强制性使用运动疗法对慢性期脑卒中患者上肢运动功能的康复疗效

Efficacy of Constraint-induced Movement Therapy on Motor Function of Upper Extremity of Chronic Stroke Patients

目的探讨强制性使用运动疗法(CIMT)对慢性期脑卒中患者上肢运动功能的康复疗效。方法15例慢性期脑卒中偏瘫患者(平均病程13.5个月)在CIMT治疗期间健侧穿戴吊带和夹板限制肢体动作,每天清醒时固定时间不少于90%,连续12d;同时接受塑形训练,密集训练患侧肢体活动,完成日常生活动作,连续两周共10个工作日。在CIMT治疗前2周的基线期、治疗前和治疗后采用上肢功能测验(UEFT)和简易上肢机能检查(STEF)评价患者的上肢运动功能。结果患者在CIMT治疗前2周的基线期内,UEFT和STEF显现出微小改善(ES0.11,0.13);接受2周CIMT治疗后,UEFT和STEF显现出较为明显的改善(ES0.8,0.5)。结论CIMT是改善慢性期脑卒中患者上肢运动功能的一种有效治疗方法,短期CIMT介入可以促进患侧上肢功能多方面的改善。

Objective To explore the efficacy of constraint induced movement therapy （CIMT） on motor function of upper extremity of chronic stroke patients. Methods Fifteen chronic stroke patients with hemiparesis （course of diseases more than 13.5 months） were treated by CIMT, involving restriction of movement of the intact upper extremity by placing it in a sling for 90% of waking hours for 12 days and training （by shaping） of the more affected extremity for 6 hours on the 10 workdays during that period, The therapeutic effect was evaluated with upper extremity function test （UEFT） and simple test for evaluating hand function （STEF）. Results Patients showed a significant and very large degree of improvement after treatment on UEFT and STEF （ES, 0, 8 and 0.5, L respectively）. Conclusion CIMT may be an efficacious method for improvement of the affected arm function of chronic stroke patients.