改制强制性运动疗法对脑卒中上肢运动功能的影响  

Effect of Modified Constraint-induced Movement Therapy for Motor Function of Upper Extremity after Stroke

作　　者：秦茵[1] 毕胜[2] 李玲[3] 瓮长水[2] 

机构地区：[1]南京军区福州总医院中医理疗科,福建福州市350025 [2]解放军总医院,北京市100853 [3]解放军总医院第一附属医院康复理疗科,北京市100037

出　　处：《中国康复理论与实践》2010年第4期367-369,共3页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的研究改制的强制性运动疗法(mCIMT)对脑卒中偏瘫患者上肢运动功能障碍的疗效。方法选取脑卒中偏瘫患者30例,分成mCIMT组和对照组,每组15例。mCIMT组不限制健手的使用,患肢接受重复、密集的行为再塑的技术强化训练,6h/d,5d/周,连续训练2周。对照组采用常规治疗方法进行训练。疗效评测使用运动活动日志(MAL)和简易上肢功能检查(STEF),分别于治疗前、治疗后2周、1个月和3个月进行疗效评定。结果两组治疗2周后MAL指数和STEF分数均明显高于治疗前(P<0.01);mCIMT组在治疗结束1个月和3个月的MAL指数和STEF分数较治疗前均明显提高(P<0.01);治疗组与对照组疗效比较有显著性差异(P<0.05);对照组治疗后1和3个月的MAL指数和STEF分数与治疗前比较均无显著性差异(P>0.05)。结论mCIMT能显著提高脑卒中偏瘫患者的上肢运动功能,其疗效明显优于常规康复方法。Objective To investigate the therapeutic effects of modified constraint-induced movememt therapy（mCIMT） on upper extremity motor function of stroke patients with hemiparasis,and to compare the effects of mCIMT with those of conventional rehabilitation.Methods Thirty stroke patients with hemiparesis were divided into mCIMT group and control group （conventional rehabilitalion）,15 cases in each group. The mCIMT group received mCIMT （by shaping） in the affected extremity without restriction of movement of intact upper extremity,6 h a day,five times a week,for two weeks while the control group was treated with traditional rehabilitation in upper-limb and hands functional exercises. Motor activity logs（MAL） score and simple test for evaluating hand function（STEF ） score were measured in two groups before treatment and 2 weeks,1 month and 3 months after treatment.Results There were improvement in MAL and STEF scores in both mCIMT group and control group 2 weeks after treatment compared with pre-treatment（P〈0.01）,and the scores of MAL and STEF on post-treatment 1 month and 3 months were higher than those of pre-treatment in mCIMT group （P〈0.05,P〈0.01）,but there was no significant difference in MAL and STEF score between pre-treatment and post-treatment 1 month and 3 months in control group（P〈0.05）.Conclusion Significant improvement in the affected hand function could be achieved with modified constraint-induced movement therapy in stroke patients,better than conventional rehabilitation therapy.

关 键 词：改制的强制性运动疗法 脑卒中 上肢 功能 

分 类 号：R743[医药卫生—神经病学与精神病学]