《中国康复理论与实践》 ›› 2017, Vol. 23 ›› Issue (7): 807-810.doi: 10.3969/j.issn.1006-9771.2017.07.015

• 临床研究 • 上一篇    下一篇

推拿手法对脑卒中患者表面肌电信号的影响

廖若夷1, 2, 张婷2, 蔡华安3, 张月娟2, 彭廷云2, 陈芊妤2, 樊冰倩3, 桂一莎3, 尹臻臻3   

  1. 1.湖南中医药大学,湖南长沙市 410208;
    2.湖南中医药大学第一附属医院,湖南长沙市 410007;
    3.湖南省人民医院,湖南长沙市 410016。
  • 收稿日期:2016-11-29 出版日期:2017-07-25 发布日期:2017-08-07
  • 通讯作者: 蔡华安、张月娟。E-mail: 623124733@qq.com(蔡华安);1171825297@qq.com (张月娟)。
  • 作者简介:廖若夷(1970-),女,汉族,湖南益阳市人,博士研究生,主任护师,主要研究方向:心脑血管疾病中西结合护理基础和临床。
  • 基金资助:
    1.湖南省中医药科研计划项目(No.201492); 2.湖南省中医药科研计划重点项目(No.201410; No.201604); 3.国家临床护理重点专科建设项目(No.湘财社指[2013]151号)

Variation of Surface Electromyogram with Manipulation of Tuina for Stroke Hemiplegics

LIAO Ruo-yi1, 2, ZHANG Ting2, CAI Hua-an3, ZHANG Yue-juan2, PENG Ting-yun2, CHEN Qian-yu2, FAN Bing-qian3, GUI Yi-sha3, YIN Zhen-zhen3   

  1. 1. Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;
    2. The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China;
    3. Hunan Provincial People's Hospital, Changsha, Hunan 410016, China
  • Received:2016-11-29 Published:2017-07-25 Online:2017-08-07
  • Contact: Correspondence to CAI Hua-an, ZHANG Yue-juan. E-mail: 623124733@qq.com (CAI Hua-an), 1171825297@qq.com (ZHANG Yue-juan)

摘要: 目的比较不同推拿手法作用于脑卒中患者偏瘫肢体所产生的肌电效应。方法2016年1月至5月,脑卒中偏瘫住院患者20例,由同一高年资推拿治疗师对患者双侧股直肌实施滚、拍、揉、搓、抖、按手法,每种手法持续1 min,间隔1 min。采集静息状态和实施手法过程中积分肌电值(iEMG)、均方根(RMS)和中值频率(MF)。结果静息状态下,两侧iEMG、RMS和MF均无显著性差异(t<1.147, P>0.05)。手法过程中,拍法iEMG和RMS最高(F>21.376, P<0.001),按法MF最高(F>11.772, P<0.001),其他手法下各肌电值无显著性差异(P>0.05)。拍法作用下,患侧iEMG、RMS低于健侧(P<0.05),其他手法两侧无显著性差异(P>0.05)。结论不同的推拿手法对脑卒中偏瘫侧和健侧的刺激作用不同,拍法更能刺激神经肌肉兴奋和募集更多运动单位。

关键词: 脑卒中, 偏瘫, 推拿, 手法, 表面肌电图

Abstract: ObjectiveTo compare the effect of various manipulation of Tuina on surface electromyogram (sEMG) in hemiplegics after stroke. MethodsFrom January to May, 2016, 20 inpatients with hemiplegia after stroke accepted Tuina on bilateral rectus femoris by the same therapist, with the techniques of rolling, patting, rubbing, shaking, kneading and pressing, one minute a manipulation and interval one minute. Integrated electromyography (iEMG), root mean square (RMS) and median frequency (MF) of sEMG were compared, both in rest and during Tuina. ResultsThere was no significant difference of iEMG, RMS and MF between affected and unaffected sides in rest (t<1.147, P>0.05). iEMG and RMS were the most under patting (F>21.376, P<0.001), and MF was the highest under pressing (F>11.772, P<0.001). iEMG, RMS and MF were not very different under other manipulation (P>0.05). iEMG and RMS were less in the affected side than in the unaffected side under patting (P<0.05). ConclusionVarious manipulation of Tuina may be different in neuromuscular stimulation, that patting may stimulate more muscles and motor units.

Key words: stroke, hemiplegia, Tuina, manipulation, surface electromyogram

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