神经训导虚拟模拟实际训练系统及机制研究

Research on the neurological training fictitious and imitation practical technique

目的 观察神经训导虚拟模拟（虚模）实际训练系统的效果并探讨其机制和临床适应证.方法 将120例偏瘫患者按入院先后随机分为虚模组和训导组各60例,进行1个疗程90次的治疗.分别在治疗前后进行如下功能评定：Fugl-Meyer下肢运动功能评分、运动程序信号的强度和比例,肩外展、伸肘、屈髋、伸膝、足背屈的关节活动度和日常生活能力（ADL）.数据进行分析比较了解治疗的效果,并对该疗法的机制和适应证进行探讨.结果 虚模组60例中,26例无异常步态,行走模式正常,4例有轻度划圈步态.对照组60例中6例使用足托,全部患者步态得到明显矫正.各组治疗后下肢Fugl-Meyer和ADL评分,以及行走时屈髋、伸膝、足背屈关节活动度、运动程序信号的强度和比例与治疗前差异均有统计学意义（P＜0.01）,2组间各项指标均差异无统计学意义（P＞0.05）.结论 神经训导虚模实际训练系统能有效促进患者运动功能康复,达到运动程序重建,是有效的康复训练设备,能保证神经训导康复方法 正确的应用,并能明显减轻体疗师的劳动强度.

Objective To observe the effectiveness of the neurological training fictitious and imitation practical technique. Methods One hundred and twenty hemiplegic patients were divided into two groups： simulation group and control group. The evaluations were made before and after the treatment, including Fugl-Meyer of the lower limbs, the intensity and proportion of the motor program, the motion activity of shoulder extension, elbow extension, hip flexion, knee extension, dorsi flexion, and the activity level of life. Results In the 60 cases of the simulation group, 26 were with normal gait pattern, 4 had light abnormal gait. In the 60 cases of the control group, 6 were still using foot support, but all of them got gait rectification. Before and after the treatment, the changes of Fugl-Meyer of lower limb, the intensity and proportion of the motor program, the motion activity of the hip abduction, hip flexion, knee extension, dorsi flexion, foot eversion, and the activity level of life in each group were all significant （P 〈0.01 ）, but there was no significant difference between the two groups regarding each evaluation item（ P 〉 0.05 ）. Conclusion The neurological training fictitious and imitation practical technique can improve motor function of the patients.