脑卒中患者运动功能评定的方法及其研究进展与问题

Progress and problem in the method of motor functional evaluation in stroke patients

目的:通过总结国内外关于脑卒中运动功能评定的文献,以便于在临床科研中,根据不同的需求选择简便、实用、可信度高的运动功能康复评价方法。资料来源:应用计算机检索CNKI数据库1995-01/2005-09和万方数据库1994-01/1995-01与康复评定相关的文章,检索词为“康复评定”,限定文章用语为中文。同时手工检索1985-01/2002-12与相关康复评定的书籍,限定书籍语言为中文,英文、日文、检索词为“脑卒中,康复,运动功能评定”。资料选择:纳入标准是与脑卒中运动功能评定相关的文章,选择有代表性的文献,排除重复性文献。资料提炼:共收集88篇关于脑卒中运动功能评定方面的研究文献,根据纳入标准,排除与脑卒中运动功能评定关系不大的80篇,共8篇文献纳入分析。资料综合:脑卒中运动功能评定可分为两大类,包括以肌力变化为标准的评价法和以运动模式改变为标准的评定体系。以运动模式改变为标准的评定体系中临床上常采用的有8个评定法,分别是Brunnstrom、Bobath法、上田敏法及Fugl-Meyer评定法、MAS评定法、Rivermead法、Lindmark评定法和KarenMargrethe评定法。目前最新研究的脑卒中运动功能评定方法为脑卒中病损评估法。结论:早期而全面的对脑卒中患者运动功能进行评价,有助于了解患者运动障碍的程度,指导制定康复方案,观察治疗效果及分析预后。

OBJECTIVE： By summarizing relevant literatures about motor functional assessment of stroke at home and abroad so as to select convenient, practical and highly reliable evaluation method of motor functional rehabilitation in clinical scientific research according to different requirement. DATA SOURCES： The CNKI database between January 1995 and September 2005 as well as Wanfang database from January 1994 to January 1995 were searched for articles on rehabilitation assessment with the key words of ＂rehabilitation assessment＂ in Chinese. At the same time, we also searched books relevant to rehabilitation evaluation by hand published from January 1985 to December 2002 in Chinese, English and Japanese with the key words of ＂stroke, rehabilitation, motor functional assessment＂. STUDY SELECTION： An inclusive criterion was the articles about motor functional assessment of stroke. The representative literatures were selected and the repetitive articles were excluded. DATA EXTRACTION＂ Totally 88 articles related to motor functional assessment of stroke were collected. According to the inclusive criterion, 80 papers without study of motor functional assessment of stroke were excluded, and 8 literatures were involved in the analysis. DATA SYNTHESIS： The motor functional assessment of stroke could be classified into two types, namely evaluation method of passing by change of muscle strength and method of going by the change of motor pattern. The evaluation architecture going by motor pattern had 8 evaluation methods in clinic, that were, Brnnnstrom, Bobath method, Shangtian method, Fugl- Meyer method, MAS method, Rivermead method, Lindmark method, Karen Margrethe method. Nowadays, the most common assessment of motor functional evaluation of stroke was evaluation method of stroke lesion. CONCLUSION： Early and complete motor function evaluation for stroke patients will redound to find out the degree of dysfunction, make the direct rehabilitation plan, observe the therapeutic efficacy and analyze the prognosis.