病房-家庭嵌入式运动想象训练对脑卒中患者上肢运动功能恢复的影响
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摘要
目的观察病房-家庭嵌入式运动想象训练对脑卒中上肢偏瘫患者运动功能恢复的影响。方法将32例脑卒中偏瘫患者,随机分为两组,A组16例患者给予常规康复训练并进行病房-家庭嵌入式运动想象疗法,B组16例患者仅给予病房-家庭常规康复训练。观察两组治疗前后运动功能Fugl-Meyer评分、日常生活能力改良Barthel指数、患侧上肢肌力评分变化。结果 A组在治疗8周、治疗12周时Fugl-Meyer评分、改良Barthel指数、患侧上肢肌力评分均高于B组(P<0.05),两组治疗8周、治疗12周时上述指标均高于治疗前(P<0.05)。结论病房-家庭嵌入式运动想象疗法联合常规康复训练可以显著改善脑卒中上肢偏瘫患者的上肢运动功能、日常生活能力和上肌肌力,值得临床推广应用。
Objective To observe the effect of ward-family embedded motor imagery therapy on functional recovery of upper limb of hemiplegia patients with stroke. Methods Thirty-two hemiplegia patients with stroke were randomly divided into two groups,16 patients in Group A were given routine rehabilitation training and ward-family embedded motor imagery therapy,and 16 patients in Group B were given ward-family routine rehabilitation training. The motor function( Fugl-Meyer score),activity of daily living( modified Barthel index)and muscle strength of the affected upper limb were observed before and after treatment in two groups. Results The Fugl-Meyer scores,modified Barthel index and muscle strength score of patients in Group A were higher than those of patients in Group B 8 and 12 weeks after treatment( P < 0. 05). All of the indexes mentioned above were higher 8 and 12 weeks after treatment compared with those before treatment in two groups( P < 0. 05). Conclusion Ward-family embedded motor imagery therapy in combination with routine rehabilitation training can significantly improve the motor function,activity of daily living and muscle strength of upper limb in hemiplegia patients with stroke. It is worthy of popularization.
Objective To observe the effect of ward-family embedded motor imagery therapy on functional recovery of upper limb of hemiplegia patients with stroke. Methods Thirty-two hemiplegia patients with stroke were randomly divided into two groups,16 patients in Group A were given routine rehabilitation training and ward-family embedded motor imagery therapy,and 16 patients in Group B were given ward-family routine rehabilitation training. The motor function( Fugl-Meyer score),activity of daily living( modified Barthel index)and muscle strength of the affected upper limb were observed before and after treatment in two groups. Results The Fugl-Meyer scores,modified Barthel index and muscle strength score of patients in Group A were higher than those of patients in Group B 8 and 12 weeks after treatment( P < 0. 05). All of the indexes mentioned above were higher 8 and 12 weeks after treatment compared with those before treatment in two groups( P < 0. 05). Conclusion Ward-family embedded motor imagery therapy in combination with routine rehabilitation training can significantly improve the motor function,activity of daily living and muscle strength of upper limb in hemiplegia patients with stroke. It is worthy of popularization.
引文
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[14]王朴,郭毅,张俊梅,等.运动想象疗法对脑卒中后患者上肢功能康复效果的系统评价[J].中国循证医学杂志,2011,11(5):529-539.
[15]Liu KP,Chan CC,Lee TM,et al.Mental imagery for promoting relearning for people after stroke:A randomized controlled trial[J].Arch Phys Med Rehabil,2004,85(9):1 403-1 408.
[16]Bovend'Eerdt TJ,Dawes H,Sackley C,et al.Mental techniques during manual stretching in spasticity--a pilot randomized controlled trial[J].Clin Rehabil,2009,23(2):137-145.
[17]Bovend'Eerdt TJ,Dawes H,Sackley C,et al.An integrated motor imagery program to improve functional task performance in neurorehabilitation:a single-blind randomized controlled trial[J].Arch Phys Med Rehabil,2010,91(6):939-946.
[18]Braun S,Beurskens A,Kleynen M,et al.Rehabilitation with mental practice has similar effects on mobility as rehabilitation with relaxation in people with Parkinson's disease:a multicentre randomised trial[J].J Physiother,2011,57(1):27-34.
[2]Schuster C,Butler J,Andrews B,et al.Comparison of embedded and added motor imagery training in patients after stroke:results of a randomized controlled pilot trial[J].Trials,2012,13:11.
[3]曹湾,陈启波.运动想象的脑机制及其在卒中患者运动功能康复中的应用[J].中国临床新医学,2014,7(1):88-92.
[4]中华医学会第四届全国脑血管病学术会议.各项脑血管病诊断要点[J].中华神经内科杂志,1996,29(6):379.
[5]Decety J,Grézes J.Neural mechanisms subserving the perception of human actions[J].Trends Cogn Sci,1999,3(5):172-178.
[6]胡永新,王强,孟萍萍,等.运动想象疗法对脑卒中偏瘫患者上肢功能恢复的影响[J].中华物理医学与康复杂志,2010,32(4):273-276.
[7]恽晓平.康复疗法评定学[M].北京:华夏出版社,2003.393-396.
[8]卓大宏.中国康复医学[M].第2版.北京:华夏出版社,2003:122.
[9]Decety J.The neurophysiological basis of motor imagery[J].Behav Brain Res,1996,77(1-2):45-52.
[10]Milton J,Small SL,Solodkin A.Imaging motor imagery:methodological issues related to expertise[J].Methods,2008,45(4):336-341.
[11]Ehrsson H,Geyer S,Naito E.Imagery of voluntary movement of fingers,toes,and tongue activates corresponding body part-specific motor representations[J].J Neurophysiol,2003,90(5):3 304-3 316.
[12]Dodakian L,Campbell Stewart J,Cramer SC.Motor imagery during movement activates the brain more than movement alone after stroke:a pilot study[J].J Rehabil Med,2014,46(9):843-848.
[13]Page SJ,Levine P,Leonard A.Mental practice in chronic stroke:results of a randomized,placebo-controlled trial[J].Stroke,2007,38(4):1 293-1 297.
[14]王朴,郭毅,张俊梅,等.运动想象疗法对脑卒中后患者上肢功能康复效果的系统评价[J].中国循证医学杂志,2011,11(5):529-539.
[15]Liu KP,Chan CC,Lee TM,et al.Mental imagery for promoting relearning for people after stroke:A randomized controlled trial[J].Arch Phys Med Rehabil,2004,85(9):1 403-1 408.
[16]Bovend'Eerdt TJ,Dawes H,Sackley C,et al.Mental techniques during manual stretching in spasticity--a pilot randomized controlled trial[J].Clin Rehabil,2009,23(2):137-145.
[17]Bovend'Eerdt TJ,Dawes H,Sackley C,et al.An integrated motor imagery program to improve functional task performance in neurorehabilitation:a single-blind randomized controlled trial[J].Arch Phys Med Rehabil,2010,91(6):939-946.
[18]Braun S,Beurskens A,Kleynen M,et al.Rehabilitation with mental practice has similar effects on mobility as rehabilitation with relaxation in people with Parkinson's disease:a multicentre randomised trial[J].J Physiother,2011,57(1):27-34.