镜像疗法结合运动想象训练对脑卒中后偏瘫患者上肢功能和日常生活活动能力的影响

The effect of mirror therapy supplemented with motor imaging training on the upper limb function of hemi-plegic stroke patients

目的观察镜像疗法结合运动想象训练对脑卒中后偏瘫患者上肢运动功能和日常生活活动（ADL）能力的影响。方法将脑卒中后偏瘫患者44例按随机数字表法分为治疗组和对照组，每组患者22例，所有患者均接受常规的康复训练。治疗组增加镜像疗法和运动想象相结合的作业治疗，对照组则增加常规作业训练。2组患者均于治疗前和治疗6周后（治疗后）采用Brunnstrom分期、偏瘫上肢功能测试（香港版）（FTHUE-HK）和Barthel指数（BI）评分分别评价其上肢和手的运动功能以及ADL能力。结果治疗后，治疗组患者的Brunnstrom分期、FTHUE-HK评分和BI评分分别为（4．55±0．86）级、（5．73±1．03）级和（73．50±10．89）分，对照组则分别为（3．90±1．02）级、（4．55±1．34）级和（67．05±12．03）分，2组各项指标与组内治疗前比较，差异均有统计学意义（P〈0．05），且治疗组各项指标显著优于对照组（P〈0．05）。结论镜像治疗结合运动想象训练可有效地改善脑卒中偏瘫患者的上肢功能和ADL能力。

Objective To investigate the effects of mirror therapy supplemented with motor imaging training on the upper extremity functions of hemiplegic stroke patients and on their ability in the activities of daily living （ADL）. Methods Forty-four stroke patients were divided into a control group and an experimental group with 22 patients in each. All were given routine rehabilitation treatment. In addition, the experimental group was given 30 minutes of mirror therapy daily supplemented with 15 minutes of motor imaging training. The control group was given routine occupational therapy. All the patients were assessed with Brunnstrom staging, the functional test for the hemi- plegic upper extremity-Hong Kong （FTHUE-HK） and the Barthel index （BI） scale before therapy and after 6 weeks. Results After 6 weeks of treatment, both groups showed significant improvements in upper limb function, hand function, and ADL ability. There were significant intra-group differences and significant differences between the ex- perimental and control groups in terms of Brunnstrom staging, FTHUE-HK scores and BI scores. Conclusions Mirror therapy supplemented with motor imaging training can benefit patients suffering hemiplegia in improving their upper limb functioning and their ADL ability.