【作者】 郑雅丹； 胡昔权； 李奎； 陈颖蓓； 解东风；

【Author】 ZHENG Yadan,HU Xiquan,LI Kui,CHEN Yinbei,XI E Dongfeng Dept.of Rehabilitation Medicine,the Third Affiliated Hospital of Sun Yat-sen University

【机构】 中山大学附属第三医院康复医学科；

【摘要】 目的初步观察双侧上肢训练对上肢功能中度到重度残损的恢复期脑卒中患者的疗效。方法 50例上肢功能中度到重度残损的恢复期脑卒中患者随机分为双侧训练组(n=25)、对照组(n=25),前者接受双侧(患侧、健侧)上肢同向、节律运动的重复练习,后者接受常规上肢训练,即以患侧上肢为主的单侧训练。两组患者上肢训练的时间均为1h/d,5d/W,持续4W,其余康复治疗如运动疗法和日常生活活动训练等两组均相同。两组患者分别于治疗前、治疗后予以FMA上肢部分(FMA-UE)、MAS上肢部分(即该量表的第6、7、8项,MAS-UE)和MBI评定。结果两组患者治疗后FMA-UE、FMA上肢的近端部分(FMA-PUE)和远端部分(FMA-DUE)、MAS-UE及MBI的评分均较治疗前提高,治疗前、后各量表的评分差异具有显著性(P<0.05);与对照组相比,双侧训练组患者FMA-UE、FMA-PUE的评分提高幅度更大(P<0.05)。结论对于上肢功能中度到重度残损的恢复期脑卒中患者,采用双侧上肢训练可以更好地改善其患侧上肢,尤其是上肢近端的运动功能。更多还原

【Abstract】 Objective To observe the effect of bilateral arm training on arm function of stroke patient in convalescent phase with moderate to severe upper limb impairment.Method Fifty subjects participated in a randomized,single-blind training study.Subjects in the bilateral training group(n= 25) practiced bilateral symmetrical rhythmic activities,and the control group(n=25) performed conventional armtraining, mainly unilateral training.Amount of arm training for both groups were 1 hour per day,5 days per week for 4 weeks.The Fugl-Meyer Assessment of upper extremity(FMA-UE),Motor Assessment Scale of upper extremity(MAS-UE) and Modified Barthe1 Index(MBI) were used as outcome measures.Assessments were administered at pretraining and posttraining by a rater blinded to group assignment.Result Both groups had significant improvements on the FMA-UE(P<0.0 5),Fugl-Meyer Assess- me nt of proximal upper extremity(FMA-PUE)(P<0.0 5),Fugl-Meyer Assessment of distal upper extremity(FMA-DUE)(P<0.05), MAS-UE(P<0.05) and MBI(P<0.05).The bilateral training group had significantly greater improvement on the FMA-UE(P<0.05) and FMA-PUE(P<0.05).Conclusion Bilateral armtraining may be mo re effective on arm function of stroke patient in convalescent phase with mo derate to severe upper limb impairment. Bilateral training may be more advantageous for proximal arm function.更多还原