微电子肌电桥技术对颈脊髓损伤患者桡侧腕长伸肌运动功能康复的效果

doi:10.3969/j.issn.1006-9771.2021.06.011

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (6): 698-705.doi: 10.3969/j.issn.1006-9771.2021.06.011

微电子肌电桥技术对颈脊髓损伤患者桡侧腕长伸肌运动功能康复的效果

王冲^1,^2,⁴,杜良杰^1,^3,⁴(),王志功⁵,李建军^1,^3,⁴,李军^1,^3,⁴,刘宏炜^1,^3,⁴,丛芳^1,^2,⁴,林歆^1,^2,⁴

^1.首都医科大学康复医学院，北京市 100068
^2.中国康复研究中心北京博爱医院，理疗科，北京市 100068
^3.中国康复研究中心北京博爱医院，脊柱脊髓神经功能重建科，北京市 100068
^4.中国康复科学所，神经损伤与康复北京市重点实验室，北京脑重大疾病研究院神经损伤与修复研究所，北京市 100068
^5.东南大学射频与光电集成电路研究所，江苏南京市 210000

收稿日期:2021-01-26 修回日期:2021-04-14 出版日期:2021-06-25 发布日期:2021-06-21
通讯作者: 杜良杰 E-mail:duliangjie@mail.ccmu.edu.cn
作者简介:王冲(1990-)，女，汉族，河南周口市人，硕士，医师，主要研究方向：脊髓损伤康复。
基金资助:
中央级公益性科研院所基本科研业务费专项资金项目(2015-4-48-1)

Effect of Microelectronic Electromyography Bridge on Motor Function of Extensor Carpi Radialis Longus in Patients with Cervical Spinal Cord Injury

Chong WANG^1,^2,⁴,Liang-jie DU^1,^3,⁴(),Zhi-gong WANG⁵,Jian-jun LI^1,^3,⁴,Jun LI^1,^3,⁴,Hong-wei LIU^1,^3,⁴,Fang CONG^1,^2,⁴,Xin LIN^1,^2,⁴

^1.Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
^2.Department of Physiotherapy, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
^3.Department of Spinal and Neural Function Reconstruction, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
^4.Institute of Nerve Injury and Repair, Beijing Key Laboratory of Nerve Injury and Rehabilitation, Beijing Institute of Brain Diseases, Chinese Institute of Rehabilitation Sciences, Beijing 100068, China
^5.Institute of Radiofrequency and Optoelectronic Integrated Circuits, Southeast University, Nanjing, Jiangsu 210000, China

Received:2021-01-26 Revised:2021-04-14 Published:2021-06-25 Online:2021-06-21
Contact: Liang-jie DU E-mail:duliangjie@mail.ccmu.edu.cn
Supported by:
Fundamental Research Funds for Central Public Welfare Research Institutes(2015-4-48-1)

摘要/Abstract

摘要： 目的

观察微电子肌电桥(EMGB)技术对C₅完全性脊髓损伤患者桡侧腕长伸肌运动功能的康复疗效。

方法

2016年3月至2017年3月，选择本院C₅完全性脊髓损伤患者20例，随机分为对照组(n = 10)和试验组(n = 10)。对照组进行常规腕背伸训练，试验组在此基础上增加EMGB训练，共180 d。以桡侧腕长伸肌表面肌电图(sEMG)、徒手肌力检查(MMT)、Wolf运动功能评定量表(WMFT)、脊髓损伤独立性量表(SCIM)评价各组治疗前后的患肢运动功能。

结果

治疗后，两组桡侧腕长伸肌表面肌电峰值和平均值均提高(t > 2.510, P < 0.05)；试验组左侧桡侧腕长伸肌表面肌电峰值和平均值均优于对照组(t > 2.759, P < 0.05)；试验组右侧桡侧腕长伸肌表面肌电峰值优于对照组(t = 2.691, P < 0.05)；试验组右侧桡侧腕长伸肌表面肌电平均值与对照组比较无显著性差异(t = 2.063, P = 0.054)。两组治疗后MMT均提高(t > 2.569, P < 0.05)，且试验组优于对照组(t > 2.278, P < 0.05)。两组治疗后WMFT、SCIM评分均明显提高(t > 3.839, P < 0.01)，但两组间无显著性差异(t < 1.498, P > 0.05)。

结论

EMGB训练能够提高C₅完全性脊髓损患者桡侧腕长伸肌的运动功能。

关键词: 脊髓损伤, 微电子肌电桥, 桡侧腕长伸肌, 康复

Abstract: Objective

To observe the effect of microelectronic EMG bridge (EMGB) training on the motor function of extensor carpi radialis longus in patients with complete cervical 5 spinal cord injury.

