自我效能干预结合肌电生物反馈治疗脑卒中偏瘫患者的临床效果

摘要

Objective To explore the clinical effect of self-efficacy intervention combined with electromyographic biofeedback therapy on stroke patients with hemiplegia. Methods A total of 150 stroke patients with hemiplegia were enrolled in Central Hospital of Shanghai Yangpu District from July 2017 to June 2018. They were randomly divided into control group,electromyography group and combination group,with 50 cases in each group. All patients had routine medication and rehabilitation training; the electromyography group was treated with electromyographic biofeedback therapy and self-efficacy intervention was given in the combination group; all treatments lasted for 30 days. Scores of General Self-Efficacy Scale(GSES) ,National Institutes of Health Stroke Scale(NIHSS) ,Activity of Daily Living Scale(ADL) and the therapeutic efficiency were analyzed. Results There was no significant difference of scores of GSES,NIHSS and ADL among the 3 groups before treatment(all P > 0.05). After treatment,GSES score in the combination group was significantly higher than that before treatment,in the control group and electromyography group[(27 ± 6) vs (21 ± 6) ,(22 ± 6) ,(21 ± 6) ](all P < 0.05). After treatment,NIHSS and ADL scores significantly decreased in all groups; the scores in the combination group were significantly lower than those in the control group and electromyography group[NIHSS: (9.0 ± 2.3) vs (11.4 ± 3.3) ,(9.8 ± 2.4); ADL: (15 ± 4) vs (20 ± 7) ,(17 ± 6) ]; the scores in the electromyography group was significantly lower than that in the control group (all P < 0.05 ). Effective rates in the control group,electromyography group and combination group were 72.0％ (36 /50 ) , 86.0％ (43 /50) and 96.0％ (48 /50); there was a significant difference among them(χ2 = 9.226,P = 0.010). Conclusion Self-efficacy intervention combined with electromyographic biofeedback therapy can significantly improve the self-efficacy,activity of daily living and neurological deficits,showing a good therapeutic effect on stroke patients with hemiplegia.%目的 探讨自我效能干预结合肌电生物反馈治疗脑卒中偏瘫患者的临床效果.方法 选择2017年7月至2018年6月在上海市杨浦区中心医院神经内科病房治疗的150例脑卒中偏瘫患者为研究对象.采用随机数字表法分为对照组、肌电组和联合组,各50例.3组患者均给予常规药物治疗和康复训练,肌电组在对照组基础上加用肌电生物反馈治疗,联合组在肌电组基础上给予自我效能干预,均持续30 d.对比3组患者治疗前后的一般自我效能感量表(GSES) 、美国国立卫生研究院卒中量表(NIHSS) 、日常生活能力量表(ADL) 评分及治疗有效率.结果 治疗前,3组患者GSES、NIHSS、ADL评分比较,差异均无统计学意义(均P > 0.05) .治疗后,联合组GSES评分明显高于治疗前和对照组、肌电组[(27 ± 6) 分比(21 ± 6) 、(22 ± 6) 、(21 ± 6) 分],差异均有统计学意义(均P < 0.05); 3组患者NIHSS、ADL评分均较治疗前降低,且联合组低于对照组和肌电组[NIHSS评分: (9.0 ± 2.3) 分比(11.4 ± 3.3) 、(9.8 ± 2.4) 分; ADL评分: (15 ± 4) 分比(20 ± 7) 、(17 ± 6) 分],肌电组低于对照组,差异均有统计学意义(均P < 0.05) .对照组、肌电组、联合组的治疗有效率分别为72.0％ (36 /50) 、86.0％ (43 /50) 、96.0％(48 /50) ,3组治疗有效率比较差异有统计学意义(χ2 = 9.226,P = 0.010) .结论 自我效能干预结合肌电生物反馈治疗能明显提高脑卒中偏瘫患者的自我效能和日常生活能力,改善患者的神经功能缺损,临床疗效良好.