优化运动技巧的康复训练对卒中后上肢功能恢复的作用

目的观察优化运动技巧的康复训练对卒中后上肢功能恢复的作用。方法将有上肢功能障碍的40例卒中(脑出血或脑缺血)患者按照入院病例号尾数的奇偶数,分为优化组(20例)和对照组(20例)。所有患者均接受卒中的传统康复和药物治疗,给予优化组患者优化运动技巧的康复训练,40 min/次,2次/d,5 d/周。时间均为6周。分别在治疗前及治疗后6周进行上肢Fugl-Meyer评分(FMA)、临床神经功能缺损程度评分、简易上肢功能检查(STEF)评分。结果①治疗后6周,两组FMA评分均上升,但治疗前后优化组评分的差值高于对照组,分别为(12.6±6.0)分和(3.6±2.6)分,差异有统计学意义(均P<0.01)。②在神经功能缺损程度量表评分中,治疗后肩臂运动评分和手部运动功能评分,优化组较对照组差异有统计学意义(P<0.01)。③治疗后两组简易上肢功能检查STEF评分均有提高,治疗前后评分的差值优化组高于对照组,分别为(14.8±5.3)分和(9.5±2.7)分,差异有统计学意义(P<0.01)。结论优化运动技巧的康复训练能够帮助改善卒中后上肢的运用和控制能力,促进上肢功能的恢复。

Effect of rehabilitation training for optimizing motor skills on upper limb function recovery after stroke

Objective To observe the effect of rehabilitation training for optimizing motor skills on upper limb function recovery after stroke. Methods Forty patients with stroke （ cerebral hemorrhage or cerebral ischemia; with upper limb dysfunction） were divided into either a optimized group （n = 20 ） or a control group （ n = 20） according to the even or odd number of hospitalization. All patients received tradi- tional stroke rehabilitation and drug treatment. The patients in the optimized group received the rehabilita- tion training for optimizing motor skills, 40 min once, twice a day, 5 days a week, for six weeks. The up- per extremity FMA score, clinical neurological deficit score, simple test for evaluating hand function （STEF） score were conducted before treatment and at 6 weeks after treatment, respectively. Results （1） At 6 weeks after treatment, the FMA scores in both groups increased, but the difference value of the optimized group score before and after treatment was higher than that in the control group （ 12.6 ±6.0 vs. 3.6 ±2.6）. There was significant difference （ all P 〈 0.01 ）. （2）In the neurological deficit scores, there was significant difference in the shoulder and arm movement score and hand motor function score after treatment between the optimized group and the control group （P 〈0.01 ）. （3）The STEF scores increased after treatment in both groups. The difference value in optimized group was higher than that in the control group before and after treatment （ 14.8 ± 5.3 vs. 9.5 ±2.7 ）. There was significant difference （ P 〈 0.01 ）. Conclusion The rehabilitation training for optimizing motor skills may help to improve the use of upper limbs and control ability after stroke. Key words： Stroke ; Upper extremity ; Hemiplegia; Optimized motor skills