目的观察电针结合运动想象疗法对脑卒中后肩手综合征Ⅰ期患者的临床疗效。方法将60例符合纳入标准脑卒中后肩手综合征Ⅰ期患者随机分配为运动想象疗法组(A组)、电针治疗组(B组)和电针结合运动想象疗法组(C组),每组20例。3组都给予常规...目的观察电针结合运动想象疗法对脑卒中后肩手综合征Ⅰ期患者的临床疗效。方法将60例符合纳入标准脑卒中后肩手综合征Ⅰ期患者随机分配为运动想象疗法组(A组)、电针治疗组(B组)和电针结合运动想象疗法组(C组),每组20例。3组都给予常规的康复治疗,A组增加运动想象治疗,B组增加电针治疗,C组增加电针联合运动想象疗法。治疗2周后,比较数字疼痛评定量表(numeric rating scale,NRS)、患手肿胀程度评定、关节被动活动度(passive range of motion,PROM)、Fugl-Meyer运动功能评定量表上肢部分(upper fugl-meyer assessment,U-FMA)、Barthel指数(Barthel index,BI)和临床疗效。结果(1)治疗后,3组患者在NRS评分、手部肿胀程度均较治疗前降低(P<0.05);C组NRS评分低于A组(P<0.05),C组较B组在NRS评分的差异无统计学意义(P>0.05);C组手部肿胀程度低于B组(P<0.05),C组较A组手部肿胀程度的差异无统计学意义(P>0.05);A、B两组间NRS评分、手部肿胀程度差异无统计学意义(P>0.05)。(2)治疗后,3组在肩关节各被动活动度较治疗前增大(P<0.01);C组在肩关节前屈、后伸、外展和内外旋的被动活动度较A、B组增大(P<0.01);A、B两组间差异无统计学意义(P>0.05)。(3)治疗后,3组的U-FMA评分和BI评分较治疗前升高(P<0.05);3组的U-FMA和BI评分结果显示,C组较A、B组更高(P<0.05),A、B两组间差异无统计学意义(P>0.05)。(4)A组总有效率是85%,B组总有效率是90%,C组总有效率是95%,C组较A、B组差异有统计学意义(P<0.05),A、B两组间差异无统计学意义(P>0.05)。结论3组患者经治疗在疼痛、手部肿胀、上肢运动功能和日常生活活动能力方面均得到明显改善;且与单独的电针和运动想象疗法相比,电针联合运动想象治疗肩手综合征有明显的疗效优势。展开更多
This article explains an imagery assisted virtual reality psychological skills training program used with a NCAA Division I baseball team. This is the first time that imagery has been incorporated into a virtual reali...This article explains an imagery assisted virtual reality psychological skills training program used with a NCAA Division I baseball team. This is the first time that imagery has been incorporated into a virtual reality program with the goal of increasing mental skills and strategies. Participants for this study were 27 NCAA baseball players. Each participant completed the Sport Imagery Ability Questionnaire and the Test of Performance Strategies Questionnaire at baseline and again after the winter season （2 months later）. Results indicated an increase in skill, goals and mastery imagery ability as well as increases in the use of several skills and strategies in both practice and competition. This manuscript focuses on both the development of an Imagery Assisted Virtual Reality program as well as the outcomes of the program.展开更多
文摘目的观察电针结合运动想象疗法对脑卒中后肩手综合征Ⅰ期患者的临床疗效。方法将60例符合纳入标准脑卒中后肩手综合征Ⅰ期患者随机分配为运动想象疗法组(A组)、电针治疗组(B组)和电针结合运动想象疗法组(C组),每组20例。3组都给予常规的康复治疗,A组增加运动想象治疗,B组增加电针治疗,C组增加电针联合运动想象疗法。治疗2周后,比较数字疼痛评定量表(numeric rating scale,NRS)、患手肿胀程度评定、关节被动活动度(passive range of motion,PROM)、Fugl-Meyer运动功能评定量表上肢部分(upper fugl-meyer assessment,U-FMA)、Barthel指数(Barthel index,BI)和临床疗效。结果(1)治疗后,3组患者在NRS评分、手部肿胀程度均较治疗前降低(P<0.05);C组NRS评分低于A组(P<0.05),C组较B组在NRS评分的差异无统计学意义(P>0.05);C组手部肿胀程度低于B组(P<0.05),C组较A组手部肿胀程度的差异无统计学意义(P>0.05);A、B两组间NRS评分、手部肿胀程度差异无统计学意义(P>0.05)。(2)治疗后,3组在肩关节各被动活动度较治疗前增大(P<0.01);C组在肩关节前屈、后伸、外展和内外旋的被动活动度较A、B组增大(P<0.01);A、B两组间差异无统计学意义(P>0.05)。(3)治疗后,3组的U-FMA评分和BI评分较治疗前升高(P<0.05);3组的U-FMA和BI评分结果显示,C组较A、B组更高(P<0.05),A、B两组间差异无统计学意义(P>0.05)。(4)A组总有效率是85%,B组总有效率是90%,C组总有效率是95%,C组较A、B组差异有统计学意义(P<0.05),A、B两组间差异无统计学意义(P>0.05)。结论3组患者经治疗在疼痛、手部肿胀、上肢运动功能和日常生活活动能力方面均得到明显改善;且与单独的电针和运动想象疗法相比,电针联合运动想象治疗肩手综合征有明显的疗效优势。
文摘This article explains an imagery assisted virtual reality psychological skills training program used with a NCAA Division I baseball team. This is the first time that imagery has been incorporated into a virtual reality program with the goal of increasing mental skills and strategies. Participants for this study were 27 NCAA baseball players. Each participant completed the Sport Imagery Ability Questionnaire and the Test of Performance Strategies Questionnaire at baseline and again after the winter season （2 months later）. Results indicated an increase in skill, goals and mastery imagery ability as well as increases in the use of several skills and strategies in both practice and competition. This manuscript focuses on both the development of an Imagery Assisted Virtual Reality program as well as the outcomes of the program.
