肌电反馈功能性电刺激治疗急性期脑梗死手功能障碍的临床研究  

Effects of EMG-feedback functional electrical stimulation on hand dysfunction in acute cerebral infarction patients

作　　者：宋小慧[1] 谢青[1] 崔立军[1] 鲍勇[2] 纵亚[1] 张伟明[1] 

机构地区：[1] 上海交通大学医学院附属瑞金医院康复医学科,200025 [2] 上海交通大学医学院附属瑞金医院卢湾分院康复医学科

出　　处：《中国康复医学杂志》2015年第6期538-541,共4页Chinese Journal of Rehabilitation Medicine

基　　金：上海市科学技术委员会科研计划项目(11DZ1921305);上海市卫生局科研项目局级课题(2011283);上海交通大学医工交叉课题(2012108)

摘　　要：目的:观察肌电反馈功能性电刺激(EMG-FES)对急性期脑梗死患者手功能障碍的康复治疗效果。方法:急性期脑梗死手功能障碍患者40例,采用随机数字表法分为治疗组和对照组,各20例。2组患者均接受相同的常规康复治疗,治疗组患侧上肢给予EMG-FES,对照组患侧上肢行神经肌肉电刺激(NMES)治疗,2组治疗均为每日1次,每次15min,每周5次,共8周。分别于治疗前及治疗2、4、8周后采用上肢Fugl-Meyer评分(FMA)、Barthel指数(BI)和10s抓握测试(HGRT)进行评定,对结果进行统计分析并比较其疗效。结果:治疗前评定,治疗组和对照组FMA、BI和HGRT评分组间差异均无显著性意义(P>0.05)。治疗4周后,治疗组FMA、BI和HGRT评分分别为(56.45±9.05)分、(91.00±7.18)分和(10.4±4.51)次;对照组分别为(55.55±9.71)分、(84.7±12.62)分和(8.05±4.27)次,HGRT次数组间比较差异有显著性意义(P<0.05)。治疗8周后,治疗组FMA、BI和HGRT评分分别为(62.95±3.32)分、(98.7±3.93)分和(13.0±3.68)次;对照组分别为(58.60±7.70)分、(89.7±10.94)分和(9.26±4.12)次,经比较,治疗组各项评分均较对照组明显改善,组间差异有显著性意义(P<0.05)。结论:肌电反馈功能性电刺激能有效改善脑梗死急性期患者具有一定活动能力的偏瘫手的功能和ADL能力。Objective： To observe the effects of EMG- feedback functional electrical stimulation（EMG- FES） therapy on hand function recovery in acute cerebral infarction patients.Method： Forty cerebral infarction patients were randomly divided into a treatment group and a control group.Each group contained 20 patients and received the same conventional rehabilitation treatments. In addition, the treatment group and the control group were also given EMG- FES and neuromuscular electrical stimulation（NMES）, respectively. All therapies in both groups were set once a day for 15 minutes, 5 days a week, 8weeks in total. Fugl- Meyer（FMA） upper limb assessment, Barthel index（BI）, and hand grab and relax test（HGRT） in 10 seconds were evaluated for each patient before treatment and 2, 4, 8 weeks during treatment.Result： Before treatment, no significant difference was found in the scores of FMA, BI and HGRT between both groups（P〈0.05）. At the 4th week after intervention, the scores of FMA, BI and HGRT were 56.45±9.05,91.00±7.18 and 10.4±4.51 respectively in the treatment group; and 55.55±9.71, 84.7±12.62 and 8.05±4.27 respec-tively in the control group. Only HGRT in the treatment group was significantly higher than that in the control group（P〈0.05）. At the end of treatment scores of FMA, BI and HGRT were 62.95±3.32, 98.7±3.93 and13.0 ± 3.68 respectively in the treatment group, and 58.60 ± 7.70, 89.7 ± 10.94 and 9.26 ± 4.12 respectively in the control group. The scores of FMA, BI, HGRT were all higher in the treatment group than those in the control group, and the differences between both groups were significant（P〈0.05）.Conclusion： EMG-feedback functional electrical stimulation was superior to the neuromuscular electrical stimulation on hand dysfunction of acute cerebral infarction patients.

关 键 词：脑梗死 电刺激 手功能障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]