镜像疗法与常规作业训练对老年脑卒中患者偏瘫肢体功能恢复的疗效比较

摘要

目的 在常规康复训练和针灸治疗的基础上,对比镜像疗法与常规作业训练对老年脑卒中患者偏瘫肢体功能恢复的疗效. 方法 将脑卒中后偏瘫的老年患者120例随机分为治疗组和对照组,每组患者各60例,所有患者均接受常规的康复训练和针灸治疗,同时治疗组增加镜像疗法,对照组则增加常规作业训练.比较两组患者治疗前和治疗后1个月及3个月时神经功能缺损程度(CSS)评分和日常生活活动(ADL)能力. 结果 治疗后1个月、3个月治疗组CSS评分(15.6±8.5)分、(11.6±7.2)分,ADL评分(75.3±13.9)分、(80.1±13.0)分;对照组CSS评分(16.2±5.8)分、(14.8±6.1)分,ADL评分(68.2±13.5)分、(70.5±12.9)分,除1个月时CSS评分外,差异均有统计学意义(t值分别为1.40、2.38、-3.27、-3.47,P值分别为0.166、0.019、0.001、0.001);与治疗前比较,治疗后1个月、3个月两组CSS评分和ADL评分均有改善(均P＜0.05). 结论 在常规康复训练和针灸治疗的基础上,镜像疗法比常规作业训练更能改善老年脑卒中患者3个月时的偏瘫肢体功能和生活活动能力.%Objective To compare the effect of mirror therapy (MT) supplemented by early rehabilitative intervention and acupunture therapy on recovery of hemiplegic limb function versus routine occupational training in post-stroke elderly patients.Methods Totally 120 acute-stroke elderly patients with limb paralysis were randomly divided into two groups:MT group and control group (n=60,each).All 120 patients received routine rehabilitative intervention and acupunture therapy except for 30 minutes mirror therapy daily as add-on therapy to the MT group,all patients were assessed with Chinese Stroke Scale(CSS) and the Barthel index(BI) before and after treatment 1 and 3 months.Results At the end of 1 and 3 months of treatment,CSS in the MT groups was (15.6±8.5)scores,(11.6±7.2)scores,ADL was (75.3±13.9)scores,(80.1±13.0)scores;CSS in the control group was (16.2±5.8)scores,(14.8±6.1)scores,ADL was (68.2±13.5)scores,(70.5±12.9)scores.Before treatment,CSSandADLwas (21.3±7.1)scores,(63.7±12.6)scoresin the MT group; (20.8 ± 7.6) scores,(61.7 ± 11.4) scores in the control group.There were significant differences in CSS and ADL between groups,except CSS after 1 month (t=1.40,2.38,-3.27,-3.47; P=0.166,0.019,0.001,0.001,respectively).After 3 months of treatment,CSS and ADL in the MT group had considerably outperformed those of the control group(t=2.40,-3.47,P＜0.05 or 0.01).Conclusions Mirror therapy is better than routine occupational training in improving the motor function of limbs and activities of daily living(ADL) ability 3 months after stroke,on the basis of early rehabilitative intervention and acupunture therapy.