镜像训练引导的运动想象疗法对急性缺血性脑卒中偏瘫患者上肢功能的康复效果

Effectiveness of rehabilitation with movement imagery therapy under the guidance of mirror training on upper limb function of hemiplegic patients after acute ischemic stroke

目的:本研究旨在对镜像训练引导的运动想象疗法是否能够更有效地改善急性缺血性脑卒中后偏瘫患者的上肢功能以及日常生活能力进行评价。方法:研究对象为2014年1月1日—2016年6月30日符合病例选择标准的76例急性缺血性脑卒中后偏瘫患者。将76例患者随机分入镜像训练引导的运动想象疗法组(38例)和单纯的运动想象疗法组(38例),在常规康复训练的基础上,分别接受镜像训练引导的运动想象疗法和单纯的运动想象疗法,共治疗4周。对2组治疗前后的美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、Barthel指数、上肢动作研究量表(Action Research Arm Test,ARAT)评分和Fugl-Meyer上肢运动功能评分进行比较。结果:2组患者治疗后的NIHSS评分、Barthel指数、ARAT评分和Fugl-Meyer上肢运动功能评分均较治疗前显著改善(P值均<0.05)。镜像训练引导的运动想象疗法组治疗后的NIHSS评分、Barthel指数、ARAT评分和Fugl-Meyer上肢运动功能评分的改善幅度均显著大于单纯的运动想象疗法组(P值均<0.05)。结论:镜像训练引导的运动想象疗法应用于急性缺血性脑卒中后偏瘫患者上肢功能的康复治疗,与单纯的运动想象疗法相比,可以更好地改善患者的上肢功能和生活自理能力。

Objective: To evaluate the effectiveness of rehabilitation with movement imagery therapy under the guidance of mirror training on upper limb function and viability of hemiplegic patients after acute ischemic stroke Methods: Seventy-six hemiplegic patients after acute ischemic stroke eligible for the case inclusion criteria were included in this study from January 1st, 2014 to June 30 th, 2016. They were randomly divided into two groups: group of movement imagery therapy under the guidance of mirror training(n = 38) and the group of movement imagery therapy alone(n = 38); based on the routine rehabilitation, the patients in these two groups were received movement imagery therapy under the guidance of mirror training and the movement imagery therapy alone for 4 weeks, respectively. The National Institute of Health Stroke Scale(NIHSS) score, Barthel index, Action Research Arm Test(ARAT) score and Fugl-Meyer upper limb motor function score were evaluated before rehabilitation and after 4-week rehabilitation, and were compared between the two groups.Results: The NIHSS score, Barthel index, ARAT score and Fugl-Meyer upper limb motor function score of two groups were significantly improved after 4-week rehabilitation as compared with those before rehabilitation(all P < 0.05). After rehabilitation, these measurements were improved more obviously in the group of movement imagery therapy under the guidance of mirror training as compared with those in the group of movement imagery therapy alone(all P < 0.05). Conclusion: Rehabilitation with movement imagery therapy under the guidance of mirror training can better improve the upper limb function and daily living ability of hemiplegic patients after acute ischemic stroke.