中医导引反馈康复技术机制和临床应用研究

关键词：康复  导引术  生物反馈  偏瘫  伸膝

Keywords:rehabilitation  Daoyin  biofeedback  hemiparalysis  knee extension

摘要：

      目的：研究一种符合促进中枢神经系统（CNS）可塑性变化的“技巧性使用-依赖”原理、恢复CNS损伤后运动功能的主动训练方法，观察其临床效果并进行机制探讨。方法：用六步法中医导引术诱发CNS潜能，用信号接收设备实时接收并以曲线形式显示该潜能信号，结合反馈技术，有的放矢地导引患者不断增强动作肌信号强度、减弱拮抗肌信号强度，使运动程序逐渐得到重新建立。对64例病史1年以上的陈旧性卒中偏瘫伸膝功能障碍的患者进行一疗程、90次、每次45min的治疗。治疗前后进行Lovett MMT、膝关节ROM、Fugl-Meyer

Abstract:

      Objective: To develop an active training method which coincides the principle of skilled using-dependent that can promote the variation of the central nervous system (CNS) plasticity,and the recovery of motor function after CNS injury. Method:The six-step Daoyin(Chinese physical and breathing exercises) was applied to induce the potency of CNS. The potential signals were received and real time displayed in curve by electro-signal receptor. Combining with biofeedback technique, the training was applied in order to enhance the signal intensity of agonistic muscle and reduce the signal intensity of antagonistic muscle, so that the motor program can be reconstructed gradually. Sixty-four long-term (more than 1 year) stroke patients with hemiplegia and knee extension problem undertook a training course, involving 90 times and 45min per time. The functional evaluations including Lovett MMT of quadriceps and hamstring muscles, ROM of knee, Fugl-Meyer scale of lower limb, the intensities and proportions of motor program signals were administered before and after the treatment course. Result:The differences of data before and after training of each functional evaluation were very significant（P<0.01）. The active knee extension ability improved obviously. The mechanism of this method might be rebuilding the motor program based on the exploitation of CNS potentiality. Conclusion:The neurological training rehabilitation technique is an effective method of improving knee extension ability in hemiplegic patient after stroke.