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运动想象疗法对脑卒中后患者上肢运动功能障碍的疗效观察

Clinical effect of motor imagery therapy on upper limb motor dysfunction after stroke

摘要:

目的 探讨运动想象疗法对脑卒中后患者上肢运动功能障碍的临床疗效.方法 选择120例脑卒中后上肢功能障碍患者,按照随机数字表法分为观察组及对照组,每组60例.两组均治疗原发病同时行康复治疗,观察组采用运动想象疗法,两组均治疗3个月.采用四肢简化Fugl-Meyer评分量表(FMA)以及生活自理能力Barthel指数(MBI)评价患者治疗前后的运动功能以及自理能力;采用上肢动作研究量表(ARAT)对患者治疗前后上肢动作进行评价;观察两组治疗前后生存质量评分变化.结果 治疗前两组FMA及BI评分差异均无统计学意义(t=0.13、0.23,均P>0.05).治疗后对照组FMA为(29.74±4.04)分,BI为(57.29±4.23)分,观察组FMA为(33.29±4.14)分,BI为(63.12±4.21)分,组内治疗前后差异均有统计学意义(t=3.56、5.61,均P<0.05),且观察组升高程度显著优于对照组,差异均有统计学意义(t=2.38、4.14,均P<0.05).治疗后观察组ARAT各项评分[抓(13.34±2.00)分,握(10.23±0.39)分,捏(14.53±1.43)分,粗大(8.20±0.42)分]升高程度均显著优于对照组,差异均有统计学意义(t=3.45、2.87、3.17、2.98,均P<0.05).治疗后观察组生存质量各项评分[生理领域(68.71±6.62)分,心理领域(69.02±6.38)分,社会关系(67.72±6.79)分,环境领域(70.72±6.98)分]上升程度高于对照组,差异均有统计学意义(t=4.23、3.98、3.23、2.98,均P<0.05).结论 运动想象疗法对脑卒中后患者上肢功能障碍患者临床疗效显著,可帮助患者恢复肢体运动功能,提高自理能力以及生活质量,安全性好,值得临床推广.

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abstracts:

Objective To investigate the clinical effect of motor imagery therapy on upper limb motor dysfunction in stroke patients.Methods 120 patients with post stroke upper limb disability were selected.According to the digital table,they were divided into observation group and control group,60 cases in each group.Two groups were treated with primary disease and rehabilitation treatment,the observation group used motor imagery therapy,the two groups were treated for 3 months.Limb simplified Fugl-Meyer rating scale(FMA) and self-care ability Barthel index(MBI) were used to evaluate the motor function and self-care ability of the patients before and after treatment.The upper limb movement was evaluated by ARAT before and after treatment.The quality of life score before and after treatment was observed.Results Before treatment,there were no statistically significant differences in FMA and BI scores between the two groups(t=0.13,0.23,all P>0.05).After treatment,the FMA score of the control group was (29.74±4.04)points,the BI score was (57.29±4.23)points,the FMA and BI scores of the observation group was (33.29±4.14)points,(63.12±4.21)points,respectively,the differences were statistically significant between before and after treatment in the self-group(t=3.56,5.61,all P<0.05),and the degree of elevation of the observation group was more significant than those of the control group,the differences were statistically significant(t=2.38,4.14,all P<0.05).After treatment,the degrees of elevation of the scores of ARAT in the observation group[grab (13.34±2.00)points,grip (10.23±0.39)points,pinch (14.53±1.43)points,thick (8.20±0.42)points]were significantly higher than those in the control group,the differences were statistically significant(t=3.45,2.87,3.17,2.98,all P<0.05).After treatment,the rise degree of the scores of quality of life in the observation group[physiological field (68.71±6.62)points,psychological field (69.02±6.38)points,social relations (67.72±6.79)points,environmental field (70.72±6.98)points]were higher than those in the control group,the differences were statistically significant(t=4.23,3.98,3.23,2.98,all P<0.05).Conclusion The effect of exercise therapy on the upper limb of patients after stroke has significantly clinical efficacy,and it can help patients to restore limb motor function,improve self-care ability and quality of life,it is safe and worthy of clinical promotion.

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