末端牵引式上肢康复训练系统在脑卒中后上肢运动功能障碍患者中的临床应用研究

The effect of end-traction upper limb rehabilitation training system on upper limb motor dysfunction after stroke

目的探究末端牵引式上肢康复训练系统对脑卒中后上肢运动功能障碍患者的临床疗效。方法选取2019年9月-11月在南昌大学第一附属医院康复医学科住院的脑卒中后上肢运动功能障碍患者。根据软件生成随机序列,将患者随机分为试验组和对照组。两组均接受常规药物治疗、基础性康复治疗及日常生活能力训练。此外对照组给予传统作业训练,试验组给予末端牵引式上肢康复训练,两组训练时间均为30 min/(次·d),每周治疗5 d。两组患者均在治疗前、第4周治疗结束后采用简化Fugl-Meyer上肢运动功能评分(Fugl-meyer assessment,FMA)、改良Barthel指数(modified Barthel index,MBI)进行康复评价。结果共纳入患者36例,每组各18例。所有患者均完成试验,未出现特殊不适。治疗前,试验组[(13.22±3.13)、(49.66±6.81)分]与对照组[(14.78±1.70)、(51.67±6.65)分]的FMA、MBI比较,差异均无统计学意义(t=1.858、0.896,P=0.072、0.377)。治疗4周后,两组FMA、MBI较治疗前均改善明显(P<0.05),且试验组[(27.56±15.68)、(73.55±8.72)分]较对照组[(17.67±6.73)、(65.33±9.20)分]改善明显(t=2.459、2.751,P=0.019、0.009)。结论末端牵引式上肢康复训练系统可明显改善脑卒中后上肢运动功能障碍患者上肢运动功能,提高患者日常生活能力,值得临床推广及应用。

Objective To explore the clinical effect of the end-traction upper limb rehabilitation training system on patients with upper limb motor dysfunction after stroke. Methods Patients with upper limb motor dysfunction who were admitted to the Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanchang University from September to November 2019 were selected. According to the software, the patients were randomly divided into the experimental group and the control group. Both groups received conventional medical treatment, basic rehabilitation, and activities of daily living training. In addition, the control group received traditional occupational therapy, while the experimental group received end-traction upper limb rehabilitation training. The training time of both groups was30 min/(times ·d) and 5 days per week. Rehabilitation evaluation and recording were performed before and after the fourweek treatment in both groups using the simplified upper extremity Fugl-Meyer assessment(FMA) and the modified Barthel index(MBI). Results A total of 36 patients were enrolled, with 18 in each group. All patients completed the experiment, and no special discomfort was observed. Before the treatment, there was no statistically significant difference in FMA and MBI between the experimental group [(13.22±3.13) and(49.66±6.81) points] and the control group[(14.78±1.70) and(51.67±6.65) points](t=1.858, 0.896;P=0.072, 0.377). After four-week treatment, FMA and MBI in both groups improved significantly(P<0.05);the difference between the experimental group [(27.56±15.68) and(73.55±8.72)points] and the control group [(17.67±6.73) and(65.33±9.20) points] was statistically significant(t=2.459, 2.751;P=0.019,0.009). Conclusions The end-traction upper limb rehabilitation training system can significantly improve the upper limb motor function of patients with upper limb motor dysfunction after stroke and improve the patients’ daily life ability. It is worthy of clinical promotion and application.