物反馈作为物理治疗的辅助手段并代表临床实践，但结果几乎没有证据支持使用EMG生物反馈改善脑卒中急性期步态的临床意义。
