【摘要】 目的提高脑卒中偏瘫患者上肢运动功能康复训练效果。方法采取循证联合专家评定法制订脑卒中偏瘫患者上肢运动功能康复运动想象指导语,录制成普通话、沪语2种音频;将41例脑卒中单侧偏瘫患者随机分为A组(21例)和B组(20例)。A组于第1阶段(1~3周)行常规康复训练联合运动想象训练,第2阶段(4~5周)休息,第3阶段(6~8周)行常规康复训练;B组第1阶段行常规康复训练,第2阶段休息,第3阶段行常规康复训练联合运动想象训练。结果两组训练第3、5、8周末Fugl-Meyer运动评分量表(FMA)、改良Barthel指数(MBI)和偏瘫上肢功能测试-香港版(FTHUE-HK)评分比较,差异有统计学意义(处理、时间及交互效应均P<0.01);其中A组训练3周末MBI、FTHUE-HK评分显著高于B组,B组训练8周末FMA、FTHUE-HK评分显著高于A组(均P<0.05)。结论在常规训练的基础上增加运动想象训练有助于脑卒中偏瘫患者上肢运动功能的恢复,尤其是对患者手精细运动功能恢复效果更优,但效果维持时间偏短,需坚持长期训练。更多还原

【Abstract】 Objective To improve upper limb recovery for patients with hemiparesis due to stroke.Methods Mental imagery instruction for upper limb rehabilitation was created based on evidence-based literature review and expert consultation,then Mandarin Chinese and Shanghainese version verbal instructions were recorded on tape.Forty-one patients with hemiparesis due to stroke were randomly assigned into group A of 21 and group B of 20.Group A received mental imagery and conventional rehabilitation in the first 3weeks,then had a rest period without rehabilitation exercise for two weeks and restarted conventional rehabilitation in 6th-8th weeks.Group B was given conventional rehabilitation in the first 3weeks and had a rest period of 2weeks before starting mental imagery and conventional rehabilitation in the last 3 weeks.The Fugl-Meyer Assessment(FMA),Modified Barthel Index(MBI),and Hong Kong version of the Functional Test for the Hemiplegic Upper Extremity(FTHUE-HK)were used to evaluate the effect before intervention and at 3,5 8weeks after the intervention.Results Group effect,time effect,and group-by-time effect were all significantly different in the FMA,MBI,and FTHUE-HK scores(P<0.01 for all).The MBI and FTHUE-HK scores were significantly higher in group A than group B at the end of 3rd week,while group B scored significantly higher on FMA and FTHUE-HK than group A at the end of 8th week(P<0.05 for all).Conclusion Mental imagery performed on the basis of conventional rehabilitation contributes to recovery of upper limb especially for fine motor skills,but the effect was short-lived.Long-term training is required to obtain a more desirable outcome.更多还原