肌电生物反馈治疗脑卒中后病人上肢运动功能障碍效果的Meta分析  

Effect of electromyographic biofeedback treatment on reducing upper limb motor dysfunction of patients after stroke:a Meta⁃analysis

作　　者：余梦婷 李壮苗[1] 燕文娟 张佳宇 谢延真 YU Mengting;LI Zhuangmiao;YAN Wenjuan;ZHANG Jiayu;XIE Yanzhen(School of Nursing,Fujian University of Traditional Chinese Medicine,Fujian 350122 China)

机构地区：[1]福建中医药大学护理学院,福建350122

出　　处：《护理研究》2021年第10期1697-1710,共14页Chinese Nursing Research

基　　金：国家级大学生创新创业课题,编号:201910393005;2017年福建省卫生计生委中青年骨干人才培养项目,编号:2017-ZQN-64;福建中医药大学护理学科开放课题,编号:X2019042-学科。

摘　　要：目的:系统评价肌电生物反馈治疗脑卒中后病人上肢运动功能障碍效果。方法:计算机检索PubMed、Web of Science、The Cochrane Library、EMbase、中国知网、万方数据库、维普、中国生物医学文献数据库中与肌电生物反馈治疗脑卒中后病人上肢运动功能障碍效果相关的文献,检索时间从建库至2020年6月30日。2名研究员完成文献筛选、数据提取和质量评价后,使用RevMan 5.3软件进行分析。结果:共纳入37篇文献,Meta分析结果显示,试验组Fugl-Meyer运动功能评分量表上肢部分评分高于对照组[MD=6.41,95%CI(4.54,8.28),Z=6.72,P<0.00001],试验组Fugl-Meyer运动功能量表腕手部分评分高于对照组[MD=5.76,95%CI(1.37,10.14),Z=2.57,P=0.01],试验组腕背伸肌最大收缩时肌电图波幅大于对照组[MD=32.39,95%CI(22.62,42.16),Z=6.50,P<0.00001],试验组腕主动关节活动度大于对照组[MD=10.14,95%CI(2.83,17.45),Z=2.72,P=0.007],试验组肩外展时三角肌、肱三头肌、前臂伸肌肌群收缩时肌电积分大于对照组[MD=144.56,95%CI(74.87,214.24),Z=4.07,P<0.0001],试验组肩外展时三角肌收缩时肌电图波幅大于对照组[MD=16.26,95%CI(7.97,24.56),Z=3.84,P=0.0001],试验组肩外展时肱三头肌收缩时肌电图波幅大于对照组[MD=7.25,95%CI(2.58,11.92),Z=3.04,P=0.002],试验组肩外展时前臂伸肌肌群收缩时肌电图波幅大于对照组[MD=7.63,95%CI(3.76,11.50),Z=3.87,P=0.0001],试验组肩外展活动度大于对照组[MD=14.98,95%CI(9.31,20.66),Z=5.17,P<0.00001]。结论:现有证据表明,肌电生物反馈可以改善脑卒中后病人上肢运动功能障碍,但因受纳入研究数量和质量限制,上述结论尚待更多严谨、高质量研究予以证实。Objective:To systematically evaluate effect of electromyographic biofeedback treatment on reducing upper limb motor dysfunction of patients after stroke.Methods:Literatures on effect of electromyographic biofeedback treatment on reducing upper limb motor dysfunction of patients after stroke were retrieved from PubMed,Web of Science,The Cochrane Library,EMbase,CNKI,Wanfang Data,VIP,CBM.The retrieval period was from establishment of databases to 30 June,2020.The literature screening,data extraction and quality evaluation were completed by two researchers.And RevMan 5.3 software was used for analysis.Results:A total of 37 literatures were included.Meta-analysis showed that score of the upper-limb subscale of the Fugl-Meyer Assessment in experimental group was higher than that in control group[MD=6.41,95%CI(4.54,8.28),Z=6.72,P<0.00001],the score of the wrist and hand parts of the Fugl-Meyer Assessment in experimental group was higher than that in control group[MD=5.76,95%CI(1.37,10.14),Z=2.57,P=0.01],electromyogram wave amplitude at maximum contraction of dorsi carpal extensor muscle in experimental group was large than that in control group[MD=32.39,95%CI(22.62,42.16),Z=6.50,P<0.00001],the wrist active joint range of motion in experimental group was large than that in control group[MD=10.14,95%CI(2.83,17.45),Z=2.72,P=0.007],the electromyogram score of deltoid,abdominal triceps,and forearm extensor muscle groups during shoulder abduction in experimental group was higher than that in control group[MD=144.56,95%CI(74.87,214.24),Z=4.07,P<0.0001],the electromyogram wave amplitude at deltoid contraction during shoulder abduction in experimental group was large than that in control group[MD=16.26,95%CI(7.97,24.56),Z=3.84,P=0.0001],the electromyogram wave amplitude at abdominal triceps contraction during shoulder abduction in experimental group was large than that in control group[MD=7.25,95%CI(2.58,11.92),Z=3.04,P=0.002],the electromyogram wave amplitude at forearm extensor muscle groups contraction during shoulder abducti

关 键 词：肌电生物反馈 上肢 运动功能障碍 脑卒中 META分析 循证 护理 

分 类 号：R473.74[医药卫生—护理学]