生物反馈结合镜像疗法对脑卒中后上肢功能障碍的临床效果(1)
[摘要] 目的 评价生物反馈结合镜像疗法对脑卒中后上肢功能障碍的临床效果。方法 选取我院于2014年1月～2016年1月收治的脑卒中患者110例，采用数字随机分组方法将其分为观察组及对照组，每组55例。其中对照组应用神经内科药物及康复训练，观察组联合应用生物反馈结合镜像疗法，比较两组患者的治疗效果。结果 治疗前，两组患者的FMA及Barthel指数比较差异无统计学意义(P>0.05)，治疗后，两组的上述指标均较治疗前明显改善，且观察组明显优于对照组，组间比较差异有统计学意义(P<0.05)。治疗前，两组患者的三角肌、肱三头肌、前臂伸肌群的iEMG比较差异无统计学意义(P>0.05)，治疗后，两组的上述指标均较治疗前明显改善，且观察组明显优于对照组，组间比较差异有统计学意义(P<0.05)。结论 生物反馈结合镜像疗法对脑卒中后上肢功能障碍的临床效果较好，可以有效促进脑卒中偏瘫患者上肢功能的改善，值得临床推广应用。
[关键词]生物反馈；镜像疗法；脑卒中
[中图分类号] R743.3 [文献标识码] A [文章编号] 1674-4721(2017)04(c)-0038-03
[Abstract]Objective To evaluate the clinical efficacy of biofeedback combined with mirror therapy in upper limb dysfunction after stroke.Methods A total of 110 patients with stroke treated in our hospital from January 2014 and January 2016 were selected and randomly divided into observation group and control group according to the number random grouping method，and there were 55 patients in each group.The control group was treated with neurological medication and rehabilitation training，while the observation group was treated with biofeedback combined with mirror therapy.Efficacy was compared between the two groups.Results Before treatment，FMA and Barthel index in two groups showed no significant differences(P>0.05).After treatment，FMA and Barthel index were obviously improved，moreover，FMA and Barthel index in the observation group were apparently superior to the control group，and there was a statistical differences (P<0.05).Before treatment，iEMG of the deltoids，triceps and forearm extensors presented no significant differences between two groups (P>0.05).After treatment，iEMG of the deltoids，triceps and forearm extensors was improved markedly，additionally，iEMG of the deltoids，triceps and forearm extensors in the observation group was apparently superior to the control group，and there was a statistical difference(P<0.05).Conclusion Biofeedback combined with mirror therapy in the treatment of upper limb dysfunction after stroke presents good efficacy，and has a promoting effect in the improvement of upper limb function in stroke patients with hemiplegia.Therefore，it is worthy of clinical promotion and application.
[Key words]Biofeedback；Mirror therapy；Stroke
脑卒中是世界范围内导致成年人群残疾的主要原因，60%左右的患者在患病后遗留上肢功能障碍[1]。在发生卒中后的6个月内，仅有40%的患者会恢复部分患肢功能，15%左右的患者經过康复治疗后起到较好的治疗效果。通过研究表明，进行有目的的主动性活动取得的治疗效果更好，但是大部分患者因上肢功能严重受损，肢体力量以及耐力均无法满足高强度的任务导向训练[2-4]，本研究对该类患者结合生物反馈(EMGBF疗法)结合镜像疗法，取得了良好的效果，现报道如下。
1 资料与方法
1.1 一般资料
