镜像疗法联合上肢康复机器人训练对脑卒中患者上肢功能的影响

Effect of mirror therapy combined with upper limb rehabilitation robot training on upper limb function of stroke patients

目的观察镜像疗法联合上肢康复机器人训练对脑卒中患者恢复上肢运动功能的疗效。方法选取脑卒中后上肢功能障碍患者75例,按随机数字表法分为常规治疗组、镜像疗法组、镜像疗法联合上肢康复机器人训练组,每组各25例。常规治疗组进行常规运动疗法、常规作业疗法和物理因子治疗等治疗;镜像疗法组在常规治疗组的基础上,进行镜像疗法训练;镜像疗法联合上肢康复机器人训练组在镜像疗法组的基础上应用上肢康复机器人训练。采用上肢Fugl-Meyer量表、Wolf运动功能测试、屈肘和伸腕肌最大等长收缩均方根值和积分肌电值、改良Barthel指数评价患者上肢功能状况。结果治疗6周后,3组患者上肢Fugl-Meyer量表评分、Wolf运动功能评分、屈肘和伸腕肌最大等长收缩均方根值和积分肌电值、改良Barthel指数评分比治疗前提高,且镜像疗法联合上肢康复机器人训练组优于镜像疗法组和常规治疗组,镜像疗法组优于常规治疗组,差异均有统计学意义(P<0.05)。结论镜像疗法和镜像疗法联合上肢康复机器人训练均可有效改善脑卒中患者上肢运动功能,且联合治疗效果更佳。

Objective To observe the effect of mirror therapy combined with upper limb rehabilitation robot training on upper limb function recovery of stroke patients.Method Choose 75 post-stroke patients with upper limb dysfunction and divide them into routine therapy group(n=25), mirror therapy group(n=25) and mirror therapy combined with upper limb rehabilitation robot training group(n=25) by random number table. Patients in routine therapy group receive routine physical therapy, routine occupational therapy and physical factor therapy. Patients in mirror therapy group receive mirror therapy based on the therapy of routine therapy group. Patients in mirror therapy combined with upper limb rehabilitation robot training group receive upper limb rehabilitation robot training based on the therapy of mirror therapy group. Evaluate the upper limb function of patients by Fugl-Meyer Assessment-Upper Extremities(FMA-UE), Wolf Motor Function Test(WMFT), root mean square(RMS) and integral Electromyography(iEMG) of maximum isometric contraction of elbow flexion and wrist extensor, modified Barthel Index(MBI). Result After six weeks, scores on FMA-UE, WMFT, RMS, iEMG and MBI are improved compared to the scores before therapy in all 3 groups. The effect is better in mirror therapy combined with upper limb rehabilitation robot training group than in mirror therapy group and routine therapy group. The effect is better in mirror therapy group than in routine therapy group. The differences are all significant(P<0.05). Conclusion Mirror therapy and mirror therapy combined with upper limb rehabilitation robot training can all improve upper limb function of stroke patients and the combination therapy has a better effect.