水中步行训练对脊髓损伤患者下肢表面肌电和神经功能的效果

doi:10.3969/j.issn.1006-9771.2017.05.024

《中国康复理论与实践》 ›› 2017, Vol. 23 ›› Issue (5): 599-602.doi: 10.3969/j.issn.1006-9771.2017.05.024

水中步行训练对脊髓损伤患者下肢表面肌电和神经功能的效果

刘晓广, 杨学民, 龚雷, 周珠琪, 孙盛杰

1.宁波市康复医院,a.骨、关节与脊髓损伤康复科; b.水疗室; c.康复评定科,浙江宁波市 315040。

收稿日期:2016-11-07 修回日期:2017-02-21 出版日期:2017-05-25 发布日期:2017-05-24
作者简介:刘晓广(1978-),男,汉族,河北迁安市人,主治医师,主要研究方向：骨、关节与脊髓损伤康复,骨肌疾病的慢性疼痛。E-mail: 42689630@qq.com。

Effects of Walking in Water on Surface Electromyography of Lower Limbs and Neural Function in Spinal Cord Injury Patients

LIU Xiao-guang, YANG Xue-min, GONG Lei, ZHOU Zhu-qi, SUN Sheng-jie

1. a. Department of Rehabilitation for Bone, Joint and Spinal Cord Injury; b. Department of Water Therapy; c. Department of Rehabilitation Evaluation, Ningbo Rehabilitation Hospital, Ningbo, Zhejiang 315040, China

Received:2016-11-07 Revised:2017-02-21 Published:2017-05-25 Online:2017-05-24
Contact: LIU Xiao-guang. E-mail: 42689630@qq.com

摘要/Abstract

摘要： 目的探讨水中步行训练对不完全性脊髓损伤患者下肢肌肉表面肌电(sEMG)和神经功能的效果。方法 2014年6月至2016年5月,42例胸腰段不完全性脊髓损伤患者随机分成对照组(n=21)和实验组(n=21)。两组均采用常规康复训练,实验组另加水中步行训练,共6周。训练前后测量股四头肌及胫前肌平均肌电值(AEMG),采用美国脊柱损伤学会(ASIA)下肢运动功能、感觉指数评分进行评定。结果治疗后,两组ASIA下肢运动、感觉功能评分显著改善(t>10.871, P<0.001),股四头肌及胫前肌AEMG明显改善(t>5.763, P<0.01);实验组均明显优于对照组(t>4.036, P<0.01)。结论水中步行训练能进一步改善不完全性胸腰段脊髓损伤患者下肢肌力和神经功能。

关键词: 不完全性脊髓损伤, 水中步行训练, 表面肌电图, 神经功能

Abstract: Objective To explore the effects of walking in water on surface electromyography (sEMG) of lower limbs and neural function in spinal cord injury (SCI) patients. Methods From June, 2014 to May, 2016, 42 patients with incomplete thoracolumbar SCI were divided into control group (n=21) and experimental group (n=21) randomly. All the patients accepted routine rehabilitation, while the experimental group accepted extra walking in water. Average electromyography (AEMG) of quadriceps femoris and tibialis anterior muscles was measured, and the motor and sense function was assessed with American Spinal Injury Association (ASIA) Classification before and six weeks after treatment. Results The AEMG (t>5.763, P<0.01) and the scores of motor and sense (t>10.871, P<0.001) increased in both groups after treatment, and increased more in the experimental group than in the control group (t>4.036, P<0.01). Conclusion Walking in water could further improve lower limbs muscle strength and neural function in patients with incomplete thoracolumbar SCI.

Key words: incomplete spinal cord injury, walking in water, surface electromyography, neural function

中图分类号:

R651.2

刘晓广, 杨学民, 龚雷, 周珠琪, 孙盛杰. 水中步行训练对脊髓损伤患者下肢表面肌电和神经功能的效果[J]. 《中国康复理论与实践》, 2017, 23(5): 599-602.

LIU Xiao-guang, YANG Xue-min, GONG Lei, ZHOU Zhu-qi, SUN Sheng-jie. Effects of Walking in Water on Surface Electromyography of Lower Limbs and Neural Function in Spinal Cord Injury Patients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2017, 23(5): 599-602.

