强迫运动疗法对脑卒中患者偏瘫上肢功能的影响

Influence of constraint-induced movement therapy on upper limb function of hemipalalysis in patients with stroke

目的:观察强迫运动疗法(CIMT)对脑卒中患者偏瘫上肢功能,包括手功能的康复疗效。方法:符合入选条件的40例脑卒中患者被随机均分为强迫运动组和常规康复对照组,强迫运动组只采用强迫运动疗法,即限制健侧肢体运动,治疗期间健侧上肢穿戴吊带和夹板(即清醒时固定时间不少于90%),根据制定动作程序进行患侧肢体的反复训练,每天6 h,每周5 d,连续4周,不采用其他康复治疗手段;常规康复对照组采用常规康复治疗方法即易化技术,以bobath方法为主,进行上肢及手功能训练,每天2个单元(每个单元40 min),每周5 d,连续4周。功能评价采用简化Fugl-Meyer上下肢运动功能量表(FMA)和简易上肢功能评价表(STEF)。结果:常规康复组治疗后FMA、STEF评分有明显提高(分别为26.3→34.1,38.6→41.4)(P<0.05),CIMT组有更显著提高(分别为26.3→53.2,38.7→60.5,P<0.01),且比常规康复组显著(P<0.01)。结论:CIMT对于脑卒中患者偏瘫上肢功能是较常规康复疗法更有效的康复治疗手段。

Objective： To study the influence of constraint-induced movement therapy （CIMT） on upper limb function of hemipalalysis in patients with stroke. Methods： Forty patients with stroke were＇ randomly average divided into CI-MT group and routine rehabilitation therapy （RRT） group. The CIMT group was treated with constraint-induced movement therapy i. e. training of hemipalalysis limb was conducted by 6h/d, 5d/week, 4weeks, according devised program and without other rehabilitation therapy, while uninjured side upper limb wearing suspender and cleat. The group RRT was treated with routine rehabilitation therapy by 40 min/d, 5d/week, and 4weeks. Fugal-Meyer motor assessment （FMA） and simple test for evaluating hand function （STEF） were used for evaluating function. Results： After therapy the score of FMA and STEF in group RRT increased （26.3→34.1, 38.6→41.4 respectively. P〈0.05）. but in group CIMT score of FMA and STEF more increased （26.3→53.2, 38.3→60.5 respectively. P〈0.01） and more than those of group RRT （P〈0. 01）. Conclusion： Constraint-induced movement therapy possesses more effect than routine rehabilitation therapy for upper limb function rehabilitation of hemipalalysis in patients with stroke.