标题：改良强制性运动疗法对脑梗死患者上肢功能及表面肌电信号的影响

      作者：随燕芳，林夏妃，王悦，徐金山，王珊珊，张婷，宋振华    中南大学湘雅医学院附属海口医院，海南 海口 570208

      卷次： 2020年31卷9期

      【摘要】 目的 观察改良强制性运动疗法(mCIMT)对脑梗死患者上肢功能及上肢屈伸肌群表面肌电信号特征的影响。方法 收集2017年6月1日至2019年5月31日在中南大学湘雅医学院附属海口医院康复医学科治疗的40例脑梗死患者，按随机数表法分为mCIMT组和对照组，每组20例。对照组仅给予常规康复治疗，而mCIMT组给予常规康复以及mCIMT治疗。分别于治疗前、治疗 4周后评定并比较两组患者的简易上肢机能检查量表(STEF)评分、上肢功能Fugl-Meyer (FMA)上肢评分、日常生活活动能力Barthel指数(MBI)评分以及患侧肱二头肌、肱三头肌、桡侧腕伸肌、桡侧腕屈肌肌群的表面肌电信号。结果 治疗前，两组患者各项指标比较差异均无统计学意义(P>0.05)；两组患者治疗4周后的STEF评分、FMA上肢评分明显高于本组治疗前，且mCIMT组患者治疗后的STEF评分、FMA上肢评分分别为(48.77±5.26)分、(40.53±3.13)分，明显高于对照组的(41.58±6.29)分、(33.46±3.89)分，差异均有统计学意义(P<0.05)；治疗后mCIMT组患者MBI评分为(71.87±6.07)分，与对照组的(69.36±7.88)分比较差异无统计学意义(P>0.05)；两组患者治疗4周后的患侧肱二头肌、肱三头肌、桡侧腕伸肌、桡侧腕屈肌肌群的表面肌电信号明显高于本组治疗前，且mCIMT组患者治疗后的上述各项指标分别为(242.12±67.37) mV、(212.16±50.82) mV、(157.26 ± 21) mV、(118.32 ± 26.31) mV，明显高于对照组的 (169.74 ± 28.75) mV、(170.62 ± 34.61) mV、(130.01±36.19) mV、(88.91±22.18) mV，差异均有统计学意义(P<0.05)。结论 mCIMT可以促进脑梗死患者上肢运动功能的恢复，改善患侧上肢肌群的表面肌电信号。
      【关键词】 脑梗死；运动功能；改良强制运动疗法；强制性运动疗法；表面肌电
      【中图分类号】 R743.33 【文献标识码】 A 【文章编号】 1003—6350（2020）09—1106—04

Effects of modified constraint induced movement therapy on upper limb function and surface electromyography inpatients with cerebral infarction.
SUI Yan-fang, LIN Xia-fei, WANG Yue, XU Jin-shan, WANG Shan-shan, ZHANG Ting,SONG Zhen-hua. Haikou Hospital Affiliated to Xiangya School of Medicine, Central South University, Haikou 570208, Hainan,CHINA
【Abstract】 Objective To observe the effect of modified constraint induced movement therapy on upper limbfunction and surface electromyography (SEMG) in patients with cerebral infarction. Methods A total of 40 patientswith cerebral infarction, who admitted to Department of Medicine-Rehabilitation, Haikou Hospital Affiliated to XiangyaSchool of Medicine, Central South University from June 1, 2017 to May 31, 2019, were selected and divided into themodified constraint induced movement therapy (mCIMT) group (n=20) and the control group (n=20) according to ran-dom number table method. The patients in the control group were treated with routine rehabilitation therapy, and the pa-tients in the modified constraint induced movement therapy group were treated with modified constraint induced move-ment therapy on the basis of the routine rehabilitation therapy. The simple test for evaluating hand function (STEF),Fugl-Meyer assessment (FMA) upper limb scores, Modified Barthel Index (MBI) and SEMG of biceps brachii, tricepsbrachii, extensor carpi radialis and flexor carpi radialis were evaluated before and 4 weeks after treatment. Results Be-fore treatment, there was no significant difference in all indexes between the two groups (P>0.05). After 4 weeks of treat-ment, STEF scores, FMA upper limb scores and MBI scores of the two groups were significantly higher than those be-