强化运动想象疗法对脑卒中偏瘫患者上肢功能恢复的影响  

Effects of intensive motor mental practice on the recovery of upper limb function in hemiplegic patients afterstroke

作　　者：张婷婷[1] 王强[1] 孟萍萍[1] 王玉华[1] 

机构地区：[1]青岛大学医学院附属医院康复医学科,山东266003

出　　处：《中华物理医学与康复杂志》2013年第2期115-118,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的探讨强化运动想象疗法对脑卒中偏瘫患者上肢运动功能恢复的影响。方法选择符合人组标准的39例脑卒中偏瘫患者，采用随机数字表法随机分为强化训练组、常规训练组和对照组，每组13例。3组患者均进行常规康复训练，每日1次，每次40rain，每周5次。在此基础上，常规训练组每日联合1次运动想象治疗，每次30rain；强化训练组每日联合2次运动想象治疗，每次30rain；对照组只给予运动想象的背景音乐，每日1次，每次30rain。应用Fugl-Meyer评分法（FMA）和上肢动作研究测试（ARAT）分别于治疗前及治疗后2、4和6周进行评定和比较。结果强化训练组、常规训练组和对照组治疗前的FMA评分分别为（10．36±2．11）、（7．73±5．21）和（8．36±4．11）分，各组ARAT评分分别为（1．56±2．33）、（1．33±1．58）和（1．33±1．58）分；治疗2周后，3组患者的FMA和ARAT评分均有所提高，但组间同期比较，差异均无统计学意义（P〉0．05）。治疗4周后，强化训练组的FMA评分明显高于常规训练组和对照组（P〈0．05）；常规训练组的FMA评分明显高于对照组（P〈0．05）；强化训练组ARAT评分明显高于对照组（P〈0．05）；而强化训练组与常规训练组以及常规训练组与对照组的ARAT评分同期组间比较，差异均无统计学意义（P〉0．05）。治疗6周后，强化训练组和常规训练组的FMA和ARAT评分分别明显高于对照组（P〈0．05）；强化训练组的FMA和ARAT评分亦分别明显高于常规训练组（P〈0．05）；治疗6周后，强化训练组、常规训练组和对照组患者的FMA和ARAT评分均明显提高，各组患者治疗后的FMA评分分别为（28．00±5．46）、（21．55±9．60）和（15．18±9．60）分，ARAT评分分别为（11．67±1．66）、（9．00±1．80）和（6．33±3．97）分，与治疗前组内比较，差异均有统计学意义（P〈0�Objective To investigate the effects of intensive motor mental practice （MP） on the recovery of upper limb function in hemiplegic stroke patients. Methods Thirty-nine stroke patients were randomly divided into an intensive group, a conventional group and a control group （13 cases in each group）. All received regular rehabilita- tion therapy for 6 weeks （40 rain a day, 5 d a week）. In the following 6 weeks, patients in the intensive and conven- tional groups received MP-twice a day for the intensive group and once a day for the conventional group. The patients in the control group instead listened to music daily. Motor function was assessed using the Fugl-Meycr assessment （FMA） and the action research arm test （ARAT） , which were carried out before treatment and after 2, 4 and 6 weeks of treat- ment. Results There was no significant difference in FMA or ARAT scores among the 3 groups after 2 weeks of ther- apy. After four weeks FMA improvement was significantly greater in the intensive group than in the conventional or con- trol group. There were also significant differences in FMA between the conventional and control groups. ARAT score improvement was significantly better in the intensive group than in the control group, but there was no significant differ- ence in ARAT results between the conventional and control groups. After 6 weeks FMA and ARAT scores had improved significantly more in the intensive and conventional groups than that in the control group. There were also significant differences in FMA and ARAT scores between conventional and control groups. Conclusion Intensive motor mental practice can improve the upper limb motor function of stroke patients more effectively than less aggressive treatment.

关 键 词：强化运动想象疗法 脑卒中 偏瘫 上肢 

分 类 号：R743.3[医药卫生—神经病学与精神病学]