文摘目的:评价运动想象训练(motor imagery training,MIT)对卒中后患者上肢运动功能的干预效果,采用功能性近红外光谱技术(functional near-infrared spectroscopy,fNIRS)初探MIT脑网络功能连接(functional connectivity,FC)特征。方法:纳入78例脑卒中偏瘫患者随机分为对照组和试验组,每组39例。对照组接受常规康复训练100min/天,6次/周,试验组在对照组基础上接受MIT 30min/天,6次/周,两组均干预3周。干预前以及3周后进行Fugl-Meyer上肢运动功能评定量表(FMA-UE)评定。在两组中各抽取10例左侧偏瘫且病变部位均在基底节区患者,采集10min fNIRS静息态血氧数据。设定感兴趣区(regions of interest,ROI)包括双侧前额叶(prefrontal cortex,PFC)、背外侧前额叶(dorsolateral prefrontal cortex,DLPFC)、前运动区和辅助运动皮层区(pre-motor and supplementary motor cortex,PMC&SMA)、体感联合皮层(somatosensory association cortex,SSAC)及感觉运动区(sensorimotor cortex,SMC),基于氧合血红蛋白(HbO)在时间序列上浓度计算两组患者在所有通道间及ROI间静息态FC强度差异。通过Person相关性检验,计算PMC&SMA、SMC血氧相对增量与FMA-UE评分相对增量之间的相关性。结果:干预3周后,两组患者FMA-UE评分均较干预前提高(P<0.05),且试验组提高FMA-UE评分更为显著(P<0.05)。基于HbO静息态FC分析发现,两组所有通道间FC均增加,与对照组相比,试验组具有显著性差异(P<0.01);干预3周后连通性存在显著性差异(0.01<P<0.05)的ROI-ROI包括:L_PFC-R_SSAC、L_DLPFC-R_SSAC、L_PFC-R_SMC、R_SSAC-L_DLPFC、R_SSAC-L_SSA、R_SSAC-R_PMC&R_SMA、R_SMC-L_SSAC、R_SMC-L_DLPFC、R_SMC-R_PMC&R_SMA。相关性分析发现,试验组PMC&SMA血氧相对增量与FMA-UE评分相对增量存在正相关性(r=0.658,P=0.039)。结论:MIT可改善卒中后患者的上肢运动功能,其作用机制可能与改变脑功能网络的失连接异常模式有关,如增加两侧半球运动皮质间固有FC,增加损伤侧半球运动皮质与健侧半球运动皮质、损伤侧额叶皮层间FC强度。
文摘目的:综述运动想象疗法在全膝关节置换术(total keen arthroplasty,TKA)病人中应用的基本内容、结局指标及干预效果。方法:计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、the Cochrane Library、PubMed、Embase、Web of Science等发表的中英文文献,检索时限为建库至2023年3月。由2名研究员对纳入的文献进行筛选、汇总和分析。结果:共纳入7篇随机对照试验。干预方式主要包括嵌入式和附加式,分为内部视觉想象和外部视觉想象2种;干预频次多为1 d 1次和每周5次,1次10~30 min;疗程多为4周。运动想象疗法改善了TKA病人的身体功能和生活质量,能否缓解术后疼痛尚存在争议。结论:运动想象疗法对TKA病人具有积极影响,未来仍需大量的高质量随机对照试验来验证运动想象疗法改善疼痛的效果,以便为病人制订系统的康复计划提供依据。
