肌电生物反馈在关节功能障碍康复中的应用

目的 探讨肌电生物反馈对于膝关节功能障碍康复的影响。方法 下肢骨折膝关节固定拆除后患者４２例,分为治疗组和对照组,均接受包括膝功能持续牵引等常规治疗方法,治疗组并在牵引中接受肌电生物反馈,训练股四头肌放松。结果 两组膝关节屈曲度数治疗前及治疗半月后无显著差异,１个月和２个月后治疗组较且改善明显,有生,结论肌电生物反馈训练患者掌握股卤头肌放松技术,简便易行,可以增加膝关节功能持续牵引的疗效,有利于膝     

肌电生物反馈在偏瘫康复中的若干进展

<正> 生物反馈(简称BF)20多年来随着技术及仪器的不断改进,在医学领域内得到了深入的研究和应用。但目前比较成熟且疗效肯定者,首推利用肌电活动对瘫痪肌肉进行训练,即肌电生物反馈(简称EMGBF)。本文拟就EMGBF 对偏瘫康复作用的若干进展综述如下。一、EMGBF 对偏瘫肢体的康复作用     

操作性肌电生物反馈疗法在康复医学中的应用

操作性肌电生物反馈疗法(operant conditioning electromyography biofeedback techniques)是生物反馈疗法中的一种，是涉及物理医学、控制学、生理学、解剖学、心理学及康复医学知识和技术的多学科、综合应用的新技术，在国外是一个独立的边缘学科。它借助肌电接收设备记录自主收缩肌肉时的微弱电信号，并以此为源，通过视觉或听觉通路提供反馈信号。将人们平时不易感知的体内功能变化转变为可以感知的视听信号，并让患者根据这些信号通过指导和自我训练学会控制自身不随意功     

表面肌电生物反馈联合吞咽训练在脑梗死恢复期吞咽障碍患者康复中的应用

目的观察表面肌电生物反馈（sEMG-BFB）联合吞咽训练对脑梗死恢复期吞咽障碍患者康复的影响。 方法选取脑梗死恢复期吞咽障碍患者51例,按随机数字表法将其分为常规训练组（26例）和生物反馈组（25例）。常规训练组给予口颜面功能训练、导管球囊扩张术、电刺激及吞咽功能训练等常规康复治疗,生物反馈组在此基础上,将吞咽功能训练改为在sEMG-BFB下进行。训练前、后,采用吞咽造影观察患者食管上段括约肌（UES）的开放情况,并行功能性经口摄食评估（FOIS）。 结果训练前,2组患者FOIS评分、UES开放程度之间比较,差异均无统计学意义（P&rt;0.05）。训练后,2组FOIS评分均较组内训练前有所提高（P<0.05）,且生物反馈组训练后FOIS评分［（3.76±1.42）分］高于常规训练组［（2.77±1.42）分］（P<0.05）。训练后,常规训练组UES完全开放和不完全开放的例数分别为18例和8例,生物反馈组训练后完全开放和不完全开放的例数分别为20例和5例,与组内训练前比较,差异均有统计学意义（P<0.05）。 结论在常规康复训练的基础上辅以sEMG-BFB治疗,有助于改善脑梗死恢复期吞咽障碍患者UES的开放情况,提高其吞咽功能。     

肌电生物反馈在半月板切除术后股四头肌功能恢复中的应用

将２５名半月板切除术后的患者，随机分成肌电生物反馈治疗线及对照组，指导患者进行股四头肌等长训练，训练前后均进行股四头肌的肌电水平、患肢负重及股四头肌徒手肌力测定。结果表明：训练后股四头肌的肌电增加增度肌电生物反馈组明显大于对照组（Ｐ＜０．０１）；在患肢负重能力方面，两组对比，反馈治疗组明显成于对照组（Ｐ＜０．０１）；训练前后的肌力测定显示；反馈治疗组训练后股四头肌肌力达到Ｖ组的百分率是６４．２％，     

