PNF技术对脑卒中患者躯干控制的疗效观察及躯干屈伸肌群表面肌电指标分析

目的：观察本体感觉神经肌肉促进技术（PNF）对脑卒中患者躯干控制的疗效及躯干屈伸肌群表面肌电信号的变化。方法：将30例脑卒中偏瘫患者随机分为观察组和对照组各15例，对照组给予常规康复干预，观察组在此基础上给予PNF躯干模式训练。在治疗前及治疗4周后，采用躯干控制能力测试(TCT)、Berg平衡功能量表(BBS)、Fugl-Meyer运动功能量表(FMA)以及表面肌电均方根值(RMS)对患者进行评定。结果：治疗4周后，2组患者TCT、BBS及FMA评分较治疗前均明显提高（均P＜0.05），且观察组各项评分较对照组均明显提高（均P＜0.05）。治疗前，2组患者患侧腹直肌及竖脊肌RMS组内比较均小于健侧（均P＜0.05）；治疗4周后，2组患者患侧腹直肌及竖脊肌RMS较治疗前均明显提高（均P＜0.05），且观察组健侧腹直肌及竖脊肌RMS较治疗前均明显提高（均P＜0.05）；观察组患者健患侧腹直肌及竖脊肌RMS较对照组均明显提高（均P＜0.05）。结论：PNF躯干训练技术可以明显增强脑卒中偏瘫患者躯干肌群力量，提高躯干控制能力，改善平衡功能，从而促进患者运动功能恢复。

Effect of PNF on trunk control in patients with stroke and analysis of surface electromyography of trunk flexor and extensor muscles

Objective: To observe the effect of PNF on the trunk control in patients with stroke before and after treatment and the changes of surface electromyography of trunk flexor and extensor muscles. Methods: Thirty patients with stroke were randomly divided into treatment group (n=15) and control group (n=15). The control groups was given conventional rehabilitation intervention, and the treatment group accepted PNF trunk training on the basis of conventional rehabilitation intervention. The two groups were assessed with trunk control test (TCT), Berg balance function scale (BBS), Fugl-Meyer motor function scale (FMA) and surface root mean square value (RMS) before and 4 weeks after treatment. Results: After 4 weeks of treatment, TCT, BBS and FMA scores in both groups were significantly higher than those before treatment (all P<0.05), and those in the treatment group were significantly higher than those in the control group (all P<0.05). Before treatment, the RMS of the affected side of rectus abdominis and erector spinal muscles in the two groups was significantly less than that of the healthy side (all P<0.05). After 4 weeks of treatment, RMS of the rectus abdominis and the erector spinal muscles in both groups was significantly increased as compared with that before treatment (all P<0.05), and RMS of the uninjured rectus abdominis and the erector spinal muscles in the treatment group was significantly increased as compared with that before treatment (all P<0.05). The RMS of the healthy rectus abdominis and the erector spinal muscles in the treatment group was significantly greater than that in the control group (all P<0.05). Conclusions: PNF technology can improve the trunk control ability and the function of balance, and promote the motor function recovery of patients.