动作观察疗法对脑卒中后单侧忽略的效果

Effect of Action Observation Therapy on Unilateral Spatial Neglect after Stroke

目的探讨动作观察疗法对于脑卒中后单侧忽略的治疗效果。方法 2017年3月至2018年4月,44例脑卒中后左侧单侧忽略患者随机分为对照组(n=22)和试验组(n=22)。在常规康复训练的基础上,对照组接受动态风景视频观察训练,试验组接受动作观察训练。分别于训练前、训练1周和训练3周后用中国行为性忽略测试-香港版(CBIT-HK)常规测试中的4项(短线划销、字母划销、星星划销、二分线段)进行评估,并比较简易精神状态检查(MMSE)、Fugl-Meyer评定量表(FMA)及日常生活活动能力量表(ADL)评分。结果训练1周后,两组CBIT-HK常规测试4项分数大多较训练前改善(t>2.712,P<0.05),且试验组线段二等分百分比显著优于对照组(t=4.822,P<0.001);训练3周后,两组CBIT-HK常规测试4项分数及MMSE、FMA、ADL评分均较训练前改善(t>1.596,P<0.05),试验组的短线划销、字母划销及线段二等分百分比明显低于对照组(t>3.577,P<0.01)。结论动作观察训练有助于改善脑卒中后患者单侧忽略症状。

Objective To explore the effect of action observation therapy on unilateral spatial neglect after stroke.Methods From March,2017 to April,2018,44 patients with left-sided neglect due to unilateral right-sided vascular brain lesions were randomly divided into control group(n=22)and experimental group(n=22).The control group received the dynamic landscape video observation training,and the experimental group received the action observation training,based on routine rehabilitation,for three weeks.Before treatment,one week and three weeks after treatment,they were evaluated with Chinese Behavioral Inattention Test-Hong Kong version(CBIT-HK)routine tests(short line cancellation test,letter cancellation test,star cancellation test and line segment bisect),and the scores of Mini-Mental State Examination(MMSE),Fugl-Meyer Assessment(FMA)and Activities of Daily Living(ADL)were compared.Results One week after treatment,four scores of CBIT routine tests almost improved(t>2.712,P<0.05),and the score of line segment bisect was significantly better in the experiment group than in the control group(t=4.822,P<0.001).Three weeks after treatment,four scores of CBIT routine tests and the scores of MMSE,FMA and ADL improved in both groups(t>1.596,P<0.05),and the scores of short line cancellation test,letter cancellation test and line segment bisect were significantly lower in the experiment group than in the control group(t>3.577,P<0.01).Conclusion The action observation therapy could faciliate to improve the lateral neglect of patients after stroke.