改良强制性使用运动疗法对急性期脑卒中患者上肢功能的影响  

Impacts of the Modified Constraint-Induced Movement Therapy on the Upper Limb Function in Acute Cerebral Apoplexy

作　　者：章志超[1] 杨万同[2] 廖维靖[2] 刘琦[1] 

机构地区：[1]武汉市第一医院,湖北武汉430022 [2]武汉大学附属中南医院,湖北武汉430071

出　　处：《世界中西医结合杂志》2011年第1期41-44,共4页World Journal of Integrated Traditional and Western Medicine

摘　　要：目的观察改良强制性使用运动疗法（CIMT）对急性期脑卒中偏瘫患者上肢功能的康复疗效。方法选择自2009年4月~2010年2月住院的急性期脑卒中伴上肢功能障碍患者25例,随机分为改良强制性使用运动治疗组（改良组,13例）及常规康复治疗组（常规组,12例）。改良组给予改良强制性使用运动疗法治疗,仅在治疗时间内给予健侧上肢配带限制性手套限制,同时给予集中强化的塑形训练;常规组给予主被动关节活动、神经发育疗法及功能性电刺激等治疗,两组均每天治疗4 h,每周5 d,连续2周。两组在治疗前后采用简式Fugl-M eyer运动评价表（FMA）、上肢动作研究量表（ARAT）及改良Barthel指数（MB I）进行评分。结果常规组治疗后FMA、ARAT及MB I评分较治疗前有明显提高（P〈0.05或P〈0.01）,改良组治疗后ARAT、FMA及MB I评分较治疗前显著提高（P〈0.01）;改良组治疗后各项评分较常规组明显提高（P〈0.05）。结论改良强制性使用运动疗法对急性期脑卒中患者上肢功能恢复具有积极的治疗作用,可提高患者偏瘫上肢运动功能,改善日常生活活动能力,提高生活质量。Objective To observe the rehabilitation therapy of modified constraint-induced movement therapy（CIMT）on the upper limb function in the patients of hemiplegia due to cerebral apoplexy in acute stage.Methods 25 inpatients of cerebral apoplexy in acute stage combined with upper limb function disturbance were selected from April 2009 to February 2010,which were randomized into modified CIMT group（13 cases）and conventional rehabilitation group（conventional group,12 cases）.The modified CIMT was adopted in modified CIMT group,in which,the constraint glove was used on the healthy upper limb during treatment,simultaneously,the concentrated intensive plastic training was provided.The treatment lasted 4h each day,totally 5 days each week,for 2 weeks continuously.In conventional group,positive and negative joint movements,neurodevelopmental therapy and functional electrical stimulation were adopted.Before and after treatment,the simple Fugl-Meyer Assessment（FMA）,Action Research Arm Test（ARAT and Modified Barthel Index（MBI）were used for the assessment in each group.Results In conventional group,the scores in FMA,ARAT and MBI after treatment were improved apparently as compared with those before treatment（P〈0.05 or P〈0.01）.In modified CIMT group,after treatment,ARAT,FMA and MBI scores were improved significantly（P〈0.01）.The score of every item after treatment in modified CIMT group was improved obviously as compared with conventional group（P〈0.05）.Conclusion The modified CIMT plays the active role in the recovery of the upper limb function in the patients with cerebral apoplexy in acute stage,which can improve the affected upper limb function,daily life activity and life quality of hemiplegia patients.

关 键 词：改良强制性使用运动疗法 脑卒中 上肢功能 康复 

分 类 号：R651.205[医药卫生—外科学]