肌电触发生物反馈治疗脑梗死患者早期偏瘫的临床疗效评价

目的: 探讨肌电触发生物反馈治疗对脑梗死早期偏瘫患者肢体康复的影响,并对其临床疗效进行评价。方法: 653例确诊为急性脑梗死患者按治疗意愿分为对照组(n=257)和治疗组(n=396)。2组患者均同时接受常规药物治疗,其中治疗组又分为神经肌肉电刺激(NMES)治疗(n=275)及肌电触发电刺激反馈(MTB)治疗(n=121)2个亚组,于病情稳定48 h后进行瘫痪肢体生物反馈治疗。所有病例分别于治疗前、治疗后7d及治疗结束后,采用美国国立卫生院卒中量表(NIHSS)和简氏Fugl-Meyer评定量表(FMA)评价患者神经功能缺损程度以及患肢运动功能,采用Barthel指数(BI)评价患者日常生活能力(ADL)。结果: 对照组与治疗组患者治疗前NIHSS、FMA和ADL评分比较差异无统计学意义(P>0.05)。与治疗前比较,治疗组中2亚组患者治疗后各项评分均明显提高(P<0.01);与NMES组比较,MTB组患者各项评分均有提高(P<0.05)。结论: 对急性期脑梗死患者的瘫痪肢体进行早期生物反馈训练康复治疗能促进偏瘫肢体的功能恢复,显著改善患者日常生活能力,其中MTB疗法疗效优于NMES疗法。

Evaluation on clinical curative effect of myoelectricity triggering biofeedback in treatment of early hemiplegia of cerebral infarction patients

Objective To observe the effect of myoelectricity triggering biofeedback on the rehabilitation of cerebral infarction patient's early hemiplegia, and to evaluate its clinical curative effcet. Methods 653 patients with acute cerebral infarction were divided into control group(n=257) and therapeutic group(n=396) according to the will of the patients.The patients in two groups accepted conventional therapy at the same time, and the patients in therapeutic group were divided into two subgroups: neural muscle electrical stimulus(NMES)(n=275) and myoelectricity triggering biofeedback(MTB) subgroups(n=121).The neurologic impairment degree and motor function of the patients in two groups were evaluated with NIHSS and FMA 7 d before treatment, 7 d after treatment, and at the end of treatment.At the same time, the activities of daily living(ADL) of the patients were evaluated with BI. Results There were no significant differences in the scores of NIHSS, FMA and ADL of the patients before treatment between two groups(P>0.05).Compared with before treatment, the scores of the patients in therapeutic group were significantly improved(P<0.01).Compared with NMES group, the scores of the patients in MTB group were significantly improved(P<0.05). Conclusion Rehabilitative care of cerebral infarction patient's early hemiplegia with MTB can promote the function of the hemiplegia limbs to resume, and improve patient's activity of daily living.The curative effect of MTB is superior to the NMES.