运动表象训练结合作业疗法对脑卒中偏瘫患者上肢和手功能的影响
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摘要
目的探讨运动表象训练结合作业疗法对脑卒中偏瘫患者中上肢及手功能的影响。方法选择2015年7月～2017年12月我院收治脑卒中偏瘫患者100例为研究对象,根据治疗方法不同随机分为对照组(n=50)和观察组(n=50)。两组均给予药物干预,对照组采用常规作业疗法,观察组在对照组基础上联合运动表象训练,患者均进行3个月治疗,治疗结束后对两组患者神经功能缺损程度,上肢和手功能、日常生活能力、生活质量进行临床效果评估。结果观察组治疗3个月有效率为96.00%,明显高于对照组的72.00%(P<0.05);观察组治疗后3个月NIHSS评分明显低于对照组(P<0.05);观察组治疗后3个月FMA评分及MBI评分均高于对照组(P<0.05);观察组治疗后3个月生活质量评分均高于对照组(P<0.05);观察组治疗后3个月TXA2、TXA2/PGI2水平明显低于对照组(P<0.05);观察组治疗后3个月PGI2水平明显高于对照组(P<0.05)。结论将运动表象训练结合作业疗法用于脑卒中偏瘫患者中有助于减少神经功能缺损程度,改善患者上肢、手功能及生化指标水平,提高患者生活质量,值得推广应用。
Objective To investigate the effects of sports representation training combined with occupational therapy on upper limb and hand function in stroke patients with hemiplegia. Methods One hundred patients with hemiplegia due to stroke in our hospital from July 2015 to December 2017 were selected as subjects. They were randomly divided into control group(n=50) and observation group(n=50) according to different treatment methods. The two groups were given drug intervention. The control group was treated with routine operation therapy, and the observation group was combined with sports representation training on the basis of the treatment of the control group. The patients were treated for 3 months. The degree of neurological deficit, upper limb and hand function, daily life ability and quality of life routine after treatment were evaluated for clinical effects. Results The effective rate of treatment in the observation group was96.00%, which was significantly higher than 72.00% in the control group(P<0.05). The NIHSS score in the observation group was significantly lower than that in the control group after treatment for 3 months(P<0.05). The FMA score and MBI score in the observation group after 3 months of treatment were higher than those of the control group(P<0.05).The physical health, mental state, social relationship, surrounding environment and independent ability of the observation group were higher than the control group at 3 months after treatment(P<0.05). The levels of TXA2 and TXA2/PGI2 in the observation group were significantly lower than those in the control group at 3 months after treatment(P<0.05).The PGI2 level in the observation group was significantly higher than that in the control group at 3 months after treatment(P<0.05). Conclusion The use of sports representation training combined with occupational therapy in stroke patients with hemiplegia can help reduce the degree of neurological deficit, improve the upper limb, hand function and biochemical indicators, improve the quality of life of patients, and it is worthy of promotion and application.
Objective To investigate the effects of sports representation training combined with occupational therapy on upper limb and hand function in stroke patients with hemiplegia. Methods One hundred patients with hemiplegia due to stroke in our hospital from July 2015 to December 2017 were selected as subjects. They were randomly divided into control group(n=50) and observation group(n=50) according to different treatment methods. The two groups were given drug intervention. The control group was treated with routine operation therapy, and the observation group was combined with sports representation training on the basis of the treatment of the control group. The patients were treated for 3 months. The degree of neurological deficit, upper limb and hand function, daily life ability and quality of life routine after treatment were evaluated for clinical effects. Results The effective rate of treatment in the observation group was96.00%, which was significantly higher than 72.00% in the control group(P<0.05). The NIHSS score in the observation group was significantly lower than that in the control group after treatment for 3 months(P<0.05). The FMA score and MBI score in the observation group after 3 months of treatment were higher than those of the control group(P<0.05).The physical health, mental state, social relationship, surrounding environment and independent ability of the observation group were higher than the control group at 3 months after treatment(P<0.05). The levels of TXA2 and TXA2/PGI2 in the observation group were significantly lower than those in the control group at 3 months after treatment(P<0.05).The PGI2 level in the observation group was significantly higher than that in the control group at 3 months after treatment(P<0.05). Conclusion The use of sports representation training combined with occupational therapy in stroke patients with hemiplegia can help reduce the degree of neurological deficit, improve the upper limb, hand function and biochemical indicators, improve the quality of life of patients, and it is worthy of promotion and application.
