摘要
目的探究基于"闭环康复"的数字化镜像疗法(mirror therapy,MT)对脑卒中患者上肢功能恢复的影响。方法 2017年12月—2018年4月纳入脑卒中患者90例,随机分配到数字化镜像干预组(MG组)和常规干预组(CG组),每组各45例。MG组患者先接受基于数字化镜像治疗设备的MT训练60 min,随后再接受30 min手功能康复治疗,形成"闭环康复";CG组患者分别接受运动疗法、作业治疗以及手功能康复治疗各30 min(共90 min)。所有患者均接受1次/d、5 d/周、共计4周的干预。于治疗前、治疗4周后分别采用FuglMeyer上肢评分(Fulg-Meyer Assessment Upper Limb Subscalee,FMA_UL)评价上肢运动功能,改良巴氏指数(Modified Barthel Index,MBI)评价日常生活活动能力以及改良Ashworth(Modified Ashworth Scale,MAS)评价腕屈/伸肌肌张力。结果研究过程中,5例患者(MG组3例,CG组2例)未完成干预,最终85例患者完成研究。MG组和CG组患者治疗前FMA_UL评分分别为(25.86±17.41)、(21.71±15.60)分,MBI评分分别为(66.62±21.73)、(59.14±21.58)分;治疗4周后FMA_UL评分分别为(33.43±17.08)、(26.48±16.47)分,MBI评分分别为(84.62±15.06)、(71.10±19.95)分。治疗4周后,两组患者FMA_UL评分及MBI评分均较治疗前明显提高(P<0.05),且MG组评分高于CG组(P<0.05)。两组MAS评分在治疗前后差异均无统计学意义(P>0.05)。结论基于"闭环康复"的数字化MT能够改善脑卒中患者上肢功能及日常生活能力,并且优于常规治疗方法。
Objective To explore the effect of ＂ closed-loop rehabilitation”-based digital mirror therapy （MT） on the recovery of upper limb function after stroke. Methods Between December 2017 and April 2018, 90 stroke patients were recruited and randomly assigned to digital MT group （MG） or conventional group （CG）, with 45 in each group. Patients in MG received digital MT for 60 minutes and subsequent hand function rehabilitation for 30 minutes, which was a ＂ closed-loop rehabilitation”; moreover, patients in CG received therapeutic exercises, occupational therapy, and hand function rehabilitation for 30 minutes separately （totally 90 minutes）. Both interventions were daily provided, 5 days per week and lasting for 4 weeks. Clinical assessments were provided before and after the interventions, including the Fugl-Meyer Assessment Upper Limb （FAM_UL） for motor function evaluation, the Modified Barthel Index （MBI） for the activities of daily life （ADL） evaluation, and the Modified Ashworth Scale （MAS） for the spasticity of wrist extensor/flexor. Results Five patients did not complete the study （3 in MG and 2 in CG）, so there were totally 85 subjects analysed in the end. After 4-week interventions, significant improvements of FMA_UL scores （Pre： MG, 25.86±17.41; CG, 21.71±15.60. Post： MG, 33.43±17.08; CG, 26.48±16.47） and MBI scores （Pre： MG, 66.62±21.73; CG, 59.14±21.58. Post： MG, 84.62±15.06; CG, 71.10±19.95） were found in both groups; moreover, higher scores of FMA_UL and MBI were investigated in MG comparing with CG after interventions. However, there were no significantly differences in MAS. Conclusions The ＂ closed-loop rehabilitation”-based digital MT can improve the motor function of upper limb and the ability of ADL in patients with stroke. Moreover, it is more effective than conventional treatments.
作者
丁力
荣积峰
崔晓
田婧
邵芃
王鹤玮
陈树耿
余庐婴
贾杰
DING Li;RONG Jifeng;CUIXiao;TIAN Jing;SHAO Peng;WANG Hewei;CHEN Shugeng;YU Luying;JIA Jie(Department of Rehabilitation Medicine,Huashan Hospital Fudan University,Shanghai 200040,P.R.China;Department of Rehabilitation,the First Rehabilitation Hospital of Shanghai,Shanghai 200090,P.R.China;Department of Rehabilitation,Shanghai Changning Tianshan Traditional Medicine Hospital,Shanghai 200051,P.R.China;Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350122,P.R.China;Department of Rehabilitation Medicine,Huashan Hospital Fudan University ling＇an Branch,Shanghai 200040,P.R.China;National Clinical Research Center for Geriatric Disease,Huashan Hospital Fudan University,Shanghai 200040,P.R.China)
出处
《华西医学》
CAS
2018年第10期1232-1237,共6页
West China Medical Journal
基金
上海市科学技术委员会生物医药领域科技支撑项目(15441901602
15441901502)
关键词
闭环康复
镜像疗法
上肢
脑卒中
Closed-loop rehabilitation
Mirror therapy
Upper limb
Stroke