参考文献

[1] Wang HF, Yin ZS, Chen Y, et al. Epidemiological features of traumatic spinal cord injury in Anhui Province, China [J]. Spinal Cord, 2013, 51(1): 20-22.
[2] Lemay JF, Duclos C, Nadeau S, et al. Postural and dynamic balance while walking in adults with incomplete spinal cord injury [J]. J Electromyogr Kinesiol, 2014, 24(5): 739-746.
[3] 吴琼,王欣欣,王颖鹏,等. 表面肌电图在水中运动研究中的应用进展[J]. 中国康复理论与实践, 2015, 21(4): 445-448.
[4] 陈汉青,唐光旭,杨松. 表面肌电在体育运动中的运用[J]. 廊坊师范学院学报(自然科学版), 2014, 14(3): 95-97.
[5] 李建民,郝正玮,赵雅宁. 不同步态训练方法对慢性不完全性脊髓损伤患者步行功能效果的Meta分析[J]. 中国康复理论与实践, 2013, 19(2): 183-188.
[6] Kirshblum SC, Burns SP, Biering-Sorensen F, et al. International Standards for Neurological Classification of Spinal Cord Injury (revised 2011) [J]. J Spinal Cord Med, 2011, 34(6):535-546.
[7] De Biase ME, Politti F, Palomari ET, et al. Increased EMG response following electromyographic biofeedback treatment of rectus femoris muscle after spinal cord injury [J]. Physiotherapy, 2011, 97(2): 175-179.
[8] Tsutsumi S, Ueta T, Shiba K, et al. Effects of the Second National Acute Spinal Cord Injury Study of high-dose methylprednisolone therapy on acute cervical spinal cord injury–results in spinal injuries center [J]. Spine, 2006, 31(26): 2992-2996.
[9] Brucker BS, Bulaeva NV. Biofeedback effect on electromyography responses in patients with spinal cord injury [J]. Arch Phys Med Rehabil, 1996, 77(2): 133-137.
[10] 高宁,曹维宁. 脊髓不完全性损伤患者早期康复训练疗效观察[J]. 中国伤残医学, 2013, 21(6): 313-314.
[11] Iucksch DD, Israel VL, Ribas DI, et al. Gait characteristics of persons with incomplete spinal cord injury in shallow water [J]. J Rehabil Med, 2013, 45(9): 860-865.
[12] 崔玉鹏,洪峰. 表面肌电图在人体运动研究中的应用[J]. 首都体育学院学报, 2005, 17(1): 102-104.
[13] Querry RG, Pacheco F, Annaswamy T, et al. Synchronous stimulation and monitoring of soleus H reflex during robotic body weight-supported ambulation in subjects with spinal cord injury [J]. J Rehabil Res Dev, 2008, 45(1): 175-186.
[14] Liu J, Liu Q. Use of the integrated profile for voluntary muscle activity detection using EMG signals with spurious background spikes: A study with incomplete spinal cord injury [J]. Biomed Signal Proces, 2016, 24(Suppl 2): 19-24.
[15] Yen SC, Landry JM, Wu M. Augmented multisensory feedback enhances locomotor adaptation in humans with incomplete spinal cord injury [J]. Hum Mov Sci, 2014, 35: 80-93.
[16] Tamburella F, Scivoletto G, Cosentino E, et al. Walking in water and on land after an incomplete spinal cord injury [J]. Am J Phys Med Rehabil, 2013, 92(10 Suppl 2): e4-e15.
[17] 郑洁皎,胡佑红,俞卓伟. 表面肌电图在神经肌肉功能评定中的应用[J]. 中国康复理论与实践, 2007, 13(8): 741-742.
[18] Saito H, Yamanaka M, Kasahara S, et al. Relationship between improvements in motor performance and changes in anticipatory postural adjustments during whole-body reaching training [J]. Hum Mov Sci, 2014, 37: 69-86.
[19] 胡可慧,常有军,杨廷彦,等. 肌电生物反馈疗法联合康复训练对胸腰段不完全性脊髓损伤患者下肢运动功能及表面肌电信号的影响[J]. 按摩与康复医学, 2015, 6(23): 37-39.
[20] Anwer S, Equebal A, Palekar TJ, et al. Effect of locomotor training on motor recovery and walking ability in patients with incomplete spinal cord injury: a case series [J]. J Phys Ther Sci, 2014, 26(6): 951-953.
[21] Giannantoni NM, Minisci M, Brunetti V, et al. Evaluation of pharyngeal muscle activity through nasopharyngeal surface electromyography in a cohort of dysphagic patients with acute ischaemic stroke [J]. Acta Otorhinolaryngol Ital, 2016, 36(4): 295-299.
[22] Lovecchio N, Sciumè L, Zago M, et al. Lower limbs kinematic assessment of the effect of a gym and hydrotherapy rehabilitation protocol after knee megaprosthesis: a case report [J]. J Phys Ther Sci, 2016, 28(3): 1064-1070.
[23] Labruyère R, van Hedel HJ. Strength training versus robot-assisted gait training after incomplete spinal cord injury: a randomized pilot study in patients depending on walking assistance [J]. J Neuroeng Rehabil, 2014, 11: 4.
[24] 丁葆丽,麻淑清,朱迎九,等. 水疗在脊髓损伤患者康复治疗中的应用[J]. 中国康复理论与实践, 2005, 11(10): 862-863.
[25] 张志杰,刘春龙,冯亚男,等. 温泉水疗对改善胸段不完全性脊髓损伤患者肌痉挛的疗效观察[J]. 中国康复理论与实践, 2009, 15(5): 472-473.
[26] Milner PI, Smith HC, Robinson R, et al. Growth factor regulation of intracellular pH homeostasis under hypoxic conditions in isolated equine articular chondrocytes [J]. J Orthop Res, 2013, 31(2): 197-203.
[27] Pinto S, Carvalho Md. Breathing new life into treatment advances for respiratory failure in amyotrophic lateral sclerosis patients [J]. Neurodegener Dis Manag, 2014, 4(1): 83-102.
[28] Lu TW, Chien HL, Chang LY, et al. Enhancing the examiner's resisting force improves the validity of manual muscle strength measurements: application to knee extensors and flexors [J]. J Strength Cond Res, 2012, 26(9): 2364-2371.
[29] Choi K, Bak J, Cho M, et al. The effects of performing a one-legged bridge with hip abduction and use of a sling on trunk and lower extremity muscle activation in healthy adults [J]. J Phys Ther Sci, 2016, 28(9): 2625-2628.

水中步行训练对脊髓损伤患者下肢表面肌电和神经功能的效果

Effects of Walking in Water on Surface Electromyography of Lower Limbs and Neural Function in Spinal Cord Injury Patients

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