肌电生物反馈治疗对脑卒中偏瘫步行能力的影响  

A clinical research on effects of eletromyography biofeedback therapy on stroke hemiplegic patients' walking capacity

作　　者：王玉英[1] 倪朝民[1] 刘孟[1] 昝明 郭能峰 崔俊才 

机构地区：[1]安徽医科大学附属省立医院康复医学科,合肥230001

出　　处：《中国康复医学杂志》2016年第8期874-877,共4页Chinese Journal of Rehabilitation Medicine

基　　金：国家科技支撑计划课题(2011BAI08B11)

摘　　要：目的:探讨肌电生物反馈治疗对脑卒中患者步行能力的影响。方法:62例可以独立步行5m以上,Brunnstrom分期下肢为4—5期的慢性脑卒中偏瘫患者,随机分为A、B两组,A组(观察组)在B组(对照组)常规物理疗法(PT)、作业疗法(OT)训练治疗同时增加肌电生物反馈治疗,治疗4周前后采用三维步态分析系统评测两组的步态空间域参数和步态时间域参数。结果:A、B两组治疗后在步态空间域参数中平均步幅宽较治疗前均有下降(P<0.05),平均步幅长、步伐长和步向角较治疗前均有增大(P<0.05);步态时间域参数中步速、步频和摆动相百分比较治疗前均有明显增加(P<0.05),单支撑相百分比和双支撑相百分比较治疗前均有所减小(P<0.05)。且A组的步态空间域参数及步态时间域参数均较B组变化幅度更大(P<0.05)。结论:肌电生物反馈治疗可以改善患者步态的稳定性,明显提高步速、步频,对患者步行能力有较大的帮助。Objective： To discuss effects of EMG biofeedback（EMGBF） therapy on the recovery of stroke hemiplegic pa- tients＇ walking capacity. Method： Sixty-two chronic stroke hemiplegic patients were recruited whose lower extremities all were at the 4th and the 5th Brunnstrom stage and could walk at least 5m without assistance. They were randomly as- signed into two groups： group A （observation group） and group B （control group）. Both groups had the conven- tional PT and OT treatment, group A had EMGBF therapy in additions. Before and after four weeks treatment, 3-D gait analysis system was adopted to evaluate patients＇ gait parameters in the spatial domain and time do- main. Result： In regards to patients＇ gait parameters in the spatial domain, in both groups average stride width de- creased （P〈 0.05）, while average stride length, pace length and step angle increased （P〈 0.05）; As to the gait parameters in the time domain, both groups＇ stride pace, stride frequency and sway status percentage increased significantly after treatment （P〈 0.05）. The single-support status percentage and double-support status percentage decreased after treatment （P 〈 0.05）. Group A patients＇ gait parameters changed more than that of group B in both the spatial domain and time domain, and these differences were significant （P 〈 0.05）. Conclusion： EMGBF therapy can improve hemiplegic patients＇ stride stability, stride pace and stride frequency. As a result, EMGBF therapy can help the recovery of stroke hemiplegic patients＇ walking capacity.

关 键 词：肌电生物反馈治疗 脑卒中 步态分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R454.1[医药卫生—临床医学]