镜像疗法对偏瘫患者上肢功能康复疗效的观察

目的 观察镜像疗法对卒中后偏瘫患者上肢功能康复的疗效。方法 选择30例入选卒中后8周内偏瘫患者随机分为两组：镜像疗法组和对照组，分别于治疗前及治疗后4周采用Fugl-Meyer运动评价（Fugl-Meyer motor assessment，FMA）（上肢部分），上肢运动研究测试（the action research arm test，ARAT）、运动功能评估量表（motor assessment scale，MAS）对上肢运动功能进行评分，同时评定患者的视觉模拟评分（visual analogue scale/score，VAS）、痉挛程度以及改良Barthel指数，以观察镜像疗法对偏瘫患者上肢功能康复的疗效。结果 治疗4周后，两组上肢运动能力FMA评分、ARAT评分、MAS评分、改良Barthel指数均较治疗前提高（P＜0.01）；治疗组FMA评分、ARAT评分高于对照组（P＜0.05），两组间MAS评分、改良Barthel指数提高，但差别无统计学意义（P＞0.05）。治疗组VAS评分较治疗前有下降（P＜0.05），但对照组治疗前后，VAS评分差异无统计学意义（P＞0.05），治疗后两组间的VAS差异有统计学意义（P＜0.05）。两组治疗前后及治疗后组间痉挛改善差异无统计学意义（P＞0.05）。结论 镜像疗法能提高偏瘫患者的上肢运动功能，且能减轻患者偏瘫上肢的疼痛，但对患者日常生活活动能力（activity of daily living scale，ADL）及患肢痉挛程度的改善无明显影响。

Effects of Mirror Therapy on Hemiplegic Upper Extremity Motor Recovery in Stroke Patients

Objective To observe the effects of mirror therapy （MT） compared with the conventional training therapy （CTT） on hemiplegic upper extremity recovery after stroke. Methods Thirty sub-acute patients with upper limb paralysis were randomly divided into two groups： MT group and CTT group. All 30 patients received physical treatment for a period of 4 weeks. All patients were assessed with Fugl-Meyer motor assessment （FMA）, motor assessment scale （MAS）, the action research arm test （ARAT）, the modified Ashworth scale, visual analogue score （VAS） and the modified Barthel index before treatment and after 4 weeks. Results After 4 weeks, FMA, MAS, ARAT and Barthel index scores in the two groups had improved （P〈0.01）, and the FMA, ARAT scores in the MT group were significantly higher than those of the control group （P〈0.05）, but the scores of MAS, Barthel index had no significant difference between the two groups （P〉0.05）. After 4 weeks, VAS had decreased in the MT group （P〈0.05）, but it had no difference in CTT group. In two groups, there were no significant differences of the modified Ashworth scale after treatment （P〉0.05）. Conclusion Mirror therapy can improve the functional performance of the upper extremity of stroke patients.