强制性使用运动疗法对脑梗死患者上肢运动模式和手功能的影响  

Effect of constraint-induced movement therapy on the recovery of upper-limb moving mode and hands′ function of patients with cerebral infarction

作　　者：王文清[1] 段一娜[2] 王宏卫[1] 谢睿智[1] 徐利[3] 冯晶晶[1] 方鑫洋[1] 姚艳华[1] 黄武[1] 刘亚梅[1] 

机构地区：[1]承德医学院附属医院康复医学科,承德067000 [2]承德医学院预防医学教研室 [3]北京中国人民解放军62301部队门诊部

出　　处：《中国康复医学杂志》2008年第3期228-231,共4页Chinese Journal of Rehabilitation Medicine

基　　金：河北省承德市科学技术局立项课题(200721051)

摘　　要：目的:观察强制性使用运动疗法(CIMT)对脑梗死患者上肢运动模式和手功能恢复的康复疗效。方法:将符合入选条件的36例脑梗死患者随机分为对照组(n=18例)和干预组(n=18例)。对照组采用常规Bobath方法为主,配合Rood法、Brunnstrom促进法,进行上肢和手功能训练,2h/d,5次/周,连续2周。干预组采用强制性使用运动疗法治疗:限制健侧肢体动作,在治疗期间要求患者穿戴吊带和夹板一整天,每天清醒时固定时间不少于90%,根据制定的塑形任务进行患侧肢体的反复训练,6h/d,5次/周,连续2周。结果:CIMT患者治疗后FMA的各项评分较治疗前均有显著提高,差异有显著性意义(P<0.05),治疗后两组间反射活动和协调能力与速度评分差异无显著性意义(P>0.05),其他4部分的评分差异具有显著性意义(P<0.01)。干预组治疗后简介上肢功能STEF评分较治疗前均有显著提高,差异有显著性意义(P<0.05),两组间的治疗前后评分差值比较差异有显著性意义(P<0.01)。结论:CIMT可以在短期内改善脑梗死患者上肢运动模式和提高手的精细动作和运动速度,其疗效明显优于常规康复治疗方法。Objective：To observe curative effect of constraint-induced movement therapy （CIMT） on the recovery of upper-limb moving mode and hands＇ function of patients with cerebral infarction.Method：Thirty-six patients with cerebral infarction were randomly divided into contrast group （n=18） and interference group （n=18）. Techniques of Bobath,Rood and Brunnstrom were adopted by contrast group in upper-limb and hands＇ functional exercises, 2h/d, five times a week, continuous for two weeks. CIMT was adopted by interference group, involving restriction of movement of the intact upper extremity by placing it in a sling for 90% of waking in a whole day and simultaneously training （by shaping） the affected upper extremity for 6h/d, five times a week, continuous for two weeks. Result：After treatment, the assessment of FMA in two groups were all better than before, the differences were very obvious （P〈0.05）. Between the two groups, the differences of reflection activity, coordinated function and velocity were not significant（P〉0.05）;the differences of the other 4 items of scale were very significant（P〈0.01）. In interference group post-treatment, scores of STEF were better than pre-treatment （P〈0.05）.Comparing the scores of the two groups between pre-treatment and post-treatment the differences were very significant（P〈0.01）. Conclusion： CIMT is an effective therapy in improving the upper limb motor mode and hands＇ function （fine action and movement velocity） of patients with cerebral infarction in short time （within two weeks）.

关 键 词：强制性使用运动疗法 脑梗死 上肢 运动模式 手功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]