运动想象疗法联合PNF躯干模式训练对脑卒中偏瘫患者上肢功能、步行功能和躯干控制能力的影响

Effects of Motor Imagery Therapy Combined with PNF Trunk Model Training on Upper Limb Function,Walking Function and Trunk Control Ability of Stroke Patients with Hemiplegia

目的:探讨运动想象疗法(MI)联合神经肌肉本体感觉促进术(PNF)躯干模式训练对脑卒中偏瘫患者上肢功能、步行功能和躯干控制能力的影响。方法:选取2015年1月-2019年6月期间中国人民解放军第九八三医院及中国中医科学院望京医院康复治疗中心收治的112例脑卒中偏瘫患者。根据按入院顺序编号的奇、偶数分为对照组(n=56)和研究组(n=56),对照组给予常规康复训练联合MI训练,研究组在对照组基础上联合PNF躯干模式训练,两组均干预8周。对比两组干预前、干预4周后、干预8周后的Carroll手功能评定(UEFT)、Fugl-Meyer运动功能评定(FMA)、改良的Barthel指数(m BI)、功能性步行分级(FAC)、Tinetti步态评估量表(TGA)、躯干控制能力测试(TCT)、Berg平衡功能量表(BBS)、坐-站-坐时间以及躯干前倾距离。结果:两组干预4周后、干预8周后UEFT、FMA、m BI评分逐渐升高,且研究组高于对照组(P<0.05)。两组干预4周后、干预8周后FAC、TGA评分逐渐升高,且研究组高于对照组(P<0.05)。两组干预4周后、干预8周后TCT、BBS评分逐渐升高,且研究组高于对照组(P<0.05)。两组干预4周后、干预8周后坐-站-坐时间逐渐降低,且研究组低于对照组(P<0.05),躯干前倾距离逐渐升高,且研究组高于对照组(P<0.05)。结论:MI联合PNF躯干模式训练治疗脑卒中偏瘫患者,可有效改善患者步行功能、上肢功能和躯干控制能力。

Objective:To investigate the effects of motor imagery therapy(MI)combined with neuromuscular proprioception facilitation(PNF)trunk mode training on upper limb function,walking function and trunk control ability of stroke patients with hemiplegia.Methods:112 stroke patients with hemiplegia in the 983 Hospital of Chinese people’s Liberation Army and the rehabilitation treatment center of Wangjing Hospital of Chinese Academy of traditional Chinese medicin from January 2015 to June 2019 were selected.The patients were divided into control group(n=56)and study group(n=56)according to odd and even numbers numbered according to admission sequence.The control group was given routine rehabilitation training combined with MI training,and the study group was combined with PNF trunk mode training on the basis of the control group.Both groups were intervened for 8 weeks.Carroll hand function assessment(UEFT),Fugl-Meyer motor function assessment(FMA),modified Barthel Index(m BI),functional walking classification(FAC),Tinetti gait assessment scale(TGA),trunk control ability test(TCT),Berg Balance Function Scale(BBS),sit-stand-sit time and torso forward tilt distance were compared before intervention,4 weeks after intervention and 8 weeks after intervention.Results:The scores of UEFT,FMA and MBI of the two groups increased gradually at 4 weeks and 8 weeks after intervention,and study group was higher than control group(P<0.05).FAC and TGA scores of the two groups increased gradually at 4 weeks and 8 weeks after intervention,and the study group was higher than those control group(P<0.05).TCT and BBS scores of the two groups gradually increased at 4 weeks and 8 weeks after intervention,and study group was higher than control group(P<0.05).The sit-stand-sit time of the two groups gradually decreased at 4 weeks and 8 weeks after intervention,and study group was lower than control group(P<0.05),and the torso forward tilt distance was gradually increased,and study group was higher than control group(P<0.05).Conclusion:MI combined with PNF trunk mode training can effectively improve the walking function,upper limb function and trunk control ability of stroke patients with hemiplegia.