运动想象疗法联合第三代功能性电刺激术对急性缺血性卒中患者上肢运动功能的影响  

Effects of motor imagery combined with functional electrical stimulation on upper limb motor function of patients with acute ischemic stroke

作　　者：刘首峰[1] 高春林[1] 汪皖君[1] 于长申[1] 王新平[1] 巫嘉陵[1] 

机构地区：[1]天津市环湖医院神经内科,300060

出　　处：《中国现代神经疾病杂志》2015年第3期209-213,共5页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：天津市卫生局科技攻关项目(项目编号:2013KG122);天津市科技支撑重点项目(项目编号:13ZCZDSY01600)~~

摘　　要：目的探讨运动想象疗法联合第3代功能性电刺激术对急性缺血性卒中偏瘫患者上肢运动功能的改善作用。方法共40例急性缺血性卒中患者于发病后48 h内随机接受第3代功能性电刺激术(FES组)或联合运动想象疗法(联合治疗组),2周后采用简化Fugl-Meyer运动功能评价量表(FMA)和上肢动作研究测验量表(ARAT)评价上肢运动功能、量角器测量腕关节背伸活动范围。结果与治疗前相比,两组患者治疗2周后FMA、ARAT评分和腕关节背伸活动范围均改善(P=0.000),联合治疗组患者FMA评分(t=-2.528,P=0.016)、ARAT评分(t=-2.562,P=0.014)和腕关节背伸活动范围(t=-2.469,P=0.018)改善程度均优于FES组;且治疗方法与观察时间点之间存在交互作用(均P<0.05)。结论运动想象疗法联合第3代功能性电刺激术对改善急性缺血性卒中患者上肢运动功和腕关节背伸活动范围有较好疗效。Objective To explore the effects of motor imagery(MI) combined with the third generation functional electrical stimulation(FES) on upper limb motor function in acute ischemic stroke patients with hemiplegia.Methods Forty acute ischemic stroke patients,within 48 h of onset,were randomly divided into FES group(N = 20) and combination group(FES combined with motor imagery,N =20).All patients received basic routine rehabilitation training,for example,good limb positioning,accepting braces,balance training and training in the activities of daily living(ADL).FES group received the third generation FES therapy and the combination group also received motor imagery for 2 weeks.All of the patients were assessed with Fugl-Meyer Assessment(FMA),Action Research Arm Test(ARAT) and active range of motion(AROM) of wrist dorsiflexion before and after 2 weeks of treatment.Results After2 weeks of treatment,the 2 groups had significantly higher FMA score,ARAT score and AROM of wrist dorsiflexion than that in pre-treatment(P = 0.000,for all).Besides,the FMA score(t =- 2.528,P = 0.016),ARAT score(t =- 2.562,P = 0.014) and AROM of wrist dorsiflexion(t =- 2.469,P = 0.018) in the combination group were significantly higher than that in the FES group.There were interactions of treatment methods with observation time points(P 0.05,for all).Conclusions Motor imagery combined with the third generation FES can effectively promote the recovery of upper limb motor function and motion range of wrist dorsiflexion in patients with acute ischemic stroke.

关 键 词：卒中 运动障碍 上肢 运动疗法 电刺激疗法 康复 

分 类 号：R743.3[医药卫生—神经病学与精神病学]