肌电生物反馈结合虚拟现实康复训练治疗脑卒中偏瘫  

Myoelectric biofeedback combined with virtual reality rehabilitation training in the treatment of stroke patients with hemiplegia

作　　者：高君强 冯慧丽 李君辉 GAO Junqiang;FENG Huili;LI Junhui(Sanmenxia Hospital of Traditional Chinese Medicine,Sanmenxia 472000,China)

机构地区：[1]三门峡市中医院,河南三门峡472000

出　　处：《中国实用神经疾病杂志》2022年第12期1532-1537,共6页Chinese Journal of Practical Nervous Diseases

摘　　要：目的观察肌电生物反馈结合虚拟现实康复训练对脑卒中偏瘫患者平衡功能及生活质量的影响。方法选择三门峡市中医院2020-02—2022-02治疗的脑卒中偏瘫患者128例,64例患者为单一训练组,给予虚拟现实康复训练,64例患者为联合干预组,给予肌电生物反馈结合虚拟现实康复训练。2组患者均给予连续干预3个月,干预前后检测患侧上肢肱二头肌、肱三头肌,下肢胫骨前肌、腓肠肌最大等长收缩时表面肌电图积分肌电值(iEMG)以及均方根值(RMS),检测患肢M波最大波幅(Mmax)、H波最大波幅(Hmax)并计算其比值H/Mmax。干预前后给予患者临床痉挛指数(CSI)、简易上肢功能评价(STEF),通过三维运动捕捉系统分析三维步态,记录患者步频及步速,给予患者Berg平衡量表(BBS)、脑卒中患者姿势评定量表(PASS)评价,干预前后给予功能综合评定量表(FCA)评价患者日常生活能力,比较单一训练组及联合干预组临床疗效。结果联合干预组患者上肢肱二头肌、肱三头肌,下肢胫骨前肌、腓肠肌iEMG、RMS较单一训练组高(P<0.05)。联合干预组患者Mmax、Hmax、H/Mmax较单一训练组低(P<0.05)。联合干预组患者STEF评分、步频及步速水平较单一训练组高(P<0.05),CSI评分较单一训练组低(P<0.05)。联合干预组患者PASS、BBS、FCA评分明显较单一训练组高(P<0.05)。联合干预组总有效率(96.88%)高于单一训练组(85.94%)(P<0.05)。结论肌电生物反馈结合虚拟现实康复训练治疗脑卒中偏瘫患者,可调节上下肢肌电图指标,抑制脊髓运动神经元兴奋性,改善肢体痉挛状态,提升患者上肢及下肢肢体功能,改善患者平衡能力,提升临床疗效及生活质量。Objective To observe the effects of myoelectric biofeedback combined with virtual reality rehabilitation training on balance function and quality of life in stroke patients with hemiplegia.Methods A total of128 stroke patients with hemiplegia in the Sanmenxia Hospital of Traditional Chinese Medicine were selected,and the intervention time was from February 2020 to February 2022.Sixty-four patients were in the single training group and given virtual reality rehabilitation training,while 64 patients were in the combined intervention group and given EMG biofeedback combined with virtual reality rehabilitation training intervention.Intervention in two groups of patients were intervention for 3 months in a row,intervention before and after testing patients suffering from upper biceps and triceps,lower limbs,the tibialis anterior muscle gastrocnemius maximum isometric contraction methods of electrical diagram integral electrical values(iEMG)and root mean square(RMS)value,the detection of patients with limb M wave amplitude of the maximum amplitude(Mmax),H wave(Hmax),the ratio H/Mmax is calculated.Before and after the intervention,the patients were given clinical spasm index(CSI)and simple upper limb function assessment(STEF).Three-dimensional gait was analyzed by three-dimensional motion capture system,and the patients’stride frequency and speed were recorded.The patients were evaluated by Berg balance scale(BBS)and stroke patient posture assessment scale(PASS).Before and after the intervention,the patients were given comprehensive functional assessment scale(FCA)to evaluate the daily living ability,and the clinical efficacy of single training group and combined intervention group was compared.Results The iEMG and RMS of upper limb biceps brachii,triceps brachii,tibialis anterior muscle and gastrocnemius in combined intervention group was significantly higher than that in single training group(P<0.05).The Mmax,Hmax and H/Mmax in the combined intervention group were lower than those in the single training group(P<0.05

关 键 词：脑卒中偏瘫 肌电生物反馈 虚拟现实康复训练 肌电图 脊髓运动神经元 肢体痉挛 肢体功能 平衡能力 生活质量 

分 类 号：R743.3[医药卫生—神经病学与精神病学]