基于改良分级运动想象的康复训练对脑卒中患者上肢功能改善的疗效分析

The efficacy of modified graded motor imagery therapy on upper limb motor function in patients with stroke

目的:探讨改良分级运动想象疗法对脑卒中患者上肢运动功能改善的影响。方法:将40例脑卒中患者按随机数字表法分为改良分级运动想象组(简称“mGMI组”)和对照组,每组各20例。所有患者均接受康复科常规运动康复训练,30min/次,2次/d,5d/周,共4周;mGMI组在常规运动康复训练的基础上另外进行4周的改良分级运动想象疗法训练,30min/次,1次/d,5d/周;于治疗前和治疗4周后对两组患者进行功能评定,分别采用简式Fugl-Meyer运动功能量表上肢部分(FMA-UE)、上肢和手Brunnstrom分期和上肢运动研究量表(ARAT)对患者的上肢运动功能进行评价,比较两组的疗效。结果:治疗前,两组患者的FMA-UE评分、Brunnstrom分期和ARAT评分无显著性差异(P>0.05);治疗4周后,两组患者的FMA-UE评分、Brunnstrom分期和ARAT评分与同组治疗前比较均明显改善,有显著性差异(P<0.05);mGMI组患者的FMA-UE评分、Brunnstrom分期和ARAT评分均优于对照组,有显著性差异(P<0.05)。结论:在常规运动康复训练的基础上,改良分级运动想象疗法能提高脑卒中患者上肢运动功能,治疗效果更加显著。

Objective:To investigate the effects of modified graded motor imagery(mGMI)therapy on the recovery of upper limb motor function in stroke patients.Method:Forty stroke patients who met inclusion criteria were randomly divided into modified graded motor imagery(mGMI)group and control group(n=20 in each group)according to the random number table.The patients in both groups received routine motor rehabilitation,30 minutes at a time,twice a day,5 days a week for 4 weeks.On this basis,the mGMI group was treated with modified graded motor imagery therapy for 4 weeks,once a day for 30min,5 days a week.All patients were assessed before and after treatment.The Fugl-Meyer Assessment for the Upper Extremities(FMA-UE)score,Action Research Arm Test(ARAT)and Brunnstrom arm and hand staging were used to evaluate the motor function of upper extremities.Result:There were no significant differences in the FMA-UE score,ARAT score and Brunnstrom arm and hand staging before treatment between the two groups of patients(P>0.05).After 4 weeks treatment,the FMAUE score,ARAT score,Brunnstrom arm and hand staging of the patients in the two groups were significantly improved compared with those before treatment(P<0.05).The FMA-UE score,ARAT score,Brunnstrom arm and hand staging in the patients of the mGMI group were superior to those in control group(all P<0.05).Conclusion:On the basis of routine motor rehabilitation,modified graded motor imagery therapy can improve the motor function of upper extremities in stroke patients,and the effect would be more significant.