应用肌电生物反馈疗法配合经颅磁刺激(rTMS)治疗脑卒中患者手功能障碍的效果分析  

Effect of Electromyographic Biofeedback Therapy with Transcranial Magnetic Stimulation(rTMS)on Hand Dysfunction in Stroke Patients

作　　者：师昉 黄富表[2] SHI Fang;HUANG Fu-biao(Department of Rehabilitation,Beijing Economic Development District Ronghua Community Health Service Center,Beijing 100176,China;Department of Occupational therapy,China Rehabilitation Research Center,Beijing 100068,China)

机构地区：[1]北京市经开区荣华社区卫生服务中心康复医学科,北京100176 [2]中国康复研究中心北京博爱医院作业疗法科,北京100068

出　　处：《中华养生保健》2024年第13期65-68,共4页CHINESE HEALTH CARE

基　　金：国家自然科学基金项目(U1913209)。

摘　　要：目的探讨应用肌电生物反馈疗法配合经颅磁刺激(rTMS)治疗脑卒中患者手功能障碍的效果。方法选取2022年10月—2023年10月在中国康复研究中心确诊的84例脑卒中患者为研究对象,根据不同的治疗方式,分为联合组和肌电组,每组42例,两组均实施常规脑卒中药物治疗和康复训练。肌电组采用肌电生物反馈疗法,联合组采用肌电生物反馈疗法联合rTMS治疗(健侧1 Hz,患侧10 Hz刺激)。分别在治疗前、治疗后1个月、2个月,比较两组脑卒中患者肌电值、上肢运动功能(FMA-UE)、日常生活活动能力(MBI)、上肢和手Brunnstrom分期、腕关节主动背伸活动度(AROM)评分。结果治疗1个月、2个月后,联合组脑卒中患者的肌电值高于肌电组,差异有统计学意义(P<0.05);治疗1个月、2个月后,联合组脑卒中患者的FMA-UE、MBI评分高于肌电组,差异有统计学意义(P<0.05);治疗1个月、2个月后,联合组关于上肢和手Brunnstrom分期均高于肌电组,AROM高于肌电组,差异有统计学意义(P<0.05)。结论肌电生物反馈疗法联合rTMS,可提高脑卒中患者的上肢运动功能和腕关节活动度,改善日常生活活动能力。Objective To investigate the effect of electromyobiofeedback therapy combined with transcranial magnetic stimulation(rTMS)on hand dysfunction in stroke patients.Methods A total of 84 stroke patients diagnosed in China Rehabilitation Research Center from October 2022 to October 2023 were selected and divided into combined group(n=42)and electromyography group(n=42)according to different treatment methods.Both groups underwent routine stroke drug therapy and rehabilitation training.The EMG group and the combined group were combined with rTMS(1Hz on the healthy side,10Hz stimulation on the aff ected side).EMG values,upper limb motor function(FMA-UE),activities of daily life(MBI),upper limb and hand Brunnstrom stages,and wrist active back extension mobility(AROM)scores were compared between stroke patients before and 1 month and 2 months after treatment.Results After 1 month and 2 months,the combined group had higher EMG values than the EMG group(P<0.05);after 1 month and 2 months,the FMA-UE and MBI of the combined group scores were higher than the EMG group(P<0.05);after 1 month and 2 months,the Brunnstrom stage and AROM of the combined group were higher than the EMG group(P<0.05).Conclusion EMG biofeedback therapy combined with rTMS can improve upper limb motor function and wrist mobility,and improve daily living activities in stroke patients.

关 键 词：肌电生物反馈疗法 经颅磁刺激 脑卒中 手功能障碍 效果 

分 类 号：R743.3[医药卫生—神经病学与精神病学]