动作观察疗法对恢复期脑梗死患者上肢运动功能及运动诱发电位的影响  

Effects of action observation therapy on motor function of upper extremity and motor evoked potential of recovery period cerebral infarction patients

作　　者：曾明[1] 沈芳[1] 朱美红[1] 王晶 崔尧[3] 傅建明[1] 顾旭东[1] 姚云海[1] 王春苑[1] 时美芳[1] 孙亚[1] ZENG Ming;SHEN Fang;ZHU Meihong;et al(The Second Hospital of Jiaxing Rehabilitation Medical Center, Jiaxing,Zhejiang 314000)

机构地区：[1]浙江省嘉兴市第二医院、嘉兴学院附属第二医院,浙江省314000 [2]北京泰康燕园康复医院 [3]中国康复研究中心、北京博爱医院、首都医科大学康复医学院

出　　处：《中国康复医学杂志》2018年第4期419-423,共5页Chinese Journal of Rehabilitation Medicine

基　　金：浙江省嘉兴市科技计划项目(2014AY21031-9)

摘　　要：目的:探讨基于镜像神经元理论的动作观察疗法对恢复期脑梗死患者上肢运动功能恢复及运动诱发电位的影响。方法:将53例恢复期脑梗死患者按随机数字表法分为观察组(28例)和对照组(25例)。对照组在常规康复治疗的基础上,观看不同的几何图案及数字符号,然后模仿特定动作;观察组则在常规康复治疗的基础上,采用动作观察疗法,每周6次,每次20min,共治疗8周。分别于治疗前、治疗8周后对2组患者采用上肢Fugl-Meyer运动功能评分法(FMA)、Wolf运动功能测试(WMFT)及改良Barthel指数(MBI)进行测量以评定患者的上肢运动功能及日常生活活动能力。采用诱发电位仪分别刺激患侧大脑皮质M1区、第7颈椎棘突刺激,在拇短展肌记录运动诱发电位(MEP)。结果:治疗前2组患者各项评价指标评定差异无显著性意义(P>0.05);治疗8周后,两组患者上述指标较治疗前均有所改善(P<0.05),且与对照组相比,观察组的FMA评分(42.32±12.56)、WMFT评分(51.57±11.45)、MBI评分(73.57±10.17),MEP的潜伏期(22.69±2.11)ms、波幅(1.25±0.38)mV、中枢运动传导时间(10.12±1.46)ms的改善程度较对照组显著(P<0.05)。结论:基于镜像神经元理论的运动观察疗法可改善恢复期脑梗死后中枢神经运动传导功能,改善上肢运动功能,提高日常生活活动能力。Objective： To explore the effects of action observation therapy on motor function of upper-extremity activities and motor evoked potential of recovery period cerebral infarction patients. Method： Fifty-three recovery period cerebral infarction survivors were randomly assigned to observation group （28 patients） or control group （25 patients）. The conventional rehabilitation treatments were applied in both groups. In addition,the control group looked at different geometric patterns and digital symbols, and then imitated specific actions, but the observation group received the action observation therapy for 8 weeks, 6 times per week, 20 minutes per day. Both groups were assessed by Fugl-Meyer assessment （FMA）, Wolf motor function test （WMFT）, Modified Barthel index （MBI）, the latency, amplitude and central motor conduction of motor evoked potential （MEP） on affected side before and 8 weeks after treatment. Result：After 8 weeks treatment, all assessment in both group significantly improved than those before. But all parameters in observation group improved more than those in control group. Conclusion： The action observation therapy can improve the motor conduction function of central nervous system, the motor function of upper extremity, and activities of daily living in recovery period of stroke patients.

关 键 词：动作观察疗法 镜像神经元系统 脑梗死 上肢运动功能 运动诱发电位 

分 类 号：R741[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]