表面肌电联合生物反馈在脊髓损伤踝背伸功能康复中的应用

目的:观察脊髓损伤踝背伸功能障碍患者采用表面肌电联合生物反馈疗法对其功能恢复的影响。方法:选取我科2014年7月—2016年7月收治的脊髓损伤踝背伸功能障碍患者共108例,其中男85例,女23例,年龄18—62岁,平均37.33±12.25岁。随机分为试验组54例和对照组54例。两组均接受传统的康复治疗(包括被动关节活动度手法训练、物理治疗、针灸、作业治疗等),试验组在此基础上应用表面肌电和生物刺激反馈疗法。在康复治疗前、后分别测定表面肌电(surface electromyogram,sEMG)信号波幅和肌力分级数据。结果:治疗6个月后,两组患者胫前肌sEMG信号波幅及肌力组内比较均提高显著(P0.05);组间比较试验组sEMG信号波幅和肌力均高于对照组,差异有显著性意义(P0.05)。结论:表面肌电联合生物反馈可提高脊髓损伤踝背伸功能障碍患者胫前肌自主肌电信号的波幅和肌力,对患者的功能恢复有促进作用,临床治疗有效果。     

表面肌电生物反馈在功能性踝关节不稳康复中的应用

目的:观察表面肌电生物反馈(sEMGBF)疗法对于功能性踝关节不稳(FAI)患者踝外翻功能恢复的影响.方法:选取符合标准的FAI患者50例,随机分为对照组和观察组各25例.2组患者均采用常规康复训练,对照组在常规康复训练基础上增加肌力训练,观察组在常规康复训练基础上增加sEMGBF治疗.在康复治疗前和治疗8周后,采用通...     

Computerized biofeedback knee goniometer: acceptance and effect on exercise behavior in post-total knee arthroplasty rehabilitation

OBJECTIVE: To assess device accuracy, patient acceptance, and effect of a computerized biofeedback knee goniometer (CBG), on patients' compliance with active range of motion (AROM) exercises after total knee arthroplasty (TKA). DESIGN: Two-stage study: measurement validation on asymptomatic controls and an unblinded, multiple crossover trial. SETTING: Inpatient rehabilitation. PARTICIPANTS: Asymptomatic controls (n=14) and post-TKA inpatients (n=11). INTERVENTIONS: For measurement validation, CBG-angle measurements were compared with manual, clinician-obtained angles. To assess motivational effect, the CBG was worn after TKA; on alternating days, it either monitored AROM silently (no feedback) or provided audiovisual feedback about reaching preset range of motion (ROM) goals and prompted the patients to exercise when idle. MAIN OUTCOME MEASURES: To assess accuracy, the device's readings were compared with manual measurements. Patient satisfaction was determined by a self-report questionnaire; exercise compliance was assessed by calculating activity rate and stratified interactivity intervals. RESULTS: CBG readings reproduced clinician measurements reliably between 0 degrees and 100 degrees (eta(2)=98.5%). Auditory feedback was more helpful than visual feedback for motivating exercise. During feedback-on days, the mean total activity rate +/- standard deviation was 15.1+/-10.9 activity counts per hour, and the interactivity interval was 6.7+/-5.7 minutes. The activity rate was higher on feedback-off days-22.5+/-11.1 counts/hour (P=.11)-and the mean interactivity interval was 3.6+/-2.7 minutes (P=.07). CONCLUSIONS: The CBG provided reliable, unbiased estimates of clinician measurements of joint angle within the range of 0 degrees to 100 degrees. The CBG was accepted well by most patients. Surprisingly, slightly more ROM activity was noted during feedback-off days than feedback-on days.     

Increased EMG response following electromyographic biofeedback treatment of rectus femoris muscle after spinal cord injury

Objective

To study increases in electromyographic (EMG) response from the right and left rectus femoris muscles of individuals with long-term cervical spinal cord injuries after EMG biofeedback treatment.

