任务导向性训练对脑卒中偏瘫者骨骼肌含量及肌力的影响

Effects of task oriented training on the content of skeletal muscle and muscle force after stroke

目的:探讨以任务导向性训练(task oriented training,TOT)为主的康复训练对脑卒中偏瘫骨骼肌含量、肌力以及肢体功能的影响。方法:按照入院病例号对患者进行编号,根据随机数字表,将240例脑卒中患者随机分成2组,每组120例。并安排在两个康复室进行康复训练。对照组给予常规康复训练方法,以抑制异常模式等方法促进神经修复;观察组在此基础上将任务导向性训练模式贯穿于康复训练之中,已指导和具体化康复内容。于康复治疗前1天和治疗1个月后测定患者上、下肢骨骼肌含量、肢体肌力情况,并评估患者肢体功能以及日常生活活动能力。结果:康复训练后,观察组肢体骨骼肌含量和肌力结果分别为(8.8±0.6)kg和(362.7±24.6)N,均优于训练前和训练后对照组测定结果(P<0.05);观察组患者训练后Fugl-Meyer运动功能评分(Fugl-Meyer assessment of sensorimotor recovery,FMA)和Barthel指数(the Barthel index,MBI)评分分别为(84.8±8.6)分和(82.7±5.6)分,均优于训练前和训练后对照组评分结果(P<0.05)。结论:TOT可将康复训练内容细致化和具体化,并提高患者接受康复训练的积极主动性,增强骨骼肌含量和肌力,提高运动的协调性。

Objective：To explore the effect of rehabilitation training with task oriented training（TOT） on the content of skeletal muscle, muscle force and limb function after stroke. Methods ：Totally 240 stroke patients were randomly divided into two groups（each group of 120 cases） according to the admission number of patients and were trained in two rehabilitation rooms. The patients in control group were given routine rehabilitation training to suppress the abnormal patterns and other methods to promote nerve repair. The pa- tients in observation group were given TOT to guide the rehabilitation content. One day before rehabilitation and one month after rehabilitation, content of skeletal muscle, muscle force and limb function after stroke and activities of daily living were tested. Results： After rehabilitation,the content of skeletal muscle and muscle force were （8.8 ± 0.6） kg and （362.7 ± 24.6） N in the observation group, better than those before training and those in the control group after training （P〈0.05）. Fugl-Meyer Assessment of Sensorimo- tor Recovery score（FMA） and the Barthel index（MBI） score were （84.8 ±8.6） points and （82.7±5.6） points in the observation group, better than those before training and those in the control group after training（P〈0.05）. Conclusion ：TOT can make the training content specific and meticulous,improve the initiative of patients receiving rehabilitation training, enhance skeletal muscle mass and muscle force, and improve the coordination of movement .