操作性肌电生物反馈治疗慢性颈脊髓损伤的疗效观察

目的　观察操作性肌电生物反馈治疗是否能够增强慢性颈脊髓 (C1～ 6)损伤患者上肢各肌的自主肌电信号和肌力。方法　慢性非完全性颈脊髓 (C1～ 6)损伤患者 13 9例 ,为美国迈阿嘧大学医学院附属Jackson医学中心骨、康复科门诊患者 ,病程 >6个月 ,均有不同程度上肢功能障碍和肌力减低 ,而且均为经其它康复方法治疗而无进一步功能恢复者。全部患者均接受 15次 (1个疗程 )、每次 5 0min的治疗。分别记录治疗前、后三角肌中部、肱二头肌、肱三头肌、腕伸肌、腕屈肌、指伸肌和指屈肌的肌电信号和肌力测定分级数据 ,并进行比较和统计学分析。结果　治疗后患者自主肌电信号和肌力均较治疗前有明显提高 ,差异有显著性 (P <0 .0 1)。结论　操作性肌电生物反馈是治疗非完全性、慢性颈脊髓 (C1～ 6)损伤的有效方法。

Effectiveness of operant conditioning electromyographic biofeedback on patients with chronic cervical spinal cord injury

Objective To determine whether the operant conditioning EMG biofeedback can significantly increase the voluntary EMG signal and muscle strength of the upper extremities in patients with long-term cervical spinal cord injury (SCI). Methods One hundred and thirty-nine patients with cervical (C 1-C 6) SCI were enrolled in this study. All of them had more than 6-month injured history, had less than normal muscle strength and reached a plateau in function recovery. These patients received 1 course of treatment, which included 15 treatment sessions of EMG biofeedback with 50 minutes for each session. The data including the EMG signals and muscle strength were obtained before and after treatment on the middle deltoid, biceps, triceps, wrist extensors, wrist flexors, finger extensors and flexors, respectively. The data were compared and analyzed statistically. Results In comparison with that of the pre-treatment state, the increase of both voluntary EMG signal and muscle strength after the treatment were statistically significant ( P <0.01). Conclusion EMG biofeedback procedures used as an operant conditioning technique is an effective treatment method in restoring motor function of the long-term incomplete cervical (C 1-C 6) SCI patients.