基于镜像神经元理论的视觉反馈训练在脑卒中患者上肢功能重建中的应用  

Application of visual feedback training based on mirror neuron theory in upper limb function reconstruction in stroke patients

作　　者：朱美红 时美芳 曾明 沈芳 王爱娟 陈晓燕 王佳玲 Zhu Meihong;Shi Meifang;Zeng Ming;Shen Fang;Wang Aijuan;Chen Xiaoyan;Wang Jialing(Rehabilitation Medical Center,the Second Hospital of Jiaxing,Zhejiang Province,Jiaxing 314000,China)

机构地区：[1]浙江省嘉兴市第二医院康复医学中心,314000

出　　处：《中华现代护理杂志》2020年第6期749-753,共5页Chinese Journal of Modern Nursing

基　　金：浙江省医药卫生科技计划(2018ZH044);浙江省自然科学基金(LQ19H170001);嘉兴市护理创新学科建设规划资助项目(2019-SC-013);嘉兴市中医药重点学科建设计划资助项目(2019年XK-A07)。

摘　　要：目的探讨基于镜像神经元理论的视觉反馈训练对脑卒中患者上肢功能重建的影响。方法采用便利抽样法,选取2017年6月—2018年6月在嘉兴市第二医院康复医学中心住院治疗的脑卒中患者61例为研究对象,按随机数字表法分为观察组(31例)和对照组(30例)。两组患者均采用常规的康复治疗,观察组在对照组基础上辅以视觉反馈训练。分别于康复干预前、干预8周后比较两组患者Barthel指数、Fugl-Meyer运动功能量表(FMA)(上肢部分)评分、体感诱发电位(SEP)检测N9、N20的潜伏期和波幅。结果干预后,观察组上肢FMA评分(47.91±6.92)分,高于对照组的(40.31±7.87)分,Barthel指数评分(77.33±11.82)分,高于对照组的(66.79±12.31)分,两组比较差异均有统计学意义(P<0.01);干预后,观察组患者偏瘫侧上肢SEP检测值均优于对照组,两组比较差异均有统计学意义(P<0.05)。结论基于镜像神经元理论的视觉反馈训练能改善脑卒中后早期偏瘫患者的上肢运动功能,提高日常生活活动能力,并提高SEP的N9、N20波幅,缩短其潜伏期,促进镜像神经元系统中与上肢运动功能有关脑区的兴奋度。Objective To explore the effects of visual feedback training based on the mirror neuron theory in upper limb function reconstruction in stroke patients.Methods From June 2017 to June 2018,totally 61 stroke patients hospitalized in the Rehabilitation Medical Center of the Second Hospital of Jiaxing were selected by convenient sampling and divided into the observation group(n=31)and the control group(n=30)according to the random number table.Patients in both groups received routine rehabilitation therapy,while patients in the observation group underwent visual feedback training on this basis.They were evaluated using Barthel Index,Fugl-Meyer Assessment(FMA)(upper limb),and the latency and amplitude of N9 and N20 were detected using somatosensory evoked potentials(SEP)before and 8 weeks after rehabilitation intervention.Results After the intervention,the FMA score of the upper limbs in the observation group was(47.91±6.92),higher than(40.31±7.87)in the control group,the Barthel Index of the observation group was(77.33±11.82),higher than(66.79±12.31)in the control group,and the differences between the two groups were statistically significant(P<0.01).The SEP values of the upper limbs of the hemiplegia side in the observation group were better than those in the control group,and the differences between the two groups were statistically significant(P<0.05).Conclusions The visual feedback training based on the mirror neuron theory can improve the upper limb motor function in stroke patients with early hemiplegia,improve their daily living activities,increase the N9 and N20 amplitudes of SEP,shorten their latency,and enhance the excitement of the upper limb movement related brain area in the mirror neuron system.

关 键 词：卒中 上肢功能 视觉反馈训练 镜像神经元 体感诱发电位 

分 类 号：R74[医药卫生—神经病学与精神病学]