运动观察疗法对恢复后期脑卒中患者手功能障碍的疗效研究

Efficacy of action observation therapy for hand motor function after stroke

目的:探讨运动观察疗法(AOT)和重复经颅磁刺激(rTMS)分别结合作业治疗对恢复后期脑卒中患者手功能恢复的临床疗效差异。方法:将52例住院脑卒中患者随机分为对照组16例、AOT组19例和rTMS组17例。对照组接受常规的作业治疗,运动观察疗法组在此基础上增加AOT治疗,rTMS组在此基础上增加rTMS治疗,在治疗前及治疗2个疗程后采用中文版运动功能状态量表(MSS)、Carroll双上肢功能评定及改良Barthel指数量表(MBI)对患者手功能进行评定。结果:经过2个疗程的治疗,3组的MSS、Carroll及MBI评分较治疗前均有显著提高(均P<0.05),AOT组与rTMS组各项评分均高于对照组(均P<0.05),AOT组与rTMS组评分差异无统计学意义。结论:作业治疗结合AOT或rTMS均可提高恢复后期脑卒中患者手功能,2组治疗方法对手功能能力的提高并无显著差异。

Objective:To explore the efficacy of action observation therapy for hand motor function after stroke,and to compare the differences between the effects of action observation therapy and repetitive transcranial magnetic stimulation(rTMS).Methods:Totally 52 stroke survivors were randomly assigned to three groups:the control group(n=16),the action observation therapy group(n=19),and the rTMS group(n=17).The control group received conventional occupational therapy only,the action observation therapy group received conventional occupational therapy and action observation therapy,and the rTMS group received rTMS and conventional occupational therapy.The treatment lasted for 2 courses of treatment.The curative effectiveness was assessed by motor status scale(MSS),Carroll and the modified Barthel Index(MBI)before and after the treatment.Results:After 2 courses of treatment,all of the results in the three groups were significantly better than those before treatment(all P<0.05).The results in both the action observation therapy group and the rTMS group were significantly improved as compared with those in the control group(all P<0.05).There was no significant difference in the scores between the action observation therapy group and the rTMS group.Conclusion:Conventional occupational therapy combined with the action observation therapy or the rTMS could improve the hand function after stroke.There was no significant difference in the improvements between the action observation therapy and the rTMS.