强制性使用运动疗法对脑卒中偏瘫患者上肢功能恢复的影响  

The effects of constraint-induced movement therapy on upper extremity function in stroke patients

作　　者：王刚[1] 张德清[1] 何建永[1] 徐玉华[1] 刘智权[1] 李东冬[1] 

机构地区：[1]湖北十堰郧阳医学院附属人民医院康复医学科,十堰442000

出　　处：《中华物理医学与康复杂志》2008年第7期470-473,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的观察强制性使用运动疗法（CIMT）对亚急性期脑卒中偏瘫患者上肢功能恢复的影响。方法将60例脑卒中偏瘫患者分为治疗组（n=30）和对照组（n=30），进行6周的康复治疗。2组患者均先进行常规康复训练，每日1次，每次45～60min，每周训练6次。4周后治疗组改用CIMT治疗2周，对照组治疗保持不变。采用Fugl-Meyer运动量表（FMA）、上肢功能测验（UEFT）、简易上肢机能检查（STEF）和改良Barthel指数（MBI），于治疗前、治疗4周和6周后，以及治疗结束后1个月和3个月评定2组患者的上肢运动功能和日常生活活动能力，并进行比较。结果2组治疗后不同时间段的上肢、腕和手FMA、UEFT、STEF和MBI评分与治疗前比较，差异均有统计学意义（P〈0．05）；治疗组治疗6周后及随访期间的UEFT、STEF和MBI评分与对照组比较，差异有统计学意义（P〈0．05），提示其功能改善更显著，且疗效持续至随访期。结论CIMT可促进亚急性期脑卒中偏瘫患者上肢功能的恢复，其疗效优于常规康复训练。Objective To study the effects of constraint-induced movement therapy （CIMT） on upper extremity functional performance in sub-acute stroke patients. Methods Sixty stroke survivors were divided into a treatment group （n = 30） and a control group （n = 30）. The treatment group received routine rehabilitation training for 4 weeks, followed by CIMT for two weeks; the control group received only routine rehabilitation training for six weeks. The FuglMeyer Assessment （FMA）, upper extremity function test （UEFT）, simple test for evaluating hand function （STEF） and modified Barthel Index （MBI） were used to assess motor function in the patients＇ upper extremities and their performance in the activities of daily living （ADL） before treatment, at the end of 4 and 6 weeks of treatment, and 1 and 3 months after the end of the 6-week treatment. Results After six weeks of treatment, the patients in both groups were significantly improved in terms of FMA, UEFT, STEF and MBI scores compared with their results got before treat- ment, and the treatment group scored significantly higher on the UEFT, STEF and MBI scales compared with the control group. Conclusion CIMT can effectively improve upper extremity motor function and the ADL performance of patients with sub-acute stroke. Its effectiveness is superior to that of routine rehabilitation training.

关 键 词：强制性使用运动疗法 脑卒中 上肢 

分 类 号：R743.3[医药卫生—神经病学与精神病学]