运动反馈训练联合改良强制运动疗法对脑卒中上肢功能的影响

摘要

目的：探讨运动反馈训练联合改良强制运动疗法对脑卒中上肢功能的影响。方法：前瞻性纳入2014年5月-2015年5月在广州市海珠区第一人民医院和广州医科大学附属第二医院接受康复治疗的脑卒中后偏瘫患者40例，随机分为改良强制性运动疗法（CIMT）组（改良CIMT组）及联合治疗组。每组20例。改良CIMT组患者采用改良强制性运动疗法治疗，联合治疗组在改良CIMT组的基础上联合运动反馈训练治疗。每次训练60 min，2次/d，5 d/周，共持续3周。对两组患者均于治疗前、治疗后分别进行WMFT评分、FMA-U评分及Barthel指数评定上肢运动功能及ADL能力。结果：治疗后两组患者WMFT评分、FMA-U评分及Barthel指数较治疗前均有明显改善，差异均有统计学意义（P<0.01）。联合治疗组与改良CIMT组比较， WMFT评分、FMA-U评分及Barthel指数均显著提高（P<0.01）。结论：运动反馈训练联合改良强制运动疗法能进一步改善脑卒中偏瘫患者上肢功能及日常生活活动能力，该联合疗法值得临床推广应用。%Objective:To investigate the effect of motor feedback training combined with constraint-induced movement therapy (CIMT) on upper extremities function of patients after stroke.Method:40 strokepatients were recruited. Cases were randomly divided into modified CIMT group (n=20) and combined therapy group (n=20) . The patients in modified CIMT group accepted modified constraint-induced movement therapy, the patients in combined therapy group accepted modified constraint-induced movement therapy and motor feedback training. The training schedule in both groups was last for 3 weeks. Upper-extremity motor ability was assessed with Wolf Motor Function Test(WMFT), Fugl-Meyer assessment of upper extremity (FMA-U) and Bathel Index (BI) of activities of daily living(ADL) before and after the therapy.Result:After therapy the WMFT, FMA-U and BI of both groups had significant improvements compared with pretraining (P<0.01). Through the analysis of variance, the two groups’ WMFT, FMA-U and BI after treatment were significantly different(P<0.01).Conclusion:Motor feedback training combined with constraint-induced movement therapy can improve the upper extremities function and activities of daily living of patients after stroke. These therapy is worth application in clinic.