Design

Repeated measure trials compared EMG responses before and after biofeedback treatment in patients with spinal cord injuries.

Main outcome measures

The Neuroeducator was used to analyse and provide feedback of the EMG signal and to measure EMG response.

Setting

Department of Traumatic Orthopaedics, School of Medicine, University of São Paulo, Brazil.

Participants

Twenty subjects (three men and 17 women), between 21 and 49 years of age, with incomplete spinal cord injury at level C6 or higher (range C2 to C6). Of these subjects, 10 received their spinal cord injuries from motor vehicle accidents, one from a gunshot, five from diving, three from falls and one from spinal disc herniation.

Results

Significant differences were found in the EMG response of the right rectus femoris muscle between pre-initial (T1), post-initial (T2) and additional (T3) biofeedback treatment with the subjects in a sitting position [mean (standard deviation) T1: 26 μV (29); T2: 67 μV (50); T3: 77 μV (62)]. The mean differences and 95% confidence intervals for these comparisons were as follows: T1 to T2, −40.7 (−53.1 to −29.4); T2 to T3, −9.6 (−26.1 to 2.3). Similar differences were found for the left leg in a sitting position and for both legs in the sit-to-stand condition.

Conclusions

The EMG responses obtained in this study showed that treatment involving EMG biofeedback significantly increased voluntary EMG responses from right and left rectus femoris muscles in individuals with spinal cord injuries.     

下肢关节功能康复架在术后膝关节功能康复中的应用

目的：观察关节功能康复架在膝关节功能康复中的作用。方法：应用自己设计制造的下肢关节功能康复架,对膝关节及周围骨折病人术后８～１０ｄ,行膝关节被动活动,每日３～４次,每次伸、屈４０～５０次,伸屈结束时停留于自然位置,并辅以肌肉主动收缩锻炼,以１５ｄ为限。结果：临床应用５０例,在被动活动结束时,关节活动度≥９０度,未见移位、分离、内固定松动等骨折端的并发症。结论：关节功能康复架是膝关节及周围骨折术后膝关节早期被动活动的较理想的辅助器械;早期被动运动对关节功能康复有促进作用。     

生物反馈法用于急性脑卒中所致偏瘫患者早期康复治疗的临床观察

目的 :观察生物反馈治疗仪用于脑卒中所致偏瘫患者早期康复治疗的效果。方法 :随机将 198例急性脑卒中所致偏瘫患者分为两组 ,治疗组10 3例 ,对照组 95例。两组均按神经内科的常规治疗方法用药 ,治疗组加用生物反馈治疗 ,均治疗 2 0d。使用全国第 4届脑血管病学术会议制定的脑卒中患者临床神经功能缺失评分标准进行评分。结果 :治疗组的痊愈及总显效率高于对照组 (P <0 0 1)。结论 :生物反馈治疗有助于促进脑卒中所致的偏瘫患者早期康复。     

生物反馈治疗联合康复训练在中年女性膀胱过度活动症患者中的应用效果

目的 探讨生物反馈治疗联合康复训练在中年女性膀胱过度活动症(OAB)患者中的应用效果.方法 选取医院2015年2月—2017年8月收治的中年女性OAB患者96例为研究对象,将患者按照组间年龄、病程、膀胱过度活动症患者症状评估表(OABSS)评分匹配的原则分为对照组和观察组,每组48例.对照组采取常规护理及药物治疗,观察...     

48例人工全膝关节置换术患者的康复训练

目的观察人工全膝关节置换术(TKR)患者围手术期进行系统康复训练的效果.方法选择接受TKR的患者48例62个膝关节,入院后实施系统化康复训练方案,包括肌力训练、关节活动训练、平衡功能、本体感觉及步态训练.结果本组获随访6～12个月,采用美国特种外科医院(HSS)膝关节评分标准,术后半年复查时优38例,良10例,优良率100%.结论 TKR患者围手术期进行系统康复训练能减少膝关节并发症,提高患者的生活质量.     

