镜像治疗联合任务导向性训练对脑卒中偏瘫上肢功能的疗效观察CSCD

目的:探讨镜像治疗(MT)的启动联合任务导向性训练(TOT)对脑卒中偏瘫上肢功能恢复的疗效。方方法法:将符合入选条件的轻、中度上肢运动功能障碍的40例脑卒中住院患者按照随机数字表法分为观察组和对照组,每组20例。2组患者均接受常规康复治疗,对照组在常规康复治疗的基础上增加任务导向性训练,30 min/d,观察组在对照组的基础上增加镜像治疗,30 min/d,2组均5 d/周,共治疗4周。在治疗前后分别使用Fugl-Meyer评定上肢部分(FMA-UE)、上肢动作研究量表(ARAT)评估偏瘫上肢的运动功能,使用偏瘫上肢功能测试香港版(FTHUE-HK)评估偏瘫上肢的活动表现。结果:治疗前2组患者的FMA-UE评分、ARAT评分及FTHUE-HK分级比较,差异无统计学意义(P>0.05);治疗后2组患者的FMA-UE评分及ARAT评分均较治疗前显著提高(P<0.001),FTHUE-HK分级均较治疗前显著提高(P<0.05)。通过组间比较发现,治疗后观察组FTHUE-HK分级改善明显优于对照组(P<0.05);观察组FMA-UE评分的提高分值(11.40±6.29)分,明显优于对照组的提高分值(5.05±3.35)分,差异具有统计学意义(P<0.001);观察组ARAT评分的提高分值(6.25±3.67)分,明显优于对照组的提高分值(3.25±2.73)分,差异具有统计学意义(P<0.05)。结论:镜像治疗联合并作为任务导向性训练的启动时,其诱导的启动效应可以提高脑卒中后偏瘫上肢的运动功能和活动表现。

Effect of Mirror Therapy Combined with Task-Oriented Training on Hemiplegic Upper Limb Functions after Stroke

Objective:To investigate the priming effect of mirror therapy combined with task-oriented training on hemiplegic upper limb functions after stroke.Methods:A total of forty eligible inpatients with stroke were divided into observation group and control group according to the random number table method,with 20 cases in each group.The conventional rehabilitation training was used in both groups.The control group was given upper limb task-oriented training 30 min per day in addition to conventional rehabilitation;the observation group was given mirror therapy 30 min per day in addition to the control group,both 5 days per week for 4 consecutive weeks.Assessments were administered at baseline and immediately after all the intervention.The upper limb motor functions were assessed by the Fugl-Meyer assessment-upper extremity(FMA-UE)and action research arm test(ARAT),occupational performance was assessed by the functional test of hemiplegic upper extremity-Hong Kong(FTHUE-HK).Results:There were no significant differences in FMA-UE scores,ARAT scores and FTHUE-HK grade between the two groups before treatment(P>0.05).After 4 weeks of treatment,the FMA-UE scores,ARAT scores of the two groups showed significant improvement compared with those before treatment(P<0.001),FTHUE-HK grade of the two groups showed significant improvement compared with that before treatment(P<0.05).The improvement degree of FMA-UE scores(11.40±6.29)in the observation group was more significant than that(5.05±3.35)in the control group(P<0.001),the improvement of ARAT scores(6.25±3.67)in the observation group was more significant than that(3.25±2.73)in the control group(P<0.05),the improvement of FTHUE-HK grade in the observation group was more significant than that in the control group(P<0.05).Conclusion:Mirror therapy,combined and as priming for taskoriented training,can produce clinical improvements in upper extremity function and occupational performance in patients with hemiparesis after stroke.