作业疗法结合运动想象对脑卒中偏瘫患者的上肢与手功能的影响

Study on the effect of occupational therapy combined with exercise imagination on function of upper limbs and hands in stroke patients with hemiplegia

目的探讨作业疗法结合运动想象对脑卒中偏瘫患者的上肢与手功能的影响。方法前瞻性选择脑卒中偏瘫患者48例,随机分为研究组(n=24)与对照组(n=24)。研究组在常规康复治疗的基础上采用作业疗法结合运动想象治疗,对照组仅增加作业疗法。在治疗前与治疗后2个月,分别采用Fugl-Meyer运动量表(FMA)评定上肢与手功能,采用改良Barthel指数(MBI)评定日常生活活动能力,比较两组的差异。结果两组治疗前FMA、MBI评分(研究组:24.5±8.31分,62.32±10.35分;对照组:24.99±6.87分,63.45±11.23分)均无统计学差异(P>0.05)。治疗后评分均能出现提升(研究组:38.51±7.76分,85.62±8.98分;对照组:32.22±7.54分,76.56±7.98分)。研究组治疗后FMA和MBI评分显著高于对照组,差异有统计学意义(P<0.05)。结论运动想象结合作业疗法较单纯作业疗法能更好地改善脑卒中偏瘫患者上肢与手的功能以及日常生活能力。

Objective To explore the effect of occupational therapy combined with exercise imagination on function of upper limbs and hands in patients with hemiplegia after stroke.Methods 48 patients with stroke were divided into study group(n=24)and control group(n=24).Patients in study group were additionally treated with occupational therapy combined with exercise imagination therapy on the basis of routine rehabilitation therapy,while patients in control group were only additionally applied with occupational therapy.The Fugl-Meyer exercise scaling(FMA)was used to assess the function of upper limbs and hands before and 2 months after the treatment.The activity of daily living was assessed by modified Barthel index(MBI),and the difference had been compared between these two groups.Results There was no significant difference in scores of FMA and MBI between these two groups before treatment.The FMA and MBI scores in patients of study group after treatment were significantly higher than those of patients in control group.Conclusion Combination of exercise imagination and occupational therapy can improve the function of upper limbs,hands and the ability of daily living,hence it is better than simple occupational therapy in patients with hemiplegic stroke.