基于Kinect探讨针刺结合康复训练对脑卒中患者上肢功能的影响

Effects of Rehabilitation Training Combined with Acupuncture on Upper Limb Function of Stroke Patients Based on Kinect

目的 用Kinect探讨针刺结合康复训练对脑卒中患者上肢功能的影响。方法 将脑卒中后上肢功能障碍患者随机分为对照组(康复训练)和治疗组(针刺+康复训练)各15例。比较两组患者治疗前后改良Barthel指数(modified Barthel index,MBI)、Fugl-Meyer运动功能评估(Fugl-Meyer assessment,FMA)及Wolf运动功能测试(Wolf motor function test,WMFT),用Kinect评估两组患者干预前后前臂放桌面、伸肘、喝水3个动作的运动时间(motor time,MT)、运动单位数量(motor unit number,MUN)、曲率指数(index of curvature,IC)、肘关节屈曲角度(elbow flexion angle,EFA)、肩关节屈曲角度(shoulder flexion angle,SFA)与肩关节内收角度(shoulder adduction angle,SAA)的变化。结果 经过6周治疗,治疗组患者MBI和FMA分数、WMFT总分数及伸肘分数均高于对照组(P<0.05);两组患者MBI和FMA分数、WMFT总分数、前臂放桌面、伸肘及喝水分数组内比较均高于治疗前(P<0.05)。治疗组患者3个动作的MT、MUN、IC、EFA、SFA、SAA改善情况均优于对照组(P<0.05);两组患者前臂放桌面、伸肘动作的EFA均较治疗前增加(P<0.05),MT、MUN、IC、SFA、SAA均较治疗前减小(P<0.05);两组患者喝水动作的EFA、SFA均较治疗前增加(P<0.05),MT、MUN、IC、SAA均较治疗前减小(P<0.05)。结论 针刺结合康复训练可以提高脑卒中患者上肢功能。Kinect能精准反映脑卒中患者上肢功能的变化,适合运用于临床工作。

Objective To investigate the effect of rehabilitation training combined with acupuncture(RTA) on upper limb function of stroke patients by Kinect.Methods Stroke patients with upper limb dysfunction were randomly divided into control group(rehabilitation training) and treatment group(RTA),with 15 cases in each group.The modified Barthel Index(MBI),Fugl Meyer assessment(FMA),and Wolf motor function test(WMFT) were compared between two groups before and after treatment.The changes in motor time(MT),motor unit number(MUN),index of curvature(IC),elbow flexion angle(EFA),shoulder flexion angle(SFA),and shoulder adduction angle(SAA) during three actions,namely,placing forearm on the table,extending elbow and drinking water,were evaluated by Kinect and then compared between two groups before and after treatment.Results After 6 weeks of intervention,the scores of MBI,FMA,WMFT and elbow extension in treatment group were higher than those in control group(P<0.05).The scores of MBI,FMA,WMFT and three actions after treatment were higher than those before treatment(P<0.05).For three actions,the improvement of MT,MUN,IC,EFA,SFA,and SAA in treatment group were better than those in control group(P<0.05).Compared with pre-treatment,for the action of forearm placement on the table and elbow extension,both treatment group and control group showed an increase in EFA(P<0.05),and a decrease in MT,MUN,IC,SFA and SA(P<0.05).For the action of drinking water,both treatment group and control group showed an increase in EFA and SAA(P<0.05),and a decrease in MT,MUN,IC and SAA(P<0.05).Conclusions RTA can improve the upper limb function of stroke patients.Kinect can accurately reflect the changes in upper limb function of stroke patients,and it is suitable for clinical work.