摘要
目的:通过临床随机对照实验,探讨运动再学习疗法对脑卒中患者运动功能和日常生活活动能力的影响,并与神经发育疗法相比较。方法:选择2003-02/2004-08在十堰市太和医院康复中心治疗的61例年龄<70岁、病程在1个月以内的急性脑卒中患者,以抽签法分为运动再学习组31例和神经发育疗法组30例。运动再学习组接受以运动再学习疗法为主的康复治疗程序,包括上肢功能训练、口面部功能训练、从仰卧到床边坐起训练、坐位平衡训练、站起与坐下训练、站位平衡训练和行走训练;神经发育疗法组接受以神经发育疗法为主的康复治疗,以Bobath疗法为主,分迟缓阶段、痉挛阶段以及相对恢复阶段3个不同时期进行治疗;两组患者同时接受针灸疗法和失神经治疗。所有患者在出、入院时均采用脑卒中病损评价量表评估运动功能、改良Barthel指数(共10项,每项0～15分不等,满分100分,<60分为不能自理)评定日常生活能力,同时记录住院时间。结果:按意向处理分析,61例均进入结果分析。①住院时间:运动再学习组平均住院时间短于神经发育疗法组[(25.29±13.63),(45.27±25.62)d,t=3.7843,P<0.05]。②脑卒中病损评价量表得分:两组出院时均较入院时显著增加(P<0.01),但运动再学习组治疗前后评分变化率(差值/住院时间)显著高于神经发育疗法组(0.85±0.60,0.46±0.27,P<0.01)。③Barthel指数得分:两组出院时均较入院时显著增加(P<0.01),但运动再学习组治疗前后评分变化率显著高于神经发育疗法组(1.69±1.00,0.66±0.25,P<0.01)。结论:运动再学习疗法能够显著促进脑卒中患者的运动功能和日常生活活动能力恢复,与神经发育疗法比较,提高了康复效率。
AIM： Through clinical randomized controlled trials, to explore the effects of motor relearning therapy on movement function and activities of daily living ability in patients with stroke, and compared with neurodevelopmental therapy. METHODS： Sixty-one inpatients with acute stroke aged less than 70 with less than 1 month course from the Center of Rehabilitation of Taihe Hospital of Shiyan City were selected from February 2003 to August 2004 and divided by draw method into motor relearning group with 31 cases and neurodevelopmental therapy group with 30 cases. The patients in motor relearning group accepted the rehabilitation treatment procedure mainly motor relearning therapy, including upper limb function training, actinal surface function training, sit and up training from lying on the back to bedside, sitting position balance training, standing up and sitting down training, stance balance training and walking training; Patients in neurodevelopmental therapy group accepted the rehabilitation treatment mainly neurodevelopmental therapy, Bobath therapy as the main subject included 3 different stages： retardation stage, spasm stage and relative recovery stage to treat; The patients in the two groups were treated with acupuncture and moxibustion therapy and absent-nerve therapy at the same time. When all the patients discharge and hospitalization were treated with stroke lesion evaluation scale to evaluate the motor function, improved Barthel index （totally 10 terms, with different points 0-15 points in every term, full make 100 points, less than 60 points for could not self-care） to assess the ability of daily life, meanwhile the length of stay was recorded. RESULTS： According to intention-to-treat analysis, 61 cases were all involved in the result analysis. ① The length of stay： It was shorter in motor relearning group than that in neurodevelopmental therapy group averagely [（25.29±13.63）, （45.27±25.62） days, t=3.7843,P 〈 0.05].② The score of stroke lesion evaluation scale： It significantly increased in the two groups at discharge than at discharge （P 〈 0.01）, but the change rate （difference value/length of stay） in motor relearning group before and after treatment was significantly higher than. that in neurodevelopmental therapy group （0.85±0.60, 0.46±0.27, P 〈 0.01）. ③ The score of Barthel index： It significantly increased in the two groups at discharge than that at hospitalization （P 〈 0.01）, but the score change rate in motor relearning group before and after treatment was significantly higher than that in neurodevelopmental therapy group （ 1.69±1.00, 0.66±0.25, P 〈 0.01 ）. CONCLUSION： The motor relearning therapy can significantly accelerate the recovery of motor function and activities of dally living ability in the patients with stoke, compared with neurodevelopmental therapy, it enhances the efficiency of rehabilitation.
出处
《中国临床康复》
CSCD
北大核心
2005年第29期1-3,共3页
Chinese Journal of Clinical Rehabilitation
