运动想象疗法对脑卒中患者运动功能康复的效果

doi:10.3969/j.issn.1006-9771.2017.09.019

《中国康复理论与实践》 ›› 2017, Vol. 23 ›› Issue (9): 1081-1085.doi: 10.3969/j.issn.1006-9771.2017.09.019

运动想象疗法对脑卒中患者运动功能康复的效果

杨帆, 桑德春, 张晓钰, 卢利萍, 褚宏宇

1.首都医科大学康复医学院,北京市 100068；
2.中国康复研究中心北京博爱医院,北京市 100068。

收稿日期:2017-01-11 修回日期:2017-05-08 出版日期:2017-09-25 发布日期:2017-10-10
通讯作者: 桑德春,主任医师。E-mail: sdc12663@126.com。
作者简介:杨帆(1987-),女,汉族,吉林敦化市人,硕士研究生,主要研究方向：神经康复。
基金资助:
中央级公益性科研院所基本科研业务费专项资金项目(No.2015CZ-31)

Effect of Motor Imagery on Motor Function in Hemiplegic Patients after Stroke

YANG Fan, SANG De-chun, ZHANG Xiao-yu, LU Li-ping, CHU Hong-yu

1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China;
2. Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2017-01-11 Revised:2017-05-08 Published:2017-09-25 Online:2017-10-10
Contact: Correspondence to SANG De-chun. E-mail: sdc12663@126.com

摘要/Abstract

摘要： 目的探讨运动想象疗法对脑卒中患者运动功能康复的疗效。方法2015年5月至2016年10月,40例脑卒中偏瘫患者随机分为对照组(常规康复疗法)和运动想象组(运动想象+常规康复疗法),每组20例。治疗前及治疗6周后,分别采用Fugl-Meyer评定量表(FMA)、改良Barthel指数(MBI)进行评定,采用磁共振弥散张量成像(DTI)测量患者各向异性分数(FA)。结果治疗后,两组患者FMA评分、MBI评分均较治疗前显著提高(t>5.088, P<0.001),运动想象组优于对照组(t>2.124, P<0.05)。治疗前,两组病灶侧FA均较对侧明显减小(t>3.892, P<0.01),两组间无显著性差异(t<1.144, P>0.05);治疗后,运动想象组有较多患者(5/5 vs. 2/4) FA升高。结论运动想象疗法能促进脑卒中恢复期患者运动功能及日常生活活动能力恢复,对受损白质纤维的恢复可能有帮助。

关键词: 脑卒中, 运动想象, 运动, 弥散张量成像

Abstract: ObjectiveTo explore the effect of motor imagery on motor recovery in hemiplegic patients after stroke. MethodsFrom May, 2015 to October, 2016, 40 hemiplegic patients after stroke were randomly divided into control group (accepted routine rehabilitation, n=20) and motor imagery group (accepted motor imagery and routine rehabilitation, n=20). They were assessed with Fugl-Meyer Assessment (FMA), modified Barthel Index (MBI) before and six weeks after treatment. Fractional anisotropy (FA) of the focus was measured with diffusion tensor imaging (DTI). ResultsThe scores of FMA and MBI improved in both groups after treatment (t>5.088, P<0.001), and improved more in the motor imagery group than in the control group (t>2.124, P<0.05). The FA reduced in the focus compared with the same site of unaffected side in both groups before treatment (t>3.892, P<0.01), and there was no significant difference between two groups (t<1.144, P>0.05). FA increased in more patients of the motor imagery group (5/5) than in the control group (2/4). ConclusionMotor imagery can promote the recovery of motor function and activities of daily living in stroke patients, and may help the recovery of fibers in white matter.

Key words: stroke, motor imagery, motor, diffusion tensor imaging

中图分类号:

R743.3

杨帆, 桑德春, 张晓钰, 卢利萍, 褚宏宇. 运动想象疗法对脑卒中患者运动功能康复的效果[J]. 《中国康复理论与实践》, 2017, 23(9): 1081-1085.

YANG Fan, SANG De-chun, ZHANG Xiao-yu, LU Li-ping, CHU Hong-yu. Effect of Motor Imagery on Motor Function in Hemiplegic Patients after Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2017, 23(9): 1081-1085.

