等速训练仪配合镜像疗法对脑梗死后痉挛型偏瘫的康复效果研究

目的探讨等速训练仪配合镜像疗法对脑梗死后痉挛型偏瘫的康复效果。 方法选取自2017年2月至2019年12月在连云港市第一人民医院老年医学科接受治疗的脑梗死后痉挛型偏瘫患者148例，采用随机数字表法分为对照组（常规康复治疗，37例)、上肢组（常规康复治疗+镜像疗法，37例）、下肢组（常规康复治疗+等速训练仪治疗，37例）及联合组（常规康复治疗+镜像疗法+等速训练仪治疗，37例）。对比治疗前后4组患者上肢及下肢肌力评分、上肢及下肢运动功能、上肢及下肢肌张力，康复效果，治疗前、治疗后3个月生活质量评分。 结果治疗后4组患者上肢肱二头肌、下肢股四头肌肌力评分及上肢、下肢运动功能评分与总分较治疗前均升高（P<0.05），治疗后上肢组和联合组患者上肢肱二头肌肌力评分、上肢运动功能评分均高于对照组、下肢组（P<0.05），治疗后下肢组和联合组患者下肢股四头肌肌力评分、下肢运动功能评分均高于对照组、上肢组（P<0.05）；联合组、上肢组、下肢组的上肢、下肢运动功能总评分均高于对照组（P<0.05），联合组的上肢、下肢运动功能总评分高于上肢组、下肢组（P<0.05）；治疗后4组上肢、下肢改良Ashworth痉挛量表评分均低于治疗前（P<0.05），治疗后上肢、下肢改良Ashworth痉挛量表评分在4组间比较差异均无统计学意义（P>0.05）；联合组总有效率明显高于对照组（P<0.05）；治疗后3个月，4组患者各项生活质量评分均高于治疗前（P<0.05），且治疗后3个月联合组均高于其余3组（P<0.05），上肢组和下肢组均高于对照组（P<0.05）。 结论等速训练仪配合镜像疗法能够提高脑梗死后痉挛型偏瘫患者上肢及下肢肌力、运动功能，增强康复效果，改善生活质量。

Rehabilitation effect of isokinetic trainer combined with mirror image therapy on spastic hemiplegia after cerebral infarction

ObjectiveTo explore the rehabilitation effect of isokinetic trainer combined with mirror image therapy on spastic hemiplegia after cerebral infarction. MethodsOne hundred and forty-eight patients with spastic hemiplegia after cerebral infarction who were treated in our hospital from February 2017 to December 2019 were selected and randomly divided into control group (routine rehabilitation treatment, 37 cases), upper limb group (routine rehabilitation + mirror therapy treatment, 37 cases), lower limb group (routine rehabilitation + isokinetic trainer treatment, 37 cases) and combination group (routine rehabilitation+mirror therapy+isokinetic trainer treatment, 37 cases). The muscle strength scores of upper limbs and lower limbs, motor functions of upper limbs and lower limbs and the muscle tension of upper and lower limbs before and after treatment, rehabilitation effects, quality of life scores before and 3 months after treatment were compared among the four groups. ResultsAfter treatment, the scores of muscle strength scores of biceps brachii of upper extremity and quadriceps femoris of the lower extremity and the motor function scores and total scores of the upper limbs and lower limbs of the four groups were increased (P<0.05), and the scores of biceps brachii of upper extremity muscle strength and motor function of upper limb in upper limb group after treatment and combined group were higher than those in control group and lower limb group (P<0.05), and the scores of quadriceps femoris of the lower extremity muscle strength and motor function of lower limbs in lower limb group and combined group after treatment were higher than those in control group and upper limb group (P<0.05). The total scores of upper limb and lower limb motor function in the combined group, upper limb group and lower limb group after treatment were higher than those in the control group (P<0.05), and the total scores of upper limb and lower limb motor function in the combined group after treatment were higher than those in the upper limb group and lower limb group (P<0.05). After treatment, the modified Ashworth spasm scale scores of upper and lower limbs in four groups were lower than those before treatment (P<0.05), and there was no significant difference in the modified Ashworth spasm scale scores of upper and lower limbs among the four groups after treatment (P>0.05). The total effective rate of the combined group was significantly higher than that of the control group (P<0.01). At 3 months after treatment, the scores of qauality life of the four groups were significantly higher than those before treatment (P<0.05), of which the combination group were higher than the other three groups (P<0.05), and those of upper limb group and lower limb group were higher than the control group (P<0.05). ConclusionThe isokinetic trainer combined with mirror image therapy can improve the muscle strength and motor function of upper limbs and lower limbs of patients with spastic hemiplegia after cerebral infarction, enhance the rehabilitation effect and improve the quality of life.