Methods

From March, 2016 to March, 2017, 20 patients with complete cervical 5 spinal cord injury were randomly divided into control group (n = 10) and experimental group (n = 10). The control group received routine wrist extensor muscle training, and the experimental group received EMGB training in addition, for 180 days. The motor function of the affected limb was evaluated by sEMG of extensor carpi radialis longus, Manual Muscle Test (MMT), Wolf Motor Function Test (WMFT) and Spinal Cord Lesion Independence Measure (SCIM).

Results

After treatment, the peak value and average value of sEMG of extensor carpi longus of both sides increased in both groups (t > 2.510, P < 0.05), the peak value and average value of the left side were higher (t > 2.759, P < 0.05), and the peak value of the right side was higher (t = 2.691, P < 0.05) in the experiment group than in the control group, however, there was no significant difference in average value of the right side between two groups (t = 2.063, P = 0.054). The scores of MMT increased in both groups (t > 2.569, P < 0.05), and were higher in the experimental group than in the control group (t > 2.278, P < 0.05). The scores of WMFT and SCIM increased in both groups (t > 3.839, P < 0.05), however, there was no significant difference between two groups (t < 1.498, P > 0.05).

Conclusion

EMGB training could improve the motor function of extensor carpi radialis longus in patients with complete cervical 5 spinal cord injury.

Key words: spinal cord injury, microelectronic electromyography bridge, extensor carpi radialis longus, rehabilitation

中图分类号:

R651.2

王冲,杜良杰,王志功,李建军,李军,刘宏炜,丛芳,林歆. 微电子肌电桥技术对颈脊髓损伤患者桡侧腕长伸肌运动功能康复的效果[J]. 《中国康复理论与实践》, 2021, 27(6): 698-705.

Chong WANG,Liang-jie DU,Zhi-gong WANG,Jian-jun LI,Jun LI,Hong-wei LIU,Fang CONG,Xin LIN. Effect of Microelectronic Electromyography Bridge on Motor Function of Extensor Carpi Radialis Longus in Patients with Cervical Spinal Cord Injury[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(6): 698-705.

图/表 5

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组别	n	性别(n)		年龄(岁)	病程(d)
组别	n	男	女	年龄(岁)	病程(d)
试验组	10	10	0	36.70±10.18	56.90±50.66
对照组	10	10	0	41.50±6.22	65.60±43.74
t值				1.272	0.411
P值				0.219	0.686

组别	n	治疗前				治疗后
		峰值		平均值		峰值		平均值
		左	右	左	右	左	右	左	右
对照组	10	66.46±36.34	63.01±31.41	61.21±34.50	51.28±30.09	115.51±42.22^a	108.77±37.39^b	104.15±41.66^c	99.14±33.33^d
试验组	10	77.99±36.18	62.99±27.84	66.36±33.72	51.05±25.32	160.04±55.80^e	136.29±50.06^f	144.04±54.11^g	121.12±50.26^h
t值		0.711	0.002	0.337	0.018	2.994	2.691	2.759	2.063
P值		0.486	0.999	0.740	0.985	0.008	0.015	0.013	0.054

组别	n	治疗前		治疗后		t值^a	P值^a	t值^b	P值^b
组别	n	左	右	左	右	t值^a	P值^a	t值^b	P值^b
对照组	10	0.8±0.79	0.8±0.79	1.9±1.10	1.9±0.88	2.569	0.019	2.941	0.009
试验组	10	0.8±0.79	0.7±0.67	2.6±1.35	2.6±1.35	3.639	0.002	3.987	0.001
t值		0	0.305	2.278	2.717
P值		> 0.999	0.763	0.035	0.014

组别	n	治疗前	治疗后	t值	P值
对照组	10	18.20±5.83	31.30±9.08	3.839	0.001
试验组	10	23.00±4.86	33.70±6.20	4.295	0.001
t值		2.000	0.854
P值		0.061	0.404

组别	n	治疗前	治疗后	t值	P值
对照组	10	10.50±0.85	20.70±2.58	11.87	< 0.001
试验组	10	10.80±1.40	33.70±6.20	11.39	< 0.001
t值		0.579	1.498
P值		0.569	0.152

微电子肌电桥技术对颈脊髓损伤患者桡侧腕长伸肌运动功能康复的效果

Effect of Microelectronic Electromyography Bridge on Motor Function of Extensor Carpi Radialis Longus in Patients with Cervical Spinal Cord Injury

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