运动想象疗法联合任务导向性训练对脑卒中偏瘫患者上肢运动功能的影响

Effect of Motor Imagery Combined with Task Oriented Training on Upper Limb Motor Function of Stroke Patients

目的:探讨运动想象疗法联合任务导向性训练对脑卒中偏瘫患者上肢运动功能的影响。方法:选取2020年1月~2021年8月在苏州市中医医院针灸康复科住院治疗的脑卒中偏瘫患者80例,采用随机数字表法将患者分为常规组、MI组、TOT组、联合组各20例。四组患者均接受常规康复训练,MI组在此基础上增加MI疗法,TOT组增加TOT训练,联合组同时增加MI疗法和TOT训练。四组患者治疗前及治疗四周后,均采用简式Fugl-Meyer运动功能量表上肢部分(FMA-UE)、FMAUE近端(proximal)、FMA-UE远端(distal)评价上肢运动功能;改良Barthel指数量表(MBI)评价日常生活能力。结果:治疗4周后,四组患者FMA-UE总分、FMA-UE-P和FMA-UE-D及MBI评分均较组内治疗前明显提高(P<0.05);联合组、MI组和TOT组的上述评分均较常规组明显提高(P<0.05);联合组各项评分较MI组和TOT组明显提高(P<0.05);而MI组和TOT组之间各项评分,差异无统计学意义(P>0.05)。结论:运动想象疗法和任务导向性训练均能改善脑卒中患者上肢运动功能和日常生活活动能力,两者联合治疗效果更佳。

Objective: To study the effect of motor imagery combined with task oriented training on upper limb motor function of stroke patients.Methods: 80 stroke patients hospitalized in the acupuncture rehabilitation department of v from January 2020 to August 2021 were selected. The patients were randomly divided into routine group, motor imagery group(MI group), task oriented training group(TOT group) and combined group, 20 cases in each group. All patients in the four groups received routine rehabilitation training. On this basis, MI therapy was added in the MI group, tot training was added in the TOT group, and Mi therapy and tot training were added in the combined group at the same time. Before and four weeks after treatment, the upper limb motor function was evaluated by simple Fugl Meyer motor function scale(FMA), proximal fma-ue and distal fma-ue;The modified Barthel Index Scale(MBI) was used to evaluate the ability of daily living. Results: After 4 weeks of treatment, the total scores of fmaue,fma-ue-p, fma-ue-d and MBI in the four groups were significantly higher than those before treatment(P<0.05);The above scores in the combined group, MI group and tot group were significantly higher than those in the routine group(P<0.05);The scores of the combined group were significantly higher than those of MI group and tot group(P<0.05);There was no significant difference in scores between MI group and tot group(P>0.05).Conclusions:Motor imagery combined with task oriented training can further improve the upper limb motor function of stroke patients.