肌电生物反馈联合康复训练对脊髓损伤患者运动功能及功能独立性的影响

摘要

Objective:To observe the effects of electromyographic (EMG)biofeedback therapy combined with re-habilitation training on movement dysfunction of lower limb after spinal cord injury (SCI).Methods:Sixty cases of incompletely thoracic-lumbar SCI were randomly divided into experimental group and control group,30 cases in each group.All the patients received routine rehabilitation,and the patients in the experimental group received EMG bio-feedback therapy additionally.They were assessed with surface electromyographic (sEMG)signal and muscle strength grading data before and after rehabilitation,and the clinical curative efficacy was compared.Results:The sEMG signal and strength of the quadriceps and Pretibial muscle in both two groups were increased after 8-week treatment (P <0.05),and continuously increased after 12-week treatment (P <0.01).The increase of sEMG signal in experimental group was higher than in the control group after treatment (P <0.05).The scores of ASIA motor function and FIM in two groups were increased obviously after 8-week treatment as compared with those before treatment (P <0.05),but there was no significant difference between two groups.The scores of ASIA motor func-tion and FIM in two groups were increased more obviously after 12-week treatment than those after 2-week treat-ment (P <0.01).The increase of scores in experimental group was significantly higher than in control group (P <0.05).Conclusion:The EMG biofeedback therapy combined with rehabilitation training is effective for movement dysfunction of lower limb after SCI,which can significantly improve the sEMG signal and muscle strength of quadri-ceps and Pretibial muscle.Moreover,it can improve the level of functional independence,and reduce complications.%目的：：观察肌电生物反馈疗法联合康复训练对脊髓损伤(SCI)患者运动功能障碍的康复疗效。方法：60例胸腰段不完全性脊髓损伤患者随机分为观察组和对照组,每组30例。2组均进行常规康复治疗,观察组加用双下肢肌电生物反馈治疗。治疗前及治疗后8周、12周进行下肢肌肉最大收缩时表面肌电(sEMG)信号采集、运动功能评定及功能独立性(FIM)评定,比较临床疗效。结果：治疗8周后,2组患者股四头肌、胫前肌最大收缩时的sEMG 信号均较治疗前明显提高(P <0.05),治疗后12周继续提高(P <0.01)；观察组 sEMG 信号增幅高于对照组(P <0.05)。治疗8周后,2组患者 ASIA 运动功能评分及 FIM 评分亦较治疗前提高(P <0.05),组间比较差异无统计学意义；治疗12周后,2组 ASIA 运动功能及 FIM 评分较治疗8周后提高更明显(P <0.01),观察组更高于对照组(P <0.05)。结论：肌电生物反馈疗法联合康复训练对胸腰段不完全性脊髓损伤患者运动功能有促进作用,能明显提高患者的股四头肌、胫前肌表面肌电信号及肌力,并能提高功能独立水平,减少并发症。