肌电生物反馈联合任务导向性训练对偏瘫上肢功能障碍患者的影响  

Effect of myoelectric biofeedback combined task-oriented training on hemiplegic patients with upper limb dysfunction

作　　者：蔡琛[1] 杨宁[1] 孙晓东[1] 王国英[1] 张芬[1] 冯学伟[1] 李晓兵 CAI Chen;YANG Ning;SUN Xiaodong;WANG Guoying;ZHANG Fen;FENG Xuewei;LI Xiaobing(Zhengzhou People's Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州人民医院,河南郑州450003

出　　处：《中国实用神经疾病杂志》2020年第7期602-606,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河南省科技攻关项目(编号:182102310537)。

摘　　要：目的探讨偏瘫上肢功能障碍患者应用肌电生物反馈与任务导向性训练联合方案对上肢日常生活活动能力、神经功能、训练满意度的影响。方法选取郑州人民医院神经内科2017-03—2018-05治疗的脑卒中后偏瘫患者40例,采用数字表抽取法随机分组,分别应用常规康复方案(对照组,n=20)与肌电生物反馈、任务导向性训练联合康复方案(观察组,n=20),并对其治疗前后的上肢日常生活活动能力(EMG、FMA、MBI评分)、神经功能(NIHSS评分)、训练满意度展开对比。结果康复治疗前上肢日常生活活动能力即EMG、FMA、MBI各维度评估值差异无统计学意义(P>0.05);治疗后经评定均高于治疗前,且观察组各项指标均高于对照组,差异有统计学意义(P<0.05)。2组治疗前NIHSS评分差异无统计学意义(P>0.05),治疗后均低于治疗前,且观察组评估分值低于对照组,差异有统计学意义(P<0.05)。观察组训练满意度为95%,对照组为75%,2组比较差异有统计学意义(P<0.05)。结论肌电生物反馈与任务导向性训练联合方案治疗偏瘫上肢功能障碍患者,可有效改善上肢日常生活活动能力,促进神经功能缺损恢复,且明显提高了训练满意度。Objective To investigate the effect of electromyoelectric biofeedback combined with guided training on the activity,nerve function and satisfaction of upper limbs in patients with hemiplegic upper limb dysfunction.Methods Forty patients with post-stroke hemiplegia treated in the Department of Neurology of Zhengzhou People's Hospital from March 2017 to May 2018 were randomly divided into groups using the digital table extraction method.The conventional rehabilitation program(control group,n=20),myoelectric biofeedback,Task-oriented training combined with rehabilitation program(observation group,n=20),and comparison of upper limb daily living activities(EMG,FMA,MBI score),neurological function(NIHSS score),and training satisfaction before and after treatment.Results Before rehabilitation treatment,there was no difference between the two groups in the evaluation values of the daily life activity of the upper limbs,namely EMG,FMA and MBI(P>0.05).After treatment,all the indexes in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).There was no difference in NIHSS score between the two groups before treatment(P>0.05),which was lower after treatment than before treatment,and the evaluation score of the observation group was lower than that of the control group,with statistically significant difference(P<0.05).The training satisfaction of the observation group was 95.2%and that of the control group was 78.6%,with statistically significant difference(P<0.05).Conclusion For the patients with hemiplegic upper limb dysfunction who are clinically admitted and treated,the combined treatment of electromyoelectric biofeedback and tasker-oriented training can effectively improve the daily life activity ability of upper limbs,promote the recovery of nerve function defects,and significantly improve the training satisfaction,which is of great value.

关 键 词：偏瘫 上肢功能障碍 肌电生物反馈 任务导向性训练 上肢日常生活活动能力 

分 类 号：R493[医药卫生—康复医学]