火针联合机器人手套镜像疗法对脑卒中后手及上肢功能障碍影响

Effect of Fire Needle Combined With Robotic Glove Mirror Therapy onHand and Upper Limb Dysfunction After Stroke

目的:观察火针联合机器人手套镜像疗法对脑卒中后手及上肢功能障碍的影响。方法:选取某院康复科收治的113例脑卒中患者,按随机数字表法分成观察组和对照组,其中脱落3例,实际纳入110例,均分为两组,每组55例。两组患者均接受常规康复治疗,观察组在此基础上采用火针联合机器人手套镜像疗法,对照组采用机器人手套镜像疗法。治疗4周后,观察治疗前后等速肌力指标包括峰力矩(PT)、平均功率(AP)、最大总用功(TW);上肢表面肌电图均方根值(RMS)、肱二头肌协同收缩率(CR)、肱三头肌协同收缩率;简化手功能Fugl-Meyer评分量表(FMA);改良Barthel指数量表(MBI)的变化情况。结果:治疗前,两组患者PT、AP、TW、RMS、CR、FMA、MBI值比较差异均无统计学意义。治疗4周后,两组患者PT、AP、TW、FMA、MBI值较前升高(均P<0.05),RMS值较前均降低(均P<0.05);观察组PT、AP、TW、FMA、MBI值均高于对照组(均P<0.05),RMS值低于对照组(P<0.05);两组患者治疗前后及治疗后的CR值均无明显变化(均P>0.05)。结论:火针配合机器人手套镜像疗法能明显改善患者的手部及上肢运动功能,提高患者日常生活能力。

Objective:To observe the effect of Fireneedle combined with robotic glove mirror therapy on hand and upper limb dysfunction after stroke.Methods:113 stroke patients admitted to the Rehabilitation Department of Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine from July 2022 to July 2023 were included,and they were divided into observation group and control group according to the random number table method,with 3 cases falling out,and 110 cases were actually included,with 55 cases in each group,and both groups received conventional rehabilitation treatment.After 4 weeks of treatment to observe the isokinetic muscle strength indexes including peak moment(PT),average power(AP)and maximum total effort(TW)before and after treatment were observed in the two groups.Upper extremity surface electromyography root mean square(RMS),biceps cosystole(CR),triceps cosystole;Simplified Hand Function Fugl-Meyer Rating Scale(FMA);The modified Barthel Index scale(MBI).Results:Before treatment,there were no statistically significant differences in PT,AP,TW,RMS,CR,FMA,MBI values between the two groups.After four weeks of treatment,PT,AP,TW,FMA and MBI scores were higher than before(P<0.05),while RMS values were lower than before(P<0.05);The values of PT,AP,TW,FMA and MBI in the observation group were higher than those in the control group(P<0.05),and the RMS values were lower than those in the control group(P<0.05);There was no significant change in CR value before and after treatment in two groups(P>0.05).Conclusion:Fire needle combined with robotic glove mirror therapy can significantly improve the motor function of the hands and upper limbs of the patients,and improve the patients'daily living ability.