运动想象疗法结合肌电生物反馈对脑卒中偏瘫患者上肢功能恢复的影响

目的 研究运动想象疗法结合肌电生物反馈对脑卒中偏瘫患者上肢功能恢复的作用.方法 选择60例临床确诊的脑卒中偏瘫患者,采用随机数字表法随机分为对照组、电刺激组和综合组,每组20例.所有患者均接受常规药物治疗和常规康复治疗,电刺激组增加肌电生物反馈疗法,综合组增加运动想象疗法和肌电生物反馈疗法.4周为1个疗程,所有患者分别于治疗前和治疗2个疗程后采用Fugl-Meyer运动功能评定量表(FMA)评定上肢运动动能,采用改良Barthel指数(MBI)评定日常生活活动能力,并测定偏瘫侧上肢相关肌肉的肌电积分(iEMG).结果 治疗8周后,所有患者上肢FMA评分、MBI评分及患侧上肢肌肉iEMG值均较治疗前改善明显(P＜0.05);而且综合组各项指标的改善较另外两组更加明显(P＜0.05).结论 运动想象疗法结合肌电生物反馈疗法可以更有效地促进脑卒中偏瘫患者上肢功能的改善.

Abstract：

Objective To study the effects of motor imagery therapy combined with electromyographic (EMG) biofeedback on upper limb function in hemiplegic patients.Methods Sixty hemiplegic stroke patients were recruited and divided into a control group (n=20),an electrical stimulation group (n=20) and a combination group (n=20).All groups received basic medication and routine rehabilitation training once daily for 4 weeks.The electrical stimulation group was also treated with EMG biofeedback,and the combination group with motor imagery therapy plus EMG biofeedback.The Fugl-Meyer assessment (FMA),the modified Barthel index (MBI) and EMG parameters were assessed before and after 2 courses of treatment.Results After 8 weeks of treatment all groups had significantly higher FMA scores and MBI scores,and better integrated EMG values,but the effects in the combination group were significantly better than those in the other two groups.Conclusions Motor imagery therapy combined with EMG biofeedback can more effectively promote recovery of upper limb function in hemiplegic stroke patients.

Effects of motor imagery therapy combined with electromyographic biofeedback on upper limb function in hemiplegic stroke patients