镜像疗法对脑卒中偏瘫患者下肢平衡及步行能力影响的Meta分析  

Effects of Mirror Therapy on Lower Limb Balance and Walking Ability in Stroke Patients with Hemiplegia:a Meta-Analysis

作　　者：焦凡 谢湘梅[1] 罗阿兰 骆佳佳 刘琴[1] 胡晓莹[2] JIAO Fan;XIE Xiang-mei;LUO A-lan;LUO Jia-jia;LIU Qin;HU Xiao-ying(Department of Respiratory and Critical Care,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Nursing,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Nursing,College of Science and Technology of Jiangxi University of Traditional Chinese Medicine,Nanchang 330004,China;Operating Room,Fuyang People’s Hospital,Fuyang 236000,China)

机构地区：[1]南昌大学第二附属医院呼吸与危重症医学科,南昌330006 [2]南昌大学第二附属医院护理部,南昌330006 [3]江西中医药大学科技学院护理学系,南昌330004 [4]阜阳市人民医院手术室,安徽阜阳236000

出　　处：《南昌大学学报（医学版）》2020年第6期37-44,56,共9页Journal of Nanchang University：Medical Sciences

摘　　要：目的系统评价镜像疗法对脑卒中偏瘫患者下肢平衡及步行能力康复的效果。方法通过计算机检索中国知网(CNKI)、维普中文科技期刊(VIP)、中国生物医学文献服务系统(CBM)、万方数据库、PubMed、Web of Science、The Cochrane Library等中英文数据库关于镜像疗法对脑卒中偏瘫患者下肢功能疗效的随机对照试验(randomized controlled trial,RCT)。对所获得文献按照标准筛选、提取资料、评价文献质量,应用RevMan5.3软件对资料进行Meta分析。结果共纳入16篇文献,691例脑卒中偏瘫患者,其中镜像组350例,对照组341例。镜像组的平衡能力[SMD=0.98,95%CI(0.48,1.47),P=0.0001]、Fugl-Meyer运动评分量表下肢部分评分[MD=4.29,95%CI(1.82,6.76),P=0.0007]、功能性步行功能分级[MD=0.62,95%CI(0.35,0.90),P<0.00001]、步速[SMD=0.89,95%CI(0.50,1.28),P<0.00001]、步频[MD=6.69,95%CI(3.09,10.28),P=0.0003]、步幅[MD=6.13,95%CI(0.24,12.02),P=0.04]和步长[SMD=0.80,95%CI(0.47,1.13),P<0.00001]优于对照组,差异有统计学意义。结论镜像疗法可在一定程度上改善脑卒中偏瘫患者下肢平衡及步行能力。Objective To systematically evaluate the effects of mirror therapy on the rehabilitation of lower extremity balance and walking ability in stroke patients with hemiplegia.Methods The CNKI,VIP,CBM,Wanfang Database,PubMed,Web of Science and Cochrane Library were searched for randomized controlled trials about the effect of mirror therapy on lower limb function in stroke patients with hemiplegia.The literature was screened,data were extracted and the quality of literature was evaluated.Meta-analysis was performed using RevMan 5.3 software.Results A total of 16 articles involving 691 stroke patients with hemiplegia were included in this analysis,including 350 cases in mirror therapy group and 341 cases in control group.Compared with control group,mirror therapy significantly improved the balance ability(SMD=0.98,95%CI(0.48,1.47),P=0.0001),Fugl-Meyer Assessment-Lower Extremity score(MD=4.29,95%CI(1.82,6.76),P=0.0007),Functional Ambulation Category Scale score(MD=0.62,95%CI(0.35,0.90),P<0.00001),walking speed(SMD=0.89,95%CI(0.50,1.28),P<0.00001),stride frequency(MD=6.69,95%CI(3.09,10.28),P=0.0003),stride amplitude(MD=6.13,95%CI(0.24,12.02),P=0.04)and stride length(SMD=0.80,95%CI(0.47,1.13),P<0.00001).Conclusion Mirror therapy can improve the lower limb balance and walking ability in stroke patients with hemiplegia.

关 键 词：脑卒中 镜像疗法 下肢运动能力 平衡能力 步行能力 META分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]