选取2014年1月～2016年1月在我院康复科住院治疗的脑卒中偏瘫患者110例，所有患者均符合以下诊断标准：①临床初次诊断为脑梗死或脑出血，经过头颅CT或MRI证实；②病程<3个月，病情平稳，无合并心、肝、肾等重要脏器病变，改良Ashworth评分≤Ⅱ级；③能够配合治疗；④为单侧肢体偏瘫，上肢Brunnstrom分级Ⅲ～Ⅴ期。排除标准：①开颅手术后出现脑梗死或大量出血；②合并严重的心、肺感染；③有精神障碍及抑郁病史。采用数字随机分组方法将所有患者分为观察组、对照组，每组55例，其中观察组中男32例，女23例；年龄39～81岁，平均(54.8±4.1)岁；病程12～57 d，平均(24.8±3.2)d；脑梗死31例，脑出血24例。对照组中男29例，女26例；年龄38～82岁，平均(55.9±3.8)岁；病程11～58 d，平均(25.3±4.1)d；脑梗死30例，脑出血25例。两组患者的一般资料差异无统计学意义(P>0.05)，具有可比性。 (徐冬梅 冯珍)
[关键词]生物反馈；镜像疗法；脑卒中
[中图分类号] R743.3 [文献标识码] A [文章编号] 1674-4721(2017)04(c)-0038-03
[Abstract]Objective To evaluate the clinical efficacy of biofeedback combined with mirror therapy in upper limb dysfunction after stroke.Methods A total of 110 patients with stroke treated in our hospital from January 2014 and January 2016 were selected and randomly divided into observation group and control group according to the number random grouping method，and there were 55 patients in each group.The control group was treated with neurological medication and rehabilitation training，while the observation group was treated with biofeedback combined with mirror therapy.Efficacy was compared between the two groups.Results Before treatment，FMA and Barthel index in two groups showed no significant differences(P>0.05).After treatment，FMA and Barthel index were obviously improved，moreover，FMA and Barthel index in the observation group were apparently superior to the control group，and there was a statistical differences (P<0.05).Before treatment，iEMG of the deltoids，triceps and forearm extensors presented no significant differences between two groups (P>0.05).After treatment，iEMG of the deltoids，triceps and forearm extensors was improved markedly，additionally，iEMG of the deltoids，triceps and forearm extensors in the observation group was apparently superior to the control group，and there was a statistical difference(P<0.05).Conclusion Biofeedback combined with mirror therapy in the treatment of upper limb dysfunction after stroke presents good efficacy，and has a promoting effect in the improvement of upper limb function in stroke patients with hemiplegia.Therefore，it is worthy of clinical promotion and application.
[Key words]Biofeedback；Mirror therapy；Stroke
脑卒中是世界范围内导致成年人群残疾的主要原因，60%左右的患者在患病后遗留上肢功能障碍[1]。在发生卒中后的6个月内，仅有40%的患者会恢复部分患肢功能，15%左右的患者經过康复治疗后起到较好的治疗效果。通过研究表明，进行有目的的主动性活动取得的治疗效果更好，但是大部分患者因上肢功能严重受损，肢体力量以及耐力均无法满足高强度的任务导向训练[2-4]，本研究对该类患者结合生物反馈(EMGBF疗法)结合镜像疗法，取得了良好的效果，现报道如下。
1 资料与方法
1.1 一般资料
选取2014年1月～2016年1月在我院康复科住院治疗的脑卒中偏瘫患者110例，所有患者均符合以下诊断标准：①临床初次诊断为脑梗死或脑出血，经过头颅CT或MRI证实；②病程<3个月，病情平稳，无合并心、肝、肾等重要脏器病变，改良Ashworth评分≤Ⅱ级；③能够配合治疗；④为单侧肢体偏瘫，上肢Brunnstrom分级Ⅲ～Ⅴ期。排除标准：①开颅手术后出现脑梗死或大量出血；②合并严重的心、肺感染；③有精神障碍及抑郁病史。采用数字随机分组方法将所有患者分为观察组、对照组，每组55例，其中观察组中男32例，女23例；年龄39～81岁，平均(54.8±4.1)岁；病程12～57 d，平均(24.8±3.2)d；脑梗死31例，脑出血24例。对照组中男29例，女26例；年龄38～82岁，平均(55.9±3.8)岁；病程11～58 d，平均(25.3±4.1)d；脑梗死30例，脑出血25例。两组患者的一般资料差异无统计学意义(P>0.05)，具有可比性。 (徐冬梅 冯珍)