手功能康复器对脑卒中后偏瘫患者手功能康复的效果研究

目的对比研究自由康复法、针灸疗法及手功能康复器配合自由康复法3种不同诊治方法对新发脑卒中偏瘫患者手运动功能、感觉功能以及运动模式的康复效果。方法将49例首次发病的新发脑卒中患者随机分为自由康复组16例，针灸组16例和手功能康复器训练组17例，分别接受相应的治疗及护理。采用盲法对3组患者治疗前后的手运动功能、感觉功能以及运动模式进行对比。结果3组治疗后Brunnstrom-手的感觉运动功能评定，Fugl-Meyer评定得分比治疗前有明显进步，Carr-shepherd-手精细功能评定得分无显著改善。治疗2周后Brunnstrom-手的感觉运动功能评定、Fugl-Meyer评定分值自由康复组和针灸治疗组比较无显著差异；手功能康复器训练组与另2组比较差异显著；Carr-shepherd-手精细功能评定分值3组间两两比较均无显著差异。治疗1个月后，Brunnstrom-手的感觉运动功能评定分值3组间两两比较差异显著；Fugl—Meyer评定分值自由康复组和针灸治疗组比较无显著差异，手功能康复器训练组与另2组比较差异显著；Carr—shepherd-手精细功能评定分值3组间两两比较均无显著差异。结论针灸、自由康复及手功能康复器对脑卒中后偏瘫患者的手运动功能、感觉功能改善均有效，手功能康复器配合自由康复的治疗效果最佳。但其对手精细功能的改善有待提高。

Research in effect of hand function recovery machine on hand function rehabilitation of hemiplegia patients after stroke

Objective To compare the rehabilitation effect of free rehabilitation, the needle therapy and the hand function recovery machine combined with free rehabilitation on movement function, the feeling function as well as the movement pattern of newly stroke patients with hemiplegia. Methods 49 newly stroke patients were divided into the free rehabilitation group, the acupuncture group and the hand function recovery machine group, each group received corresponding intervention. The movement function, the feeling function as well as the movement pattem were compared among the three groups using blind method, Results Brunnstrom evaluation for hands feeling- movement function, the Fugl- Meyer evaluation score showed obvious progress compared to before the treatment, score of fine hand- function assessment of Carrshepherd showed no change. Two weeks after treatment, Brunnstrom evaluation for hands feeling-ovement function and the Fugl- Meyer evaluation score showed no difference between the free rehabilitation group and the acupuncture group, but the hand function recovery machine group showed better results than the other two groups. One months after treatment, Brunnstrom evaluation for hands feeling-movement function was different among these groups, but not the Fugl- Meyer evaluation score, the hand function recovery machine group showed better results than the other two groups, still score of fine hand- function assessment of Carrshepherd showed no change. Conclusions Acupuncture, free rehabilitation, hand function recovery machine all make progress in hand function recovery for newly stroke patients with hemiplegia, but hand function recovery machine combined with free rehabilitation proved to be the best method. Its effect for hand intricate function needs to be enhanced.