川平法联合镜像手套式任务导向训练对脑卒中患者上肢康复效果的随机对照试验  

Effect of repetitive facilitative exercise combined with mirror glove task-oriented training on the upper limb function in stroke patients with hemiplegia:a randomized controlled trial

作　　者：吴美玲 陈焱强 陈琦 龚璇 张伟 WU Mei-ling;CHEN Yan-qiang;CHEN Qi;GONG Xuan;ZHANG Wei

机构地区：[1]湖北省中西医结合医院康复医学中心,湖北武汉430015 [2]武汉大学中南医院,湖北武汉430071

出　　处：《中国疗养医学》2025年第5期43-47,共5页Chinese Journal of Convalescent Medicine

摘　　要：目的探讨川平法(RFE)联合镜像手套式任务导向训练(MT-TOT)在脑卒中患者上肢康复中的应用效果。方法选取2023年6月至2024年6月湖北省中西医结合医院的脑卒中上肢及手功能障碍患者54例,采用随机数字表分为对照组、川平组、联合组。对照组给予关节活动技术及任务导向训练(TOT);川平组给予RFE及TOT治疗;联合组给予RFE与MT-TOT联合治疗。治疗前后采用Fugl-Meyer评定量表上肢部分(FMA-UE)、Carroll手功能评定法(UEFT)、改良Barthel指数(MBI)、世界卫生组织生存质量测定简表(WHOQL-BREF)对患者上肢运动功能、手功能、日常生活能力及生存质量进行评价。结果因对照组1例突发癫痫及联合组1例再发卒中而排除该两例患者,最终纳入研究患者为52例,其中对照组17例、川平组18例、联合组17例。治疗前三组患者的FMA-UE评分、UEFT评分、MBI评分、WHOQL-BREF评分差异均无统计学意义(P>0.05)。治疗3周后,三组患者的上述指标均较治疗前提高,差异有统计学意义(P<0.05);川平组、联合组各指标改善均较对照组显著(P<0.05),其中联合组在FMA-UE评分改善最为显著(P<0.05),而在UEFT评分、MBI评分、WHOQL-BREF评分上与川平组比较差异无统计学意义(P>0.05)。结论RFE、MT-TOT均可改善患者上肢和手功能、提高日常生活能力及生存质量,其中RFE与MT-TOT联合治疗对上肢运动功能改善作用最优。Objective To explore the effect of repetitive facilitative exercise(RFE)combined with mirror glove task-oriented training(MT-TOT)on the upper limb rehabilitation in stroke patients with hemiplegia.Methods From June,2023 to June,2024,54 stroke patients with upper limb and hand dysfunction in Hubei Provincial Hospital Integrated Chinese and Western Medicine were selected and randomly divided into the control group,RFE group,and combination group.Patients in the control group received joint mobilization techniques and TOT.Both RFE and TOT were given to patients in the RFE group,and those in the combination group were managed by RFE and MT-TOT.Before and after treatment,the Fugl-Meyer Assessment of Upper Extremities(FMA-UE),Upper Extremity Function Test(UEFT),modified Barthel index(MBI),and the World Health Organization Quality of Life-BREF(WHOQL-BREF)were used to evaluate the upper limb and hand function,activity of daily living,and quality of life.Results One case of sudden epilepsy in the control group and one case of recurrent stroke in the combination group were excluded.Ultimately,52 patients were included in the study,including 17 in the control group,18 in the RRFE group,and 17 in the combination group.There were no significant differences in the FMA-UE scores,UEFT scores,MBI,and WHOQL-BREF scores among the three groups before treatment(P>0.05).After 3 weeks of treatment,the above indicators in the three groups all showed significant improvement compared to before treatment(P<0.05),which were significantly pronounced in the RFE group and combination group than the control group(P<0.05).The most significant improvement of the FMA-UE scores was observed in the combination group(P<0.05).However,there were no significant differences in the UEFT scores,MBI,and WHOQL-BREF scores after treatment between the RFE group and combination group(P>0.05).Conclusion Both RFE and MT-TOT can improve upper limb and hand function,enhance activity of daily living,and increase quality of life in patients.Among these,the combinatio

关 键 词：脑卒中 川平法 任务导向性训练 镜像疗法 智能镜像手套 

分 类 号：R743.3[医药卫生—神经病学与精神病学]