运动想象疗法对脑卒中偏瘫患者步行能力的影响  

The effect of motor imagery therapy on walking ability in patients with post-stroke hemiplegia

作　　者：王鹂[1] 马朝阳[1] 游菲[1] 熊修安[1] 万文俊[1] 王颖[1] 张婷[1] 

机构地区：[1]武汉市中心医院康复科,武汉430014

出　　处：《中华物理医学与康复杂志》2014年第5期353-356,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的观察常规康复治疗联合运动想象疗法对脑卒中偏瘫患者步行能力的影响。方法采用随机数字表法将80例脑卒中偏瘫患者分为治疗组（40例）及对照组（40例）。2组患者均给予对症药物治疗及常规康复干预，治疗组在此基础上辅以运动想象疗法。于治疗前、治疗6周后对2组患者10m最快步行速度（10mMWS）、跨步长、步频进行检测，同时采用Fugl—Meyer运动功能量表（FMA）下肢部分、Holden步行功能分级（FAC）对2组患者步行功能进行评定。结果治疗前2组患者各项指标组间差异均无统计学意义（P〉0．05）。分别经6周治疗后，发现2组患者各项指标均较治疗前明显改善（P〈0．05），并且治疗组各项指标[该组10InMWS为（0．53±0．20）m／s，跨步长为（78．91±20．46）em，步频为（78．10±12．03）步／分钟，FMA下肢评分为（24．13±5．77）分，FAC分级为（3．60±1．01）分]改善幅度均显著优于对照组水平[该组10mMWS为（0．42±0．15）m／s，跨步长为（69．75±18．31）cm，步频为（71．14±9．29）步／分钟，FMA下肢评分为（20．65±4．70）分，FAC分级为（2．93±0．89）分]，组间差异均具有统计学意义（P〈0．05）。结论常规康复干预联合运动想象疗法可进一步提高脑卒中偏瘫患者步行能力，该联合疗法值得临床推广、应用。Objective To study the effect of motor imagery therapy combined with conventional rehabilita- tion treatment on walking ability in patients with post-stroke hemiplegia. Methods Eighty patients with post-stroke hemiplegia were randomly divided into a treatment group （40 cases） and a control group （40 cases）. All the patients in both groups were given basic medication and conventional rehabilitation treatment. In addition, the patients in treatment group were given motor imagery therapy. The 10 m maximum walking speed （10 m MWS） , stride length, cadence, Fugl-Meyer motor assessment （lower limb） （FMA-L） and Holden＇s functional ambulation classification （FAC） were used to evaluate walking ability before the beginning of training and at the end of six weeks of training. Results Before intervention there was no significant difference between the two groups in terms of all the assessment （P 〉0.05）. At the end of training, all measurements in both groupsE the treatment group： 10 m MWS （0.53 ±0.20）m/s,stride length （78.91 ± 20. 46 ） cm, cadence （78. 10±12.03）min, FMA-L （24. 13±5.77）,FAC （3.60±1.01）;the control group： 10 m MWS （0.42±0. 15）m/s,stride length （69.75 ± 18. 31）cm,cadence （71.14 ±9.29）/min, FMA-L （20.65± 4.70）, FAC （2.93 ±0.89） ] were significantly better than those before training （P 〈 0.05） , and the improvements in treatment group were significantly better than those in control group （P 〈0.05）. Conclusion Motor imagery therapy combined with conventional rehabilitation treatment can distinctly improve the walking ability in patients with post-stroke hemiplegia.

关 键 词：运动想象疗法 脑卒中 步行能力 

分 类 号：R743.3[医药卫生—神经病学与精神病学]