太极式运动想象疗法对脑梗死患者的运动功能以及fNIRS的影响  

Effect of Taiji exercise imagination therapy on motor function and fNIRS in patients with cerebral infarction

作　　者：罗雅丽[1] 陈劲松[1] 陈莎莎 刘双[1] Luo Yali;Chen Jinsong;Chen Shasha(Mianyang Central Hospital, Mianyang 621000, China)

机构地区：[1]绵阳市中心医院康复医学科,四川绵阳621000

出　　处：《中国康复》2022年第5期267-271,共5页Chinese Journal of Rehabilitation

基　　金：2020年四川省卫生和健康委员会科研课题重点研究项目(20ZD020)。

摘　　要：目的:观察运动想象太极步法对脑梗死患者平衡功能、下肢运动功能以及步态的影响。方法:将脑梗死患者133例随机将其分为3组,即观察组、运动想象(MI)组、对照组。对照组采用基础药物与常规康复方案;MI组在对照组的基础上,进行30min的运动想象疗法;观察组在对照组基础上,进行30min的运动想象式太极步,即把7类太极拳步态融入运动想象疗法中。治疗前与治疗8周后观察3组患者Fugl-Meyer评定量表(下肢部分)、Berg平衡量表(BBS)、改良Barthel指数(MBI)、步态分析、等速肌力测试以及近红外脑功能成像(fNIRS)。结果:FMA、BBS、MBI评分结果比较,干预8周后3组各指标均高于治疗前(P<0.05),观察组上述指标均高于其余2组(P<0.05),MI组FMA和MBI评分高于对照组(P<0.05),BBS评分与对照组比较差异无统计学意义。步态分析结果比较,干预8周后3组步行周期、步长偏差、左右摆动相偏差均较治疗前明显降低,患侧髋关节屈伸、患侧膝关节屈伸角度均较治疗前明显提高(P<0.05);观察组在步长偏差、左右摆动相偏差、患侧髋关节屈伸度3个方面的改善均优于MI组和对照组(P<0.05);在患侧膝关节屈伸度方面,观察组仅优于对照组,与MI组差异无统计学意义;而在步行周期一项观察组与其余两组差异无统计学意义。在等速肌力测试,治疗8周后3组在180°膝耐力指数(ER)和60°膝峰力矩(PT)均较治疗前明显提高(P<0.05);而组间比较,观察组在上述两项指标均高于MI组和对照组(P<0.05);而MI组也在上述两项指标高于对照组(P<0.05)。在fNIRS方面,治疗前3组3个区域浓度比较差异均无统计学意义;治疗8周后,3组SMC、SMA区域浓度均高于治疗前(P<0.05),在PMC区域3组均与治疗前无差异。组间比较,观察组在SMC区域高于其余两组(P<0.05),在SMA区域观察组仅高于对照组,与MI无差别;在PMC区域,3组间无差别。结论:太极式运动想象疗法可以有�Objective:To observe the effects of exercise imagination Taiji footwork on balance function,lower limb motor function and gait in patients with cerebral infarction.Methods:A total of 133 patients with cerebral infarction were randomly divided into three groups:observation group,motor imagination(MI)group and control group.The control group was treated with basic drugs and routine rehabilitation program.On the basis of the control group,the MI group received 30 min of motor imagination therapy and the observation group was subjected to 30 min of exercise imagination Tai Chi step:7 types of Tai Chi gait were integrated into exercise imagination therapy.Fugl Meyer Rating Scale(lower limbs),Berg Balance Scale(BBS),modified Barthel Index(MBI),gait analysis,isokinetic muscle strength test and near infrared brain function imaging(fNIRS)were observed before and 8 weeks after treatment.Results:After 8 weeks of intervention,the indexes of the three groups were higher than those before treatment(P<0.05).The above indexes of the observation group were higher than those of the rest two groups(P<0.05),while the scores of FMA and MBI in the MI group were higher than those in the control group(P<0.05),and there was no significant difference in the BBS between the MI group and the control group.In gait analysis,after 8 weeks of intervention,the walking cycle,step deviation and left-right swing phase deviation of the three groups were significantly lower than those before treatment,and the flexion and extension angles of hip joint and knee joint on the affected side were significantly higher than those before treatment(P<0.05).The improvement of walking cycle,step length deviation,left-right swing phase deviation and hip flexion and extension of the affected side in the observation group were better than those in the MI group and the control group(P<0.05).In terms of knee flexion and extension,the observation group was only better than the control group,and there was no significant difference between the observation group and the

关 键 词：运动想象 太极 脑梗死 下肢 近红外脑功能成像 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]