本体感觉神经肌肉促进技术联合康复训练对脑卒中后上肢痉挛患者表面肌电图的影响  

Effects of Proprioceptive Neuromuscular Facilitation Technology Combined with Rehabilitation Training on Surface Electromyography in Patients with Upper Extremity Spasticity After Stroke

作　　者：邱志茹[1] 王军杰[1] 张晓艳 王雪君 王梦杰 QIU Zhiru;WANG Junjie;ZHANG Xiaoyan;WANG Xuejun;WANG Mengjie(Department of Neuroelectrophysiology of Stroke Center,Zhengzhou First People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第一人民医院卒中中心神经电生理室,河南郑州450000

出　　处：《河南医学研究》2022年第14期2539-2542,共4页Henan Medical Research

摘　　要：目的观察本体感觉神经肌肉促进技术联合康复训练对脑卒中后上肢痉挛患者表面肌电图的影响。方法选择2019年1月至2021年6月于郑州市第一人民医院治疗的80例脑卒中后上肢痉挛患者,根据随机数字表法分为探究组和参照组,各40例。参照组者接受常规康复训练,探究组在常规康复训练基础上接受本体感觉神经肌肉促进技术干预,两者患者均连续治疗6个月。治疗前、后检测两组患者最大等长收缩(MIVC)下肘关节屈曲、伸展时肱二头肌、肱三头肌积分肌电值(iEMG)水平,计算肱二头肌、肱三头肌肌电信号值的均方根(RMS)值,并计算肱二头肌、肱三头肌协同收缩率(CR),采用患者改良Ashworth痉挛量表(MAS)、徒手肌力评定(MMT)、Fugl-Meyer运动功能量表、日常生活能力评定表(ADL)、生活质量综合评定问卷-74(GQOLI-74)评价患者相关指标。结果探究组MIVC下肘关节屈曲时肱二头肌、肱三头肌iEMG水平及肘关节伸展时肱三头肌iEMG水平高于参照组(P<0.05),探究组MIVC下肘关节伸展时肱二头肌iEMG水平低于参照组(P<0.05)。探究组肱二头肌、肱三头肌的RMS、CR水平低于参照组(P<0.05),MMT评分高于参照组(P<0.05),MAS评分低于参照组(P<0.05),探究组上肢运动功能、ADL评分、GQOLI-74评分高于参照组(P<0.05)。结论本体感觉神经肌肉促进技术联合康复训练干预脑卒中后上肢痉挛患者,可改善患者表面肌电图指标,缓解上肢痉挛,改善上肢肌力,提升上肢功能,改善患者日常生活水平,提升患者生活质量。Objective To observe the effect of proprioceptive neuromuscular facilitation technology combined with rehabilitation training on surface electromyography in patients with upper extremity spasticity after stroke.Methods A total of 80 patients with upper extremity spasticity after stroke who were treated in Zhengzhou First People’s Hospital from January 2019 to June 2021 were selected and randomly divided into exploration group and reference group,with 40 cases in each group.The reference group was given routine rehabilitation training,and the exploration group was given proprioceptive neuromuscular facilitation technology intervention on the basis of routine rehabilitation training,both patients were treated for 6 months continuously.Before and after treatment,the integral electromyographic(iEMG)values of biceps brachii and triceps brachii were measured during elbow flexion and extension under maximum isometric voluntary contraction(MIVC)in the two groups,the root mean square(RMS)value of electrical signal of biceps brachii and triceps brachii and the contraction rate(CR)of biceps brachii and triceps brachii were calculated.The related indexes of the patients were evaluated by modified Ashworth spasticity scale(MAS),manual muscle test(MMT),Fugl-Meyer motor function scale,activity of daily living(ADL)and generic quality of life inventory-74(GQOLI-74).Results The iEMG levels of the biceps brachii and triceps brachii when the elbow joint was flexed and the iEMG level of the triceps brachii when the elbow joint was extended in the exploration group were higher than those in the reference group(P<0.05),and the iEMG level of the biceps brachii when the elbow joint was extended was lower than that in the reference group(P<0.05).The RMS and CR levels of biceps brachii and triceps brachii in the exploration group were lower than those in the reference group(P<0.05).The MMT score in the exploration group was higher than that in the reference group(P<0.05),and the MAS score was lower than that in the reference group(P<0.05

关 键 词：脑卒中后上肢痉挛 本体感觉神经肌肉促进技术 康复训练 表面肌电图 肌力 上肢功能 日常生活水平 

分 类 号：R444[医药卫生—诊断学]