采用任务导向性训练及反复刺激治疗严重上肢瘫痪患者  

Management of severe upper extremity deficits by task-oriented training combined with repeated stimulation

作　　者：汤清平[1] 詹海兰[1] 欧阳春红[1] 冯建宏[1] 周权[1] 

机构地区：[1]湖南省脑科医院康复科,湖南长沙410007

出　　处：《中国现代医学杂志》2011年第19期2305-2308,2311,共5页China Journal of Modern Medicine

基　　金：国家自然科学基金(No:30973167)

摘　　要：目的探讨重复易化任务导向性训练配合反复刺激对严重上肢功能受损脑卒中患者上肢功能的影响。方法 30例有严重上肢功能障碍的脑卒中患者,根据年龄分层随机将患者分成3个康复治疗组:神经促进技术(NDT)组11例,重复易化任务导向性训练(ROT)组9例,重复易化任务导向性训练配合反复刺激(ROT+RS)组10例。采用Fugl-Meyer上肢功能评定表评价治疗前后运动功能。结果重复测量方差分析(RM ANOVA)显示Fugl-Meyer总分、手、腕、协调性及速度的功能评分3组之间差异有显著性,进一步两两比较提示(ROT+RS)组手、腕、协调性及速度评分高于ROT组和NDT组,(ROT+RS)组上肢功能总分高于NDT组。肩/肘/前臂评分3组之间差异无显著性。结论重复易化任务导向性训练配合反复刺激能显著改善严重上肢受损脑卒中患者的上肢运动功能,特别是手、腕、上肢运动的协调性和速度。【Objective】 To explore the influences of the repeated eased task-oriented training（ROT） combined with repeated stimulation（RS） on upper limb ability for the stroke survivors with severe upper limb deficits.【Methods】 Stratified randomized sampling based on the age was used to assign the subjects to 3 rehabilitation groups： neurodevelopmental treatment（NDT）,repeated eased task-oriented training（ROT）,and repeated eased task-oriented training combined with repeated stimulation（ROT＋RS）.Fugl-Meyer Upper Extremity assessment was applied to evaluate the upper limb ability.【Results】 Repeated measures analysis of variance（RM ANOVA） showed that significant differences of overall score of upper extremities,the domains of hand,wrist,coordination and speed were found between 3 groups.LSD indicated that the scores of the hand,wrist,coordination and speed of the subjects in（ROT＋RS） were higher those of subjects in the NDT group and ROT group after interventions.And the total scores of the upper limb of the subjects in（ROT＋RS） group were higher than those of subjects in the NDT group.However,the domain of the shoulder/ elbow/ forearm was not significantly different among groups.【Conclusions】 These findings demonstrated that ROT combined with RS is valuable to improve the motor ability of the upper limbs for stroke survivors with severe upper limb deficits,especially for the ability of hand,wrist,coordination and speed.

关 键 词：脑卒中 任务导向性训练 反复刺激 上肢 运动功能 

分 类 号：R493[医药卫生—康复医学] R743[医药卫生—临床医学]