水中步行训练对脊髓损伤患者下肢表面肌电和神经功能的效果

摘要

目的 探讨水中步行训练对不完全性脊髓损伤患者下肢肌肉表面肌电(sEMG)和神经功能的效果.方法 2014年6月至2016年5月,42例胸腰段不完全性脊髓损伤患者随机分成对照组(n=21)和实验组(n=21).两组均采用常规康复训练,实验组另加水中步行训练,共6周.训练前后测量股四头肌及胫前肌平均肌电值(AEMG),采用美国脊柱损伤学会(ASIA)下肢运动功能、感觉指数评分进行评定.结果 治疗后,两组ASIA下肢运动、感觉功能评分显著改善(t>10.871,P<0.001),股四头肌及胫前肌AEMG明显改善(t>5.763,P<0.01);实验组均明显优于对照组(t>4.036,P<0.01).结论 水中步行训练能进一步改善不完全性胸腰段脊髓损伤患者下肢肌力和神经功能.%Objective To explore the effects of walking in water on surface electromyography (sEMG) of lower limbs and neural func-tion in spinal cord injury (SCI) patients. Methods From June, 2014 to May, 2016, 42 patients with incomplete thoracolumbar SCI were di-vided into control group (n=21) and experimental group (n=21) randomly. All the patients accepted routine rehabilitation, while the experi-mental group accepted extra walking in water. Average electromyography (AEMG) of quadriceps femoris and tibialis anterior muscles was measured, and the motor and sense function was assessed with American Spinal Injury Association (ASIA) Classification before and six weeks after treatment. Results The AEMG (t>5.763, P<0.01) and the scores of motor and sense (t>10.871, P<0.001) increased in both groups after treatment, and increased more in the experimental group than in the control group (t>4.036, P<0.01). Conclusion Walking in water could further improve lower limbs muscle strength and neural function in patients with incomplete thoracolumbar SCI.