主动医学康复技术在残疾人体育运动中的应用效果

Резеда Ахметовна Бодрова, А.Д. Закамырдина, А. М. Делян, Галина Мазгаровна Каримова, Л.Ф. Васильева, R. A. Bodrova, A. D. Zakamyrdina, Arthur M. Delyan, G. M. Karimova, Lyudmila F. Vasilyeva
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引用次数: 0

摘要

本研究的目的:研究主动医学康复技术对从事体育运动的残奥运动员的效果。材料与方法:对48例年龄25.9±2.1岁的外伤性腰椎疾病患者进行回顾性分析。将所有患者分为两组:主组(19例)患者在标准治疗背景下接受1个疗程的主动医学康复(AMR),包括机械治疗和在下肢和背部肌肉肌电图(EMG)控制下的生物反馈电刺激。对照组(29人)接受标准治疗。AMR课程结束后,进行综合检查,包括问卷数据:美国脊髓损伤协会ASIA分类、功能独立性FIM量表、活动与生活质量修正功能评估量表VFM (Valutazione Funzionale Mielolesi)、状态-特质焦虑量表、Beck抑郁量表;Neurosoft neuroemg - micro设备的神经电生理研究,Neurosoft Poly-Spectrum计算机心电图的心率变异性(HRV), EN-TreeM上自由运动伴有同心和离心肌肉收缩的指标。结果:主组患者多交感反射兴奋性(PRV)明显降低。植物性反应性也有改善(系数30/15为1.45;P <0.001),表明副交感神经调节和心率恢复正常。亚洲量表的评估显示感觉功能改善了13.4%,运动功能改善了17.4%。在VFM量表上,指标增加了14.7%,在FIM量表上增加了11.5%。当在斯皮尔伯格-哈宁量表上评估心理-情绪领域时,反应性焦虑水平显著下降10.9%,抑郁水平显著下降30.5%。在同心收缩过程中,肌肉力量增加了18.1% (p < 0.001),平均力量增加了83.1% (p < 0.001),平均幅度增加了68.7% (p < 0.001),平均速度增加了27.2% (p=0.002)。治疗后各项指标分析,主组与对照组比较差异有统计学意义(p < 0.001)。结论:肌电控制下的生物反馈技术的应用,提高了创伤性脊髓病患者医学康复的有效性,改善了患者的生活质量。
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The effectiveness of active medical rehabilitation technologies among Paralympians engaged in playing sports
The purpose of the study: to study the effectiveness of active medical rehabilitation technologies among Paralympians engaged in playing sports.Materials and methods: examined 48 male patients aged 25.9 ± 2.1 years with traumatic disease of the lumbar spinal cord. All examined were divided into 2 groups: patients of the main group (19 people) against the background of standard therapy received a course of active medical rehabilitation (AMR), including mechanotherapy and electrical stimulation with biofeedback under the control of electromyography (EMG) of the muscles of the lower extremities and back. Patients in the comparison group (29 people) received standard therapy. After the AMR course, a comprehensive examination was performed, including the data of the questionnaires: the ASIA classification (American Spinal Injury Association), the FIM (Functional Independence Measure) scale of functional independence, the modified functional assessment scale of activity and quality of life VFM (Valutazione Funzionale Mielolesi), State-Trait Anxiety Inventory, the Beck depression scale; electroneurophysiological studies on the Neurosoft Neuro-EMG-Micro device, heart rate variability (HRV) on the Neurosoft Poly-Spectrum computer electrocardiograph, indicators of free movement with concentric and eccentric muscle contractions on EN-TreeM.Results: polysympathetic reflex excitability (PRV) significantly decreased in patients of the main group. There was also an improvement in vegetative reactivity (coefficient 30/15 is 1.45; p <0.001) during the orthostatic test, indicating normalization of parasympathetic regulation and heart rate. The assessment on the ASIA scale revealed an improvement in sensory function by 13.4 % and motor function by 17.4 %. On the VFM scale, an increase in indicators was observed by 14.7 % and on the FIM scale by 11.5 %. When assessing the psycho-emotional sphere on the Spielberger-Khanin scale, a significant decrease in the level of reactive anxiety was noted by 10.9 %, and the level of depression by 30.5 %. A significant increase in muscle strength by 18.1 % (p < 0.001) was also observed during concentric contractions, the average power increased by 83.1 % (p < 0.001), the average amplitude increased by 68.7 % (p < 0.001), the average speed by 27.2 % (p=0.002). When analyzing the indicators after the treatment, significant differences were obtained between the main and the comparison group (p < 0.001).Conclusion: the use of biofeedback technologies under the control of electromyography leads to an increase in the effectiveness of medical rehabilitation and improves the quality of life in Paralympians with traumatic spinal cord disease.
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