运动想象训练联合经颅直流电刺激对脑卒中偏瘫患者上肢功能的影响

Effects of mental practice combined with transcranial direct current stimulation on the function of the upper limbs in hemiplegic patients with stroke

目的探讨运动想象训练(mental practice,MP)联合经颅直流电刺激(transcranial direct current stimulation,tDCS)对脑卒中偏瘫患者上肢功能恢复的临床疗效。方法选取2015年8月至2016年12月在阜阳市人民医院康复医学科接受康复治疗的脑卒中住院患者80例,按照随机数表法分成2组,观察组41例,对照组39例,2组患者均给予tDCS治疗,观察组患者在tDCS治疗基础上联合MP,1次/d,每周5 d,治疗4周。分别于治疗前及治疗4周后采用Fugl-Meyer评分(Fugl-Meyer assessment,FMA)和改良Barthel指数(modified Barthel index,MBI)进行疗效评定。结果治疗前2组患者FMA、MBI分值比较差异无统计学意义(P>0.05),治疗4周后2组FMA、MBI分值均有明显提高,观察组FMA分值较对照组差异有统计学意义(P<0.05)。结论 MP联合tDCS治疗在改善脑卒中偏瘫上肢运动功能方面有良好的疗效。

Objective To investigate the clinical effects of mental practice （ MP） combined with transcranial direct current stimulation （tDCS） on functional recovery of hemiplegic upper limbs in patients with stroke. Methods The study was conducted by u-sing case-control method. Eighty hemiplegia patients with stroke hospitalized in the Department of Rehabilitation Medicine of Fuyang Peopled Hospital from August 2015 to December 2016 were recruited for the study. The patients were randomly divided into 2 groups the observation group （ n = 41） and the control group （ n = 39 ）. The patients of the 2 groups were all treated with tDCS, but the patients in the observation group were implemented with MP, once a day, 5 days a week and for a succession of 4 weeks. Therapeutic efficacy was evaluated both before treatment and 4 weeks after treatment, by using Fugl-Meyer assessment （FMA） and the modified Barthel in-dex （MBI）. Results Before treatment, there were no significant differences in FMA scores and MBI scores, when comparisons were made between the 2 groups. Following treatment for 4 weeks, the FMA and MBI scores of the 2 groups were all significantly improved. However, statistical significance could be seen in the FMA scores of the observation group, as compared with the control group （P 〈 0. 05 ）. Conclusion Mental practice combined with tDCS could produce good effects on the motor function of the upper limbs in hemi-plegic patients with stroke.