引文
[1]张秀芳,高晓盟,赵娜,等.上肢康复机器人训练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,2016,38(3):180-182.
[2]时美芳,吴华,顾旭东,等.运动反馈结合减重平板训练对脑卒中偏瘫患者步态恢复的影响[J].中华物理医学与康复杂志,2016,38(8):612-614.
[3]Takahashi K,Domen K,Sakamoto T,et al.Efficacy of upper extremity robotic therapy in subacute poststroke hemiplegia:An exploratory randomized trial[J].Stroke,2016,47(5):1385-1388.
[4]王盛强,黄杰,高春华,等.运动想象疗法结合下肢康复机器人训练对脑卒中亚急性期偏瘫患者下肢运动功能的影响[J].中国康复医学杂志,2016,31(11):1230-1233.
[5]黄海云,彭生辉,周晶,等.手工训练对脑卒中偏瘫患者上肢及手功能影响的临床研究[J].中国康复医学杂志,2016,31(5):526-530.
[6]张有超,李斌,范录平,等.早期介入运动想象疗法对急性脑卒中偏瘫患者下肢运动功能及日常生活活动能力的影响[J].临床神经病学杂志,2016,29(4):296-298.
[7]付常喜,张秋阳.太极拳对脑卒中偏瘫患者平衡功能及步行能力的影响[J].中国康复医学杂志,2016,31(5):536-539.
[8]Zhang Y,Liu H,Wang L,et al.Relationship between functional connectivity and motor function assessment in stroke patients with hemiplegia:A resting-state functional MRI study[J].Neuroradiology,2016,58(5):503-511.
[9]陈瑞全,吴建贤,朱宗俊,等.悬吊运动疗法结合针刺夹脊穴对脑卒中偏瘫患者平衡功能的效果[J].中国康复理论与实践,2017,23(7):762-765.
[10]龙耀斌,曹锡忠.振动训练对脑卒中偏瘫患者下肢肌张力和运动功能的影响[J].中国康复医学杂志,2016,31(10):1099-1103.
[11]祝飞虹,吴赞杨,马振宇,等.核心稳定性训练结合肌电生物反馈对恢复脑卒中偏瘫患者上肢功能及日常生活活动能力的临床研究[J].中国现代医学杂志,2016,26(4):76-79.
[12]Yan R,Zhang Y,Lim J,et al.The effect and biomechanical mechanisms of intradermal needle for poststroke hemiplegia recovery:Study protocol for a randomized controlled pilot trial[J].Medicine,2018,97(16):e0448.
[13]马玉静,勾丽洁,王文清,等.镜像视觉反馈疗法对脑卒中后偏瘫患者上肢功能及其日常生活活动能力的影响[J].中华物理医学与康复杂志,2016,38(2):141-143.
[14]卢利萍,桑德春,季淑凤.下肢康复机器人训练对脑卒中偏瘫患者运动能力和日常生活活动能力的影响[J]中国康复理论与实践,2016,22(10):1200-1203.
[15]郑彭,黄国志,彭生辉.下肢康复机器人对改善脑卒中偏瘫患者下肢肌力及运动功能障碍的临床研究[J].中国康复医学杂志,2016,31(9):955-959.
[16]凌英,周楠,杨微.良姿位摆放结合运动表象训练在脑卒中卧床患者中的效果观察[J].四川医学,2016,37(3):352-354.
[17]范利,杨坚,张颖,等.等速肌力训练对偏瘫患者上肢运动功能恢复的影响[J].中国康复,2017,32(1):10-12.
[18]张春波,李灵玲.MOTOmed智能运动训练系统对脑卒中偏瘫患者上肢功能及日常生活活动能力的影响[J].中国冶金工业医学杂志,2017,34(2):225-226.
[19]王娟.上肢康复机器人训练对脑卒中后偏瘫患者上肢功能的影响[J].按摩与康复医学,2017,8(7):21-22.