下肢骨折后膝关节功能障碍的肌电生物反馈训练方法及疗效

55名本院伤骨科医院收治的下肢骨折患者,分成肌电生物反馈组和非肌电生物反馈组进行5周的康复训练.每周训练6次,共30次.研究肌电生物反馈训练对下肢骨折后膝关节功能障碍患者的关节活动度,最大伸膝力量等的影响。实验仪器为日本产BF 205型肌电生物反馈训练器.结果表明:下肢骨折后关节功能障碍患者经过正确的、利用器械的渐进抗阻康复训练,均取得很好的康复效果,但在患膝关节活动度、患膝伸肌力量增长上,有肌电生物反馈训练的渐进抗阻康复训练优于非肌电生物反馈训练.     

CPM机在膝关节镜术后康复中的应用

目的探讨膝关节镜术后应用CPM进行早期持续被动活动的临床疗效及应用价值。方法将60例行膝关节镜治疗的骨性关节炎及半月板损伤合并韧带损伤、断裂患者,随机分为试验组30例,对照组30例。试验组术后24小时开始使用CPM进行患膝关节持续被动屈曲训练,对照组沿用传统的方法,实行常规的治疗与护理加个人行为的功能锻炼。记录患者膝关节活动度、关节肿胀变化,研究时间为2周。结果术后2周试验组膝关节屈曲度为(91.22±21.39)度,关节周径为(44.35±9.23)cm。对照组膝关节屈曲度为(80.14±21.60)度,关节周径为(46.57±10.62)cm。2组比较,试验组膝关节活动度明显大于对照组(p<0.05),肿胀度明显小于对照组(p<0.05)。结论膝关节镜术后早期应用CPM机进行持续被动活动训练在预后及康复时间上均有明显优势,能防止关节粘连僵硬,有利于功能恢复,缩短康复时间。     

Get up and go test in patients with knee osteoarthritis

OBJECTIVE: To determine the reliability, minimum detectable change (MDC), and validity of the Get Up and Go (GUG) test. DESIGN: Repeated-measures test-retest for reliability. Correlational study for validity. SETTING: Institutional practice. PARTICIPANTS: Convenience sample of 130 people, 105 with knee osteoarthritis (OA) (80 women; mean age, 62+/-9 y) and 25 healthy controls (21 women; mean age, 57+/-8 y). INTERVENTIONS: Not applicable.Main outcome measures Western Ontario and McMaster Universities Osteoarthritis Index, the Activity of Daily Living Scale of the Knee Outcome Survey, and the 8 scales of the Medical Outcomes Study 36-Item Short-Form Health Survey. RESULTS: Intratester and intertester reliability was.95 (95% confidence interval [CI],.72-.98) and.98 (95% CI,.94-.99), respectively. The MDC, based on measurements by a single tester and between testers, was 1.5 and 1.2 seconds, respectively. Time to perform the GUG test was longer for persons with knee OA than it was for the controls (mean difference, 3.3s; 95% CI, 1.8-4.9). Correlations between the GUG test and measures of physical function did not differ significantly from correlations between the GUG test and measures that do not specifically evaluate physical function. CONCLUSIONS: The GUG test is reliable and has an MDC that is adequate for clinical use. Validity of the GUG test as a single measure of physical function was not supported. Further research should include testing a battery of performance-based measures of physical function.     

等速肌力测试在膝关节损伤后康复训练中的应用

运用Ｃｙｂｅｘ３３０型等速运动仪对４５例膝关节外伤后患者进行双侧膝关节等速肌力测试，并依据慢速测试（６０°／ｓ）结果指导患者进行为期２个月的渐进抗阻练习。结果发现，患膝屈伸肌峰力矩值在训练后明显增加，屈肌与伸肌峰力矩比值接进正常。康复训练前后比较，患膝功能的差别有显著性（Ｐ＜００１），说明抗阻练习对膝关节功能恢复有明显的促进作用。