运动想象在慢性期偏瘫患者下肢功能康复中的应用研究

Effect of Motor Imagery on Lower-Limb Functional Restoration in Stroke Patients with Hemiplegic

目的:探讨在康复训练中结合运动想象对偏瘫患者下肢功能恢复的影响。方法:选择脑卒中慢性期偏瘫患者20例,随机分为先运动想象组(A组)和后运动想象组(B组),两组进行两阶段(阶段Ⅰ和阶段Ⅱ)交叉实验。在实验过程中,所有患者均由治疗师采用神经生理学疗法以及运动再学习等技术进行常规康复训练,45min/次,1次/天,5天/周。A组在第Ⅰ阶段、B组在第Ⅱ阶段于常规康复训练前跟随指导语录音进行运动想象,想象内容包括患肢负重和快速步行,10～15min/次。分别评测每一阶段实验前后Rivermead运动指数(RMI)、Fugl-Meyer运动功能评定(FMA)(下肢部分)、10m最快步行速度(10mMWS)及单位体重患腿最大承重值。对A、B两组在常规康复训练结合运动想象阶段与仅常规康复训练阶段治疗前后的差值进行交叉对照比较。结果:与仅常规康复训练阶段相比,结合运动想象阶段RMI、10mMWS及单位体重患腿最大承重值提高明显(P<0.01或P<0.05);FMA差异无统计学意义(P>0.05)。结论:在康复训练中结合运动想象练习可以促进慢性期偏瘫患者下肢功能的改善。

Objective To study the effect of motor imagery combined with rehabilitative treatment on towerlimb function restoration of hemiplegie patients. Methods Two-period cross-over design was used. Twenty patients in chronic stage were randomly divided into two groups. Conventional rehabilitative treatment including neurodevelopment facilitation technique and motor relearning program （once a day, 45min per section, and 5 dags per week） was carried out in the whole stage and motor imagery was added in group A in stage Ⅰ and group B in stage Ⅱ . All patients were assessed with RMI, FMA（lower-limb）, 10m MWS and max affected limb-loading per weight at the beginning and at the end of each stage. Results RMI, 10m MWS and max affected limb-loading per weight in the stage of conventional treatment combined with motor imagery stage was better than that in the stage of regular treatment only（P〈0.01, P〈0.05）. But no significant difference in FMA in each stage（P〉 0.05）. Conclusion Motor imagery has positive effect on the lower-limb function restoration of chronic hemiplegic patients.