运动再学习方法的新进展  

Advance in motor relearning programme

作　　者：黄永禧[1] 徐本华[1] 黄真[1] 

机构地区：[1]北京大学第一医院物理医学康复科,北京100034

出　　处：《中国康复理论与实践》2000年第3期97-101,共5页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：本文对澳大利亚学者J .Carr和R .Shepherd的《中风病人运动再学习方案》作了简单介绍 ,并着重介绍此法的新进展———关于上运动神经元损害 (uppermotorneuronlesion ,UMNL)综合征的新见解和临床对策。Carr等提出 ,UMNL发生后除表现出阴性特征 (无力、丧失灵巧性等 )和阳性特征 (反射亢进、异常或痉挛性运动模式等 )外 ,还有适应特征 ,即神经系统、肌肉和其它软组织的适应性改变和适应性运动行为 ;并指出肌肉无力、废用和制动可引起软组织的特性改变 ,造成肌肉萎缩、挛缩、僵硬和张力过高等。因此 ,对脑卒中患者必须提倡早期康复、主动活动。作者认为 ,上述继发适应特征的提出具有重要意义。首先 ,要对废用综合征有足够的重视 ;其次 ,阴性特征是形成适应特征的重要条件和恢复功能的主要障碍。所以 ,对误用综合征要有全面、正确的认识 ,在强调纠正偏瘫患者的异常运动模式时 ,不要忽视正确地进行肌力和耐力等训练的重要性。The purpose of this paper is to introduce the advance of J.Carr and R. Shepherd's A Motor Relearning Programme for Stroke. In the neurosciences, it has been typical to consider the dyscontrol characteristics associated with the upper motor neuron syndrome as positive features and negative features for a long time. Recently Dr. Carr and Dr. Shepherd have proposed another group of characteristics which they call adaptive features, since it appears likely that adaptive changes to neural system, muscles and other soft tissues and adaptive motor behaviors underline some clinical signs. They point out that early rehabilitation and active life should be arranged for the stroke patient. It is the author's suggestion that we should pay more attention to the “disuse syndrome”in training of the stroke patient according to the adaptive features, and we should understand the “misuse syndrome” correctly and we should not neglect to train the muscle strength in correcting the patient's abnormal movement pattern, since the negative features are major reasons for functional disability, together with the adaptive changes that occur in soft tissues as a result of denervation, immobility and disuse.

关 键 词：脑卒中 适应特征 废用综合征 早期康复 

分 类 号：R49[医药卫生—康复医学]