改良综合康复疗法对卒中急性期中重度偏瘫患者疗效的观察

目的 探讨改良综合康复治疗对卒中急性期中重度偏瘫患者肢体康复的疗效。方法将40例卒中急性期中重度偏瘫患者按照入院病历号单双顺序,分为综合康复组21例和一般康复组19例。部分抽取传统的Bobath疗法、强制性运动疗法及运动想象疗法用于综合康复组,一般康复组接受传统的Bobath疗法。两组康复训练时间均为40min,2次/d,每周5 d,治疗时间为4周。两组分别在治疗前及治疗后4周时,进行Fugl-Meyer运动功能量表（FMA）评分和功能独立性量表（FIM）评分。结果治疗前,综合康复组和一般康复组FMA评分分别为13.8±1.9和14.2±1.4,FIM评分均为48±8;治疗后4周时,综合康复组的FMA评分（37±8）高于一般康复组（29±6）,t=3.55,P〈0.01;综合康复组FIM评分（79±8）高于一般康复组（67±8）,t=4.74,P〈0.01,差异有统计学意义。结论将传统的Bobath疗法、强制性运动疗法及运动想象疗法进行部分抽取,综合使用,较单独使用传统的Bobath疗法,对急性期中重度偏瘫患者肢体康复的疗效可能更佳。

Efficacy observation of modified comprehensive rehabilitation therapy in patients with moderate to severe hemiplegia in acute stage of stroke

Objective To investigate the effect of modified comprehensive rehabilitation therapy on extremity rehabilitation in patients with moderate to severe hemiplegia in acute stage of stroke. Methods Forty patients with moderate to severe hemiplegia in acute stage of stroke were divided into a comprehensive rehabilitation group （ n = 21 ） and a traditional rehabilitation group （ n = 19） according to the order of the ad- mission date （ single or double date）. 4 part of the traditional Bobath therapy, constraint-induced movement therapy, and motor imagery therapy were extracted and used in the comprehensive rehabilitation group; the traditional rehabilitation group received the traditional Bobath therapy alone. The time of rehabilitation training in both groups was 40 minutes, twice a day, and five days a week. The total course of treatment last for 4 weeks. Fugl-Meyer assessment （FMA） and functional independence measure （FIM） scores were performed 4 weeks before and after the treatment. Results Before the training, the FMA scores in the comprehensive rehabilitation and traditional rehabilitation groups were 13.8±1.9 and 14. 2 ±1.4 respectively, and the FIM scores were all 48±8. One month after training, the FMA score （37±8 ） in the comprehensive rehabilitation group was higher than that （ 29±6 ） in the traditional rehabilitation group（ t = 3.55, P 〈 0. 01 ） ; the FIM score （79±8 ） in the comprehensive rehabilitation group was higher than that （67±8） in the traditional rehabilitation group, and there was significant difference between the two groups （t = 4. 74, P 〈 0. 01 ）. Conclusions Partly extracted from the traditional Bobath therapy, constraint-induced movement therapy and motor imagery therapy, and comprehensively used in the rehabilitation therapy may be better than the traditional Bobath therapy alone for extremity rehabilitation in patients with moderate to severe hemiplegia in acute stage.