强制性使用运动疗法对脑卒中偏瘫患者上肢使用能力的恢复作用

目的：观察强制性使用运动疗法对脑卒中偏瘫患者上肢使用能力和运动功能的康复疗效。 方法：恢复期脑卒中上肢偏瘫患者20例，随机分为强制性使用运动疗法组(简称CI组)10例，对照组10例，CI组进行强制性使用运动疗法，对照组进行反复作业疗法，每周5 d,每日连续3h，共治疗3周；治疗前、治疗后1周、治疗后6及12个月分别采用MAL指数评定法评定患侧肢体的使用能力，采用WMFT运动功能评定法评定患侧肢体运动功能。 结果：治疗后1周2组的MAL指数均高于治疗前（P<0.01）；CI组治疗后6及12个月的MAL指数较治疗前均显著提高（P<0.05或P<0.01），对照组治疗后6及12个月的MAL指数与治疗前比较差异均无显著性(P>0.05)；2组的WMFT分数在治疗前、治疗后1周及12个月均无明显变化(P>0.05)。 结论： 强制性使用运动疗法对脑卒中偏瘫患者的上肢使用能力有较好的康复疗效，但对运动功能改善不明显。

Recovery effect of constraint-induced movement therapy on upper extremity activity of stroke patients with hemiparasis

Objective To explore the rehabilitation effect of constraint-induced movement therapy(CIMT) on upper extremity motor function of stroke patients with hemiparasis.Methods 20 chronic stroke patients were divided into 2 groups: CI group(10 cases),the patients were treated with CIMT for 3 weeks,3 h per day;control group(10 cases),the patients were treated with repetitive occupational therapy for 3 weeks,3 h per day.MAL score and WMFT score were measured in two groups before treatment and 1 week,6 months and 12 months after treatment.Results There were improvement of MAL score in both CI group and control group 1 week after treatment compared with pre-treatment(P<0.01),and the scores of MAL on post-treatment 6 months and 12 months were higher than those of pre-treatment in CI group(P<0.05,P<0.01),but no significant difference in MAL score between post-treatment 6 months and 12 months and pre-treatment in control group;there was no significant difference in WMFT between pre-treatment and post-treatment 1 week,12 months in CI group and control group(P>0.05).Conclusion CIMT can significantly increase the use ability on the upper extremity of hemiplegic patients after stroke,but can not improve the motor function of upper extremity in stroke patients.