Abstract:

Objective To explore the safety and effectiveness of biofeedback therapy on insomnia associated with anxiety and depression in the period of rehabilitation of stroke. Methods Post stroke patients with insomnia associated with anxiety and depression were enrolled into study. All the patients were treated with biofeedback therapy, which were administered 30 min/ day, 5 times/week with autonomic nervous system rehabilitation exercises. Pittsburgh Sleep Quality Index Scale (PSQI), Sleep time and Patient Health Questionnaire (PHQ-9), Hamilton Depression (HAMD), Hamilton Anxiety (HAMA), Modified Barthel Index (MBI), Mini-mental State Examination (MMSE), Fugle-Meyer Scale (FMS), National Institutes of Health Stroke Scale (NIHSS) were taken before and after the exercise and the sleep time of patients were recorded, so as to comparatively analyze the changes of score and sleep time before and after the exercise. Results The data of 30 patients were used for analysis. Sleep time after treatment was significantly improved compared with that of before treatment ([4.81±1.58] h vs [7.30±1.34] h, P <0.001]). HAMA([17.50±8.41] vs [9.00±7.01]) and HAMD ([19.53±7.82] vs [9.23±4.42]) scores were significantly improved (P <0.001). After four weeks of training, the MMSE scores, Fugle-Meyer scores and Barthel index got increased, but didn’t have statistical significance. NIHSS score was lower, which had significant difference (P =0.033).

Conclusion Biofeedback therapy in treatment of stroke patients with insomnia can improve the quality of sleep, relieve anxiety and depression, and improve the rehabilitation outcome.

Key words: Stroke; Anxiety; Depression; Insomnia; Biofeedback

摘要：

目的 研究生物反馈治疗卒中恢复期焦虑抑郁状态伴失眠的疗效及安全性。 方法 纳入卒中恢复期焦虑抑郁伴失眠患者，均给予生物反馈训练，训练方法为每周五次，每次 30 min的自主神经系统放松康复训练。所有患者在训练前后评定汉密尔顿焦虑量表（Hamilton Anxiety Scale，HAMA）、汉密尔顿抑郁量表（Hamilton Depression Scale，HAMD）、匹兹堡睡眠质量指数量表 （Pittsburgh Sleep Quality Index，PSQI）、患者健康问卷-9（Patient Health Questionnaire-9，PHQ-9）、简 易精神状态检查表（Mi ni -mental State Examination，MMSE）、Fugle-Meyer肢体功能评分（Fugl e-Meyer Scale，FMS）、美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）以及 Barthel指数（Barthel Index，BI），并采集患者的睡眠时间，对比分析训练前后这些量表评分及睡眠时 间的变化。 结果 研究共纳入并完成3 0例患者的数据统计。治疗后患者睡眠时间较治疗前显著增 加[（4.81±1.58）h vs（7.30±1.34）h，P＜0.001]。HA M A[（17.50±8.41）vs（9.00±7.01）]和 HAMD（[ 19.53±7.82）vs（9.23±4.42）]评分均有显著改善（均P＜0.001）。训练4周后患者的MMSE评 分有提高，Fugl e-Meyer分数增加，Barthel指数增加，但无统计学意义，NIHSS评分降低，差异有显著性 （P =0.033）。 结论 生物反馈疗法有利于卒中后焦虑抑郁伴失眠患者的睡眠和情绪改善，提高康复效果。

关键词: 卒中; 焦虑; 抑郁; 失眠; 生物反馈疗法