运动想象疗法对脑卒中偏瘫患者步行能力影响的系统评价

Systematic review of motor imagery on rehabilitation of walking function in stroke patients

目的：系统评价运动想象疗法对脑卒中偏瘫患者步行能力康复的效果。方法采用系统评价的办法，检索多个中英文数据库，搜集相关随机对照试验，进行质量评价后，采用RevMan 5.0软件进行数据分析。结果共纳入11篇文献，结果显示，≤6周的运动想象疗法结合常规康复治疗在提高患者平衡能力、下肢运动功能、步行能力、日常生活活动能力方面优于常规康复治疗，差异有统计学意义（P〈0.05）。但在作用效果保持方面，只有1篇文献结果显示在干预结束2周后，干预组的平衡能力和日常生活活动能力仍然优于对照组，差异有统计学意义（P〈0.05），其余文献结果显示干预结束2周后，运动想象疗法对患者平衡能力、下肢运动功能和步行能力的优势作用消失，差异无统计学意义（P 〉0.05）。结论运动想象疗法可明显改善患者下肢运动功能和步行能力，但远期效果目前并不确定。由于文中纳入的RCT研究较少，确切结果仍有待于临床开展多中心、大样本RCT来证实。

Objective To evaluate the effect of motor imagery on rehabilitation of walking functions in patients with stroke. Methods Related RCTs were systematically reviewed by using multiple electronic databases. A weighted mean difference for continuous data was calculated with 95% confidence intervals. The RevMan 5. 0 software was used to do the data analysis. Results A total of eleven trials were included. The results of systematic review showed that compared with the control group, at the end of 6-week or less than 6-week intervention, the scores of balance ability, lower limb function, walking ability and activities of daily living were significantly higher （P〈0. 05）. But the results of 2-week follow up showed these advantages could not last for two weeks for sure, the difference was statistically significant （P〈0. 05）. Other papers showed that after 2-week intervention, the scores of balance ability, lower limb function and advantages of walking ability were not significantly different （P〉0. 05）. Conclusions Motor imagery could improve the lower limb function and walking abilities in patients with stroke, but the long-term effects are not certain currently. However, large-scale RCTs of higher quality are needed to be confirmed.