动作观察疗法对脑出血患者上肢康复效果的影响

The Effects of Action Observation Therapy on Rehabilitation of Upper Limb in Patients with Cerebral Hemorrhage

目的:探讨动作观察疗法对脑出血患者上肢康复效果的影响。方法:选取2017年6月至2018年5月接受治疗脑出血的患者89例。按照随机数表法随机分为对照组和观察组,对照组患者44例,进行常规的康复治疗;观察组患者45例,在进行常规康复治疗的基础上,行动作观察疗法。分别于治疗前、治疗8周后,用Fugl-Meyer运动功能评定量表对两组患者上肢运动功能情况进行评定;用Barthel指数对两组患者日常生活活动能力改善情况进行评定;对患者的运动功能和日常生活活动能力进行评定,利用体感诱发电位检测患者感觉传导通路情况。结果:治疗前两组患者的FMA评分差异无统计学意义(P>0.05),治疗8周后,观察组患者的FMA评分比对照组高,差异具有统计学意义(P<0.05);两组患者治疗前BI指数均明显小于治疗8周后,差异具有统计学意义(P<0.05);观察组患者的BI指数在治疗8周后情况变化与对照组相比,差异无统计学意义(P>0.05);两组患者治疗8周后SEP的N9、N20的潜伏期缩短、波幅变大;治疗8周后,观察组患者N9、N20的潜伏期缩短值明显大于对照组,N9、N20的波幅增大值观察组明显优于对照组,差异具有统计学意义(P<0.05)。结论:动作观察疗法对脑出血患者上肢康复有良好效果,上肢活动能力增强、日常生活能力和SEP明显改善。

Objective:To investigate the effect of motion observation on the rehabilitation of upper limb in patients with cerebral hemorrhage.Methods:From June 2017 to May 2018,89 patients were randomly divided into two groups with intracerebral hemorrhage:the control group and the observation group.The control group was consisted of 44 patients.The observation group used the routine rehabilitation treatment.On the basis of routine rehabilitation treatment,45 patients in the observation group were treated with action observation therapy respectively before and after 8 weeks of treatment.The motor function of upper limbs in two groups was evaluated by Fugl-Meyer motor function assessment scale.The Barthel index was used to evaluate the improvement of ADL in the two groups.The motor function and activity of daily living(ADL)were evaluated by somatosensory evoked potential to detect the sensory conduction pathway in patients.Results:There was no significant difference in FMA score between the two groups before treatment(P>0.05).After 8 weeks of treatment,the FMA score of the patients in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The BI index of the two groups before treatment was significantly lower than that after 8 weeks treatment.The difference was statistically significant(P<0.05).The BI index of the patients in the observation group was different from that in the control group after 8 weeks of treatment.There was no significant difference between the two groups(P>0.05).After 8 weeks of treatment,the incubation period of N9 and N20 of SEP in the two groups was shortened and the amplitude increased.After 8 weeks of treatment,the shortened latency of N9,N20 in the observation group were significantly higher than that of the control group,The amplitude increase value of N9 and N20 in the observation group was significantly better than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:The action observation had good effect on the upper limb recovery of the patients with cerebral hemorrhage,the ability of upper limb activity increased,and the daily living ability and SEP improved obviously.