运动想象治疗脑卒中患者手部运动功能的疗效研究

Efficacy of motor imagery on hand function in stroke patients

目的:探讨运动想象(MI)疗法的可行性及有效性,总结适合脑卒中后偏瘫患者的训练方案。方法:将16例脑卒中偏瘫患者随机分为运动想象组(MI)6例、执行运动(EM)组5例、空白组(CG)5例。MI组给予运动想象治疗,EM组进行动作的实际操作训练,CG组仅进行常规康复治疗。使用简易上肢机能检查(STEF)、Fugl-Meyer上肢功能检查(FMA)、改良巴氏指数(MBI)评价患者训练前后的上肢运动功能、日常生活活动能力检查。结果:治疗4周后,MI组及EM组上肢FMA、STEF、评分较训练前及CG组训练后均有明显提高(P<0.05),且MI改善更优于EM组(P<0.05)。治疗4周后,3组MBI评分组内及组间比较差异均无统计学意义。结论:运动想象结合手部运动疗法对患手运动功能的提高比常规训练有更显著的优势。

Objectives：To investigate the feasibility and efficacy of motor imagery（MI）on motor recovery for stroke patients,and to summarize the fittest training program.Methods：Sixty stroke patients were randomly divided into the motor imagery（MI）group（n=6）,the executive motion（EM）group（n=5）and the control group（CG）（n=5）.The patients in the MI group were treated with the MI training,and those in the EM group trained with the actual operation.Each training time took 30 min,20times totally,in a period of four weeks.The patients in the CG group received conventional rehabilitation only.Patients were assessed by Simple Test for Evaluating Hand Function（STEF）,Fugl-Meyer assessment of motor function（FMA）and Modified Barthel Index（MBI）before and after training.Results：After 4weeks of training,the scores of the FMA and STEF were higher in the MI group and the EM group than before training（P〈0.05）,and those were significantly improved in the MI group and the EM group when compared with the CG group（P〈0.05）,especially the MI group.There was no significant improvement of MBI score among the three groups.Conclusions：MI combined with the physical therapy had a more significant advantage on restoration of hand function than conventional rehabilitation.