目的 比较镜像疗法和综合康复治疗对脑卒中患者下肢功能障碍的临床疗效。方法 选择2015-03至2016-09来秦皇岛市第一医院康复理疗科做康复治疗的脑卒中患者86例,根据excel表格随机数字表法随机分为两组:采用镜像疗法治疗组(镜像疗法组,43例)和综合康复治疗组(综合康复组,43例),共治疗4周。比较两组治疗前后FMA评分、MBI评分、神经功能损伤评分、Brunnstrom分级以及FAC分级。结果 研究结果显示,镜像疗法组治疗后FMA评分(23.46±5.09)、MBI评分(46.97±6.77)显著高于综合康复组FMA评分(18.77±4.17)、MBI评分(39.87±5.52)(P<0.05)。镜像疗法组治疗后神经功能损伤评分(9.81±2.31)显著低于综合康复组神经功能损伤评分(18.97±3.56)(P<0.05),治疗后镜像疗法组Brunnstrom分级和FAC分级显著优于综合康复组(P<0.05)。结论 镜像疗法是治疗脑卒中后下肢功能障碍的有效方法,能改善下肢运动功能及日常生活能力,提高生存质量,值得推广应用。
Abstract
Objective To compare the curative effect of mirror therapy and comprehensive rehabilitation therapy for lower limb dysfunction among patients of stroke so as to determine the superiority of mirror therapy. Methods Eighty-six patients with stroke who had received rehabilitation treatment at our hospital between March 2015 and September 2016 were selected as subjects.Using random number table method, these patients were randomly divided into two groups: the mirror therapy group (n=43) and the comprehensive rehabilitation treatment group (n=43).The treatment lasted four weeks. The FMA score, MBI score, nerve function injury score, Brunnstromstage classification and FAC before and after treatment were compared between the two groups. Results The FMA score was (23.46±5.09) and the MBI score was (46.97±6.77) after treatment in the mirror therapy group, significantly higher than (18.77±4.17) and (39.87±5.52)in the comprehensive rehabilitation group(P<0.05).After treatment, neurological injury score (9.81±2.31) in the mirror therapy group was significantly lower than (18.97±3.56) of the comprehensive rehabilitation group (P<0.05).Brunnstrom stage classification and FAC in the mirror therapy group were significantly better than those in the comprehensive rehabilitation group (P<0.05). Conclusions Mirror therapy is effective for patients with lower limb dysfunction after stroke, which can enhance the patients' lower limb motor function and productivity, improve the quality of survival, and is worthy of popularization and application.
关键词
镜像疗法 /
脑卒中 /
下肢功能障碍 /
运动功能
Key words
mirror therapy /
stroke /
lower limb dysfunction /
motor function
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参考文献
[1] 王 争.减重步行训练对出血性脑卒中后遗症期偏瘫患者的康复效果观察[J].贵州医药, 2016, 40(7): 717-718.
[2] 庄卫生, 钱宝延, 曹留拴,等.基于镜像神经元的动作观察疗法在运动功能康复中的应用[J].中国康复, 2013, 28(5): 387-389.
[3] 彭 辰, 谢建平, 马建强,等.镜像疗法联合多感觉刺激对偏瘫患者早期上肢功能恢复的效果观察 [J]. 浙江中西医结合杂志, 2017, 27(1): 36-39.
[4] 方向华.中国卒中的流行现状及其影响因素[J].中国脑血管病杂志,2004,1(5):233-237
[5] Kallio K, Nilsson-Wikmar L, Thors Nan. Modified constraint-induced therapy for the lower extremity in elderly persons with chronic stroke: single-subject experimental design study [J]. Topics in Stroke Rehabilitation, 2014, 21(2): 111-119.
[6] 朱玉连, 胡永善, 刘 宇.脑卒中患者下肢强制性运动对其步行能力恢复的研究进展[J].中国康复医学杂志, 2013,28(9): 883-886.
[7] 蒋金鹏, 刘洪武, 王志双.镜像疗法配合康复训练对脑卒中偏瘫患者上肢运动功能的临床疗效分析[J].中国医学装备, 2015,12(9): 107-109.
[8] 过 筠, 章惠英, 章雅青, 等.运动想象疗法对脑卒中偏瘫患者下肢运动功能的影响[J].上海交通大学学报(医学版), 2012, 32(10): 1351-1355.
[9] 崔韶阳, 许明珠, 王曙辉, 等.针刺配合镜像疗法对脑梗死偏瘫患者下肢功能障碍的影响[J].上海针灸杂志, 2017, 36(1): 9-13.
[10] Min K S, Jee S J, Kim Y W. Effect of Transcranial Direct Current Stimulation on Postural Stability and Lower Extremity Strength in Hemiplegic Stroke Patients [J]. Annals of Rehabilitation Medicine,2013, 37(6): 759-765.
[11] 沈 芳, 王 晶, 曾 明.镜像疗法在脑卒中偏瘫患者上肢运动功能康复中应用的研究进展[J].中国康复医学杂志, 2016, 31(5): 590-593.
[12] 唐朝正,丁 政,张晓莉,等.镜像疗法治疗高位脊髓损伤后上肢Ⅱ型复杂性局部疼痛综合征的有效性:自身交叉对照研究[J].中国组织工程研究, 2015, 19(5): 716-720.
[13] 李怡君, 林克忠, 郑筱儒. 台湾地区脑卒中作业治疗的科研发展:以镜像治疗为例[J].中国康复, 2015, 30(6): 432-434.
[14] 赵志军, 王海燕. 镜像疗法对脑卒中偏瘫患者促进患肢功能恢复的功能磁共振研究[J].贵州医药, 2016, 40(9): 979-981.
[15] 李 晶, 秦 达, 闫 红.脑卒中偏瘫患者早期行运动疗法40例疗效观察[J].贵州医药, 2013, 37(6): 544-545.
[16] 戚红亮.早期强化膝关节控制训练对脑卒中偏瘫患者下肢运动功能的影响分析[J].中国当代医药, 2015, 22(10): 61-63.
基金
秦皇岛市科学技术局课题(201401A282)
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