运动想象联合改良强制性运动疗法对脑卒中患者上肢运动功能的影响

Effects of motor imagery combined with modified constraint-induced movement therapy on upper limb motor function in stroke patients

目的:探讨运动想象疗法联合改良强制性运动疗法对脑卒中患者上肢运动功能的影响。方法:将首发脑卒中患者40例随机分为研究组和对照组,每组各20例。对所有患者进行常规康复训练和改良强制性运动疗法,前者2次/d,30min/次;后者1次/d,1h/次,均5d/周,共4周。研究组患者在此基础上,另外进行4周的运动想象疗法,20min/次,1次/d,5d/周。在入组时和治疗4周后进行功能评定,采用简化Fugl-Meyer运动功能量表上肢部分(FMA-UE)、上肢运动研究量表(ARAT)和改良Barthel指数量表(MBI)评价患者上肢运动功能和日常生活活动能力。结果:治疗4周后,2组患者FMA-UE评分、ARAT评分和MBI评分均较治疗前均明显提高(均P<0.01),研究组患者上述评分均高于对照组(P<0.01,0.05)。结论:运动想象联合改良强制性运动疗法可以显著改善脑卒中患者的上肢和手运动功能、日常生活活动能力。

Objective:To investigate the effects of motor imagery combined with modified constraint-induced movement therapy on the upper limb motor function in stroke patients.Methods:All 40 first-ever stroke patients were randomly divided into experimental group and control group(n=20 in each group)according to the random number table.Both groups received traditional rehabilitation and modified constraint-induced movement therapy for 5 days a week for 4 weeks.The experimental group was given twice a day for 30 min,and the control group was given once a day for 1 h.On this basis,the experimental group was treated with motor imagery for 4 weeks,once a day for 20 min,5 days a week.All patients were assessed before and after treatment.The Fugl-Meyer Assessment for the Upper Extremities(FMA-UE)score and Action Research Arm Test(ARAT)were used to assess upper limb motor function.The modified Barthel index(MBI)was used to evaluate the activities of daily living.Results:After 4 weeks of treatment,the FMA-UE score,ARAT score and MBI score in the two groups were significantly improved as compared with those in the same group before treatment(all P<0.01);the FMA-UE score,ARAT score and MBI score in the experimental group were higher than those in the control group(P<0.01).Conclusion:Motor imagery combined with modified constraint-induced movement therapy may effectively improve the upper limb motor function and promote the activity of daily living in stroke patients.