太极拳“云手”运动想象疗法对脑卒中偏瘫患者手功能恢复的影响  

Effects of Taijiquan “yunshou” action motor imagery on hand motor function in hemiplegic patients after stroke

作　　者：章惠英[1] 王燕[1] 章雅青[1] 蒋旭侃 袁晓玲[1] 帕孜力亚[1] 

机构地区：[1]上海交通大学护理学院,200025 [2]上海交通大学医学院附属瑞金医院康复科,200025

出　　处：《中华现代护理杂志》2014年第26期3297-3301,共5页Chinese Journal of Modern Nursing

基　　金：2012年度上海交通大学医学院护理学科重点项目（JYHZ1201）

摘　　要：目的：探讨太极拳“云手”运动想象疗法对脑卒中偏瘫患者手功能恢复的影响。方法选择2012年10月-2013年3月在上海市某三甲医院康复科住院的符合入选标准的32例脑卒中偏瘫患者，运用交叉对照设计方法随机分为A组（16例）和B组（16例）。第1-3周A组进行常规康复训练和太极拳“云手”运动想象疗法相结合的训练、B组仅进行常规康复训练。第4-5周A、B两组均不进行正规的运动想象疗法及常规康复训练，称为洗脱期。第6-8周A组仅进行常规康复训练、B组进行常规康复训练结合太极拳“云手”运动想象疗法的训练。实验前和实验后第3，5，8周时均用Fugl-Meyer运动功能量表（FMA）、改良的Barthel指数（MBI）和偏瘫上肢功能测试（香港版）（FTHUE-HK）对两组患者上肢以及手的精细功能进行评定。结果 A、B两组患者治疗前FMA、MBI和FTHUE-HK评分差异无统计学意义（P＞0．05）。每阶段结束后A、B两组的以上各项评分较实验前均有改善（P＜0．01）；B组FMA评分在8周末时为（50．31±7．69）分，明显高于A组（42．50±10．09）分，差异有统计学意义（t＝-2．46， P＜0．05）；A组MBI评分在3周末为（24．69±2．87）分，明显高于B组（20．63±3．10）分，差异有统计学意义（t＝3．85，P＜0．01）；B组FTHUE-HK评分在5周末和8周末时均高于A组，差异有统计学意义（t分别为-2．14，-4．40；P＜0．05）。结论在常规训练的基础上，随干预时间的延长，太极拳“云手”运动想象疗法有助于脑卒中偏瘫患者手功能的恢复，提高康复训练的效果。Objective To study the effect of Taijiquan “yunshou” action motor imagery on hand motor function in hemiplegic patients after stroke .Methods From October 2012 to March 2013, 32 hospitalized hemiplegic stroke patients met the inclusion criteria in rehabilitation ward of a hospital in Shanghai were randomly divided into group A and group B .At the first of 1 -3 weeks, group A were treated routine rehabilitation training and Taijiquan “yunshou” action motor imagery therapy , group B were treated only routine rehabilitation training .At the 4-5 weeks , both of the groups haven＆#39;t got the regular motor imagery therapy and routine rehabilitation training , known as the washout period .At the last of 6-8 weeks, group A were treated only routine rehabilitation training , group B were treated routine rehabilitation training and Taijiquan “yunshou”action motor imagery therapy .Patients were assessed with Fugl-Meyer Motor Assessment （ FMA） , Modified Barthel Index（MBI） and Hong Kong Edition of Functional Test for the Hemiplegic Upper Extremity Scale （FTHUE-HK） before the experiment, 3 weeks, 5 weeks and 8 weeks after rehabilitation therapy.Results Before the experiment , the differences between the A , B groups from scores of the FMA , MBI and FTHUE-HK were not statistically significant （P〉0.05）, while both of the groups had a significant improvement after the end of each stage than before the experiment （P〈0.01）.FMA score of group B at the 8 weeks was significantly higher than that of group A[（50.31 ±7.69） vs （42.50 ±10.09）;t=-2.46,P〈0.05].The MBI score was significantly higher in group A than B at the 3 weeks [（24.69 ±2.87）vs（20.63 ±3.10）,t=3.85,P〈0.01].The score of FTHUE-HK of group B was significantly higher than that of group A at the 3,8 weeks （t=-2.14,-4.40,respectively;P 〈0.05）.Conclusions With the time extend, the outcomes suggested that on the basic of routine rehabilitation training , Taijiquan “yunshou” action motor imagery therapy is ve

关 键 词：脑卒中 偏瘫 太极拳 运动想象 手功能 康复训练 

分 类 号：R248.9[医药卫生—中医临床基础]