运动想象疗法对脑卒中偏瘫患者肩关节半脱位康复治疗的效果

Effect of Movement Imagination Therapy on Shoulder Subluxation in Patients with Hemiplegia following Stroke

目的探讨运动想象疗法在脑卒中偏瘫患者肩关节半脱位(GHS)康复治疗中的效果。方法将脑卒中GHS 60例患者按随机数字表法分为治疗组和对照组,各30例。均给予常规GHS康复训练,治疗组同时进行运动想象训练。2组治疗前后采用Fugl-Meyer上肢运动功能评分(FMA)、疼痛视觉模拟评分(VAS)、改良Barthel(MBI)指数评估患侧上肢功能,采用双肩关节半脱位X线照片法(AHI)评定肩关节复位情况。结果治疗4周后,2组FMA、VAS、MBI指数及GHS复位率均较治疗前明显提高(P<0.01)。治疗组FMA、VAS、MBI指数较对照组有明显提高(P<0.05),但肩关节复位总有效率与对照组差异无统计学意义(P>0.05)。结论运动想象疗法对脑卒中后偏瘫患者GHS疗效确切,可明显改善患侧上肢运动功能、疼痛及日常生活能力,但运动想象疗法联合常规康复对GHS的治疗不优于单独的常规康复治疗。

Objective To discuss the effect of movement imagination therapy on shoulder subluxation in patients with hemiplegia following stroke.Methods Sixty patients with hemiplegia following stroke were randomly assigned to receive regular rehabilitation alone（control group,n=30） or in combination with movement imagination therapy（treatment group,n=30）.Ipsilateral upper limb motor function was evaluated by Fugl-Meyer assessment（FMA）,visual analog scale（VAS） and modified Barthel index（MBI）.The reduction of shoulder joint was assessed by double shoulder arthrography.Results After treatment for 4 weeks,scores of FMA,VAS,MBI and shoulder joint reduction were significantly improved in both groups（P0.01）.Compared with control group,scores of FMA,VAS and MBI obviously increased in treatment group（P0.05）.However,no significant differences were found in the total effective rate of shoulder joint reduction between the two groups（P0.05）.Conclusion The movement imagination therapy can obviously improve ipsilateral upper limb motor function,relieve pain and enhance daily living skills in patients with hemiplegia following stroke.However,combined treatment with regular rehabilitation and movement imagination therapy is not superior to reqular rehabilitation alone for shoulder subluxation.