›› 2011, Vol. 6 ›› Issue (05): 381-387.

• 论著 • 上一篇    下一篇

镜像疗法对偏瘫患者上肢功能康复疗效的观察

张洪翠1,于大君2,刘志华3,李铁山1   

  1. 1山东省青岛市青岛大学医学院附属医院康复医学科2青岛第五人民医院神经内科3青岛市中心医院康复科
  • 收稿日期:2010-12-10 修回日期:2010-11-10 出版日期:2011-05-20 发布日期:2011-05-20
  • 通讯作者: 李铁山

Effects of Mirror Therapy on Hemiplegic Upper Extremity Motor Recovery in Stroke Patients

ZHANG Hong-Cui, YU Da-Jun, LIU Zhi-Hua, et al   

  • Received:2010-12-10 Revised:2010-11-10 Online:2011-05-20 Published:2011-05-20

摘要: 目的 观察镜像疗法对卒中后偏瘫患者上肢功能康复的疗效。方法 选择30例入选卒中后8周内偏瘫患者随机分为两组:镜像疗法组和对照组,分别于治疗前及治疗后4周采用Fugl-Meyer运动评价(Fugl-Meyer motor assessment,FMA)(上肢部分),上肢运动研究测试(the action research arm test,ARAT)、运动功能评估量表(motor assessment scale,MAS)对上肢运动功能进行评分,同时评定患者的视觉模拟评分(visual analogue scale/score,VAS)、痉挛程度以及改良Barthel指数,以观察镜像疗法对偏瘫患者上肢功能康复的疗效。结果 治疗4周后,两组上肢运动能力FMA评分、ARAT评分、MAS评分、改良Barthel指数均较治疗前提高(P<0.01);治疗组FMA评分、ARAT评分高于对照组(P<0.05),两组间MAS评分、改良Barthel指数提高,但差别无统计学意义(P>0.05)。治疗组VAS评分较治疗前有下降(P<0.05),但对照组治疗前后,VAS评分差异无统计学意义(P>0.05),治疗后两组间的VAS差异有统计学意义(P<0.05)。两组治疗前后及治疗后组间痉挛改善差异无统计学意义(P>0.05)。结论 镜像疗法能提高偏瘫患者的上肢运动功能,且能减轻患者偏瘫上肢的疼痛,但对患者日常生活活动能力(activity of daily living scale,ADL)及患肢痉挛程度的改善无明显影响。

关键词: 卒中; 偏瘫; 康复; 上肢; 功能偏侧化; 运动

Abstract: Objective To observe the effects of mirror therapy (MT) compared with the conventional trainingtherapy (CTT) on hemiplegic upper extremity recovery after stroke.Methods Thirty sub-acute patients with upper limb paralysis were randomly divided into twogroups: MT group and CTT group. All 30 patients received physical treatment for a period of 4weeks. All patients were assessed with Fugl-Meyer motor assessment (FMA), motor assessmentscale (MAS), the action research arm test (ARAT), the modified Ashworth scale, visual analoguescore (VAS) and the modified Barthel index before treatment and after 4 weeks.Results After 4 weeks, FMA, MAS, ARAT and Barthel index scores in the two groups hadimproved (P <0.01), and the FMA, ARAT scores in the MT group were significantly higher thanthose of the control group (P <0.05), but the scores of MAS, Barthel index had no significantdifference between the two groups (P> 0.05). After 4 weeks, VAS had decreased in the MT group(P <0.05), but it had no difference in CTT group. In two groups, there were no significant differencesof the modified Ashworth scale after treatment (P> 0.05).Conclusion Mirror therapy can improve the functional performance of the upper extremity ofstroke patients.

Key words: Stroke; Hemiplgia; Rehabilitation; Upper extremity; Functional laterality; Exercise