[20]李元进,万裕萍.头针与上肢机器人联动疗法对脑卒中偏瘫上肢功能的影响[J].长江大学学报(自科版),2016,13(30):38-40.
[2]时美芳,吴华,顾旭东,等.运动反馈结合减重平板训练对脑卒中偏瘫患者步态恢复的影响[J].中华物理医学与康复杂志,2016,38(8):612-614.
[3]Takahashi K,Domen K,Sakamoto T,et al.Efficacy of upper extremity robotic therapy in subacute poststroke hemiplegia:An exploratory randomized trial[J].Stroke,2016,47(5):1385-1388.
[4]王盛强,黄杰,高春华,等.运动想象疗法结合下肢康复机器人训练对脑卒中亚急性期偏瘫患者下肢运动功能的影响[J].中国康复医学杂志,2016,31(11):1230-1233.
[5]黄海云,彭生辉,周晶,等.手工训练对脑卒中偏瘫患者上肢及手功能影响的临床研究[J].中国康复医学杂志,2016,31(5):526-530.
[6]张有超,李斌,范录平,等.早期介入运动想象疗法对急性脑卒中偏瘫患者下肢运动功能及日常生活活动能力的影响[J].临床神经病学杂志,2016,29(4):296-298.
[7]付常喜,张秋阳.太极拳对脑卒中偏瘫患者平衡功能及步行能力的影响[J].中国康复医学杂志,2016,31(5):536-539.
[8]Zhang Y,Liu H,Wang L,et al.Relationship between functional connectivity and motor function assessment in stroke patients with hemiplegia:A resting-state functional MRI study[J].Neuroradiology,2016,58(5):503-511.
[9]陈瑞全,吴建贤,朱宗俊,等.悬吊运动疗法结合针刺夹脊穴对脑卒中偏瘫患者平衡功能的效果[J].中国康复理论与实践,2017,23(7):762-765.
[10]龙耀斌,曹锡忠.振动训练对脑卒中偏瘫患者下肢肌张力和运动功能的影响[J].中国康复医学杂志,2016,31(10):1099-1103.
[11]祝飞虹,吴赞杨,马振宇,等.核心稳定性训练结合肌电生物反馈对恢复脑卒中偏瘫患者上肢功能及日常生活活动能力的临床研究[J].中国现代医学杂志,2016,26(4):76-79.
[12]Yan R,Zhang Y,Lim J,et al.The effect and biomechanical mechanisms of intradermal needle for poststroke hemiplegia recovery:Study protocol for a randomized controlled pilot trial[J].Medicine,2018,97(16):e0448.
[13]马玉静,勾丽洁,王文清,等.镜像视觉反馈疗法对脑卒中后偏瘫患者上肢功能及其日常生活活动能力的影响[J].中华物理医学与康复杂志,2016,38(2):141-143.
[14]卢利萍,桑德春,季淑凤.下肢康复机器人训练对脑卒中偏瘫患者运动能力和日常生活活动能力的影响[J]中国康复理论与实践,2016,22(10):1200-1203.
[15]郑彭,黄国志,彭生辉.下肢康复机器人对改善脑卒中偏瘫患者下肢肌力及运动功能障碍的临床研究[J].中国康复医学杂志,2016,31(9):955-959.
[16]凌英,周楠,杨微.良姿位摆放结合运动表象训练在脑卒中卧床患者中的效果观察[J].四川医学,2016,37(3):352-354.
[17]范利,杨坚,张颖,等.等速肌力训练对偏瘫患者上肢运动功能恢复的影响[J].中国康复,2017,32(1):10-12.
[18]张春波,李灵玲.MOTOmed智能运动训练系统对脑卒中偏瘫患者上肢功能及日常生活活动能力的影响[J].中国冶金工业医学杂志,2017,34(2):225-226.
[19]王娟.上肢康复机器人训练对脑卒中后偏瘫患者上肢功能的影响[J].按摩与康复医学,2017,8(7):21-22.
[20]李元进,万裕萍.头针与上肢机器人联动疗法对脑卒中偏瘫上肢功能的影响[J].长江大学学报(自科版),2016,13(30):38-40.