参考文献

[1] Wang W, Jiang B, Sun H, et al. Prevalence, incidence and mortality of stroke in China: Results from a Nationwide Population-Based Survey of 480,687 adults [J]. Circulation, 2017, 135(8): 759-771.
[2] Zhao XF, Du Y, Liu PG, et al. Acupuncture for stroke: evidence of effectiveness, safety, and cost from systematic reviews [J]. Top Stroke Rehabil, 2012, 19(3): 226-233.
[3] Valiengo L, Casati R, Bolognini N, et al. Transcranial direct current stimulation for the treatment of post-stroke depression in aphasic patients: a case series [J]. Neurocase, 2016, 22(2): 225-228.
[4] Saposnik G, Levin M. Virtual reality in stroke rehabilitation: a meta-analysis and implications for clinicians [J]. Stroke, 2011, 42(5): 1380-1386.
[5] Høyer E, Jahnsen R, Stanghelle JK, et al. Body weight supported treadmill training versus traditional training in patients dependent on walking assistance after stroke: a randomized controlled trial [J]. Disabil Rehabil, 2012, 34(3): 210-219.
[6] Nikhil S. Motor imagery after stroke: where next? [J]. Imag Med, 2012, 4(1): 129-136.
[7] Porro CA, Francescato MP, Cettolo V, et al. Primary motor and sensory cortex activation during motor performance and motor imagery: a functional magnetic resonance imaging study [J]. J Neurosci, 1996, 16: 7688-7698.
[8] Dettmers C, Benz M, Liepert J, et al. Motor imagery in stroke patients, or plegic patients with spinal cord or peripheral diseases [J]. Acta Neurol Scand, 2012, 126(4): 238-247.
[9] Yeo SS, Seo JP, Kwon YH, et al. Precommissural fornix in the human brain: a diffusion tensor tractography study [J]. Yonsei Med J, 2013, 54(2): 315-320.
[10] Zijta FM, Froeling M, Nederveen AJ, et al. Diffusion tensor imaging and fiber tractography for the visualization of the female pelvic floor [J]. Clin Anat, 2013, 26(1): 110-114.
[11] Huseyinsinoglu BE, Ozdincler AR, Krespi Y. Bobath concept versus constraint-induced movement therapy to improve arm functional recovery instrokepatients: a randomized controlled trial [J]. Clin Rehabil, 2012, 26(8): 705-715.
[12] Pereira S, Mehta S, Lobo L, et al. Functional electrical stimulation for improving gait in persons with chronic stroke [J]. Top Stroke Rehabil, 2012, 19(6): 491-498.
[13] Langhammer B, Stanghelle JK. Can physiotherapy after stroke based on the Bobath concept result in improved quality of movement compared to the motor relearning programme [J]. Physiother Res Int, 2011, 16(2): 69-80.
[14] Kho AY, Liu KP, Chung RC. Meta-analysis on the effect of mental imagery on motorrecovery of the hemiplegic upper extremity function [J]. Aust Occup Ther J, 2014, 61(2): 38-48.
[15] Hong IK, Choi JB, Lee JH. Cortical changes after mental imagery training combined with electromyography-triggered electrical stimulation in patients with chronic stroke [J]. Stroke, 2012, 43(9): 2506-2509.
[16] Brunelli S, Morone G, Iosa M, et al. Efficacy of progressive muscle relaxation, mental imagery, and phantom exercise training on phantom limb: a randomized controlled trial [J]. Arch Phys Med Rehabil, 2015, 96(2): 181-187.
[17] Berger CC, Ehrsson HH. The fusion of mental imagery and sensation in the temporal association cortex [J]. J Neurosci, 2014, 34(41): 13684-13692.
[18] Torunn A, Julie B, Dahle LA, et al. Stroke patients do not need to be inactive in the first two-weeks after stroke: results from a stroke unit focused on early rehabilitation [J]. Int J Stroke, 2012, 7(1): 25-31.
[19] Svendsen ML, Ehlers LH, Ingeman A, et al. Higher stroke unit volume associated with improved quality of early stroke care and reduced length of stay [J]. Stroke, 2012, 43(11): 3041-3045.
[20] Song J, Nair VA, Young BM, et al. DTI?measures track and predict motor function outcomes in?stroke?rehabilitation utilizing BCI technology [J]. Front Hum Neurosci, 2015, 9: 195.
[21] Aja-Fernandez S, Alberola-Lopez C, Westin CF. Noise and signal estimation in magnitude MRI and Rician distributed images: a LMMSE approach [J]. IEEE Trans Image Process, 2008, 17(8): 1383-1398.
[22] Assemlal HE, Tschumperle D, Brun L, et al. Recent advances in diffusion MRI modeling: angular and radial reconstruction [J]. Med Image Anal, 2011, 15(4): 369-396.
[23] Durrleman S, Fillard P, Pennec X, et al. Registration, atlas estimation and variability analysis of white matter fiber bundles modeled as currents [J]. Neuroimage, 2011, 55(3): 1073-1090.
[24] Seo Y. Effects of different field strengths, gradient directions, and acquisitions on fractional anisotropy in diffusiontensor imaging: A tract-based spatial statistics study [J]. Concept Magnetic Resonance Part B, 2013, 43B(1): 41-48.

运动想象疗法对脑卒中患者运动功能康复的效果

Effect of Motor Imagery on Motor Function in Hemiplegic Patients after Stroke

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	周治宁, 周容, 肖燕文, 王博文, 吕娇娇, 刘宇. 多靶区经颅直流电刺激对健康成年人工作记忆-姿势控制双任务表现的影响[J]. 《中国康复理论与实践》, 2024, 30(1): 21-28.
[2]	林娜, 高菡璐, 卢惠苹, 陈燕清, 郑军凡, 陈述荣. 虚拟现实技术对脑卒中上肢功能影响的弥散张量成像研究[J]. 《中国康复理论与实践》, 2024, 30(1): 61-67.
[3]	王昊懿, 史亚伟, 鲁俊, 许光旭. 主观垂直感知障碍对脑卒中患者功能影响的回顾性研究[J]. 《中国康复理论与实践》, 2024, 30(1): 68-73.
[4]	陈珺雯, 陈谦, 陈程, 李淑月, 刘玲玲, 吴存书, 龚翔, 鲁俊, 许光旭. 改良八段锦身体活动对脑卒中患者心肺功能、运动功能和日常生活活动能力的效果[J]. 《中国康复理论与实践》, 2024, 30(1): 74-80.
[5]	胡永林, 马颖, 窦超, 陆安民, 江小鸽, 宋新建, 肖玉华. 肩部控制训练联合神经松动术对脑卒中偏瘫患者肩痛及上肢功能的效果[J]. 《中国康复理论与实践》, 2024, 30(1): 81-86.
[6]	魏梦力, 钟亚平, 周易文, 桂辉贤, 关烨明, 于婷婷. 单侧前交叉韧带重建患者步行双侧下肢肌肉协同模式差异[J]. 《中国康复理论与实践》, 2024, 30(1): 95-104.
[7]	王贺, 韩靓, 阚梦凡, 于少泓. 电刺激治疗脑卒中后肩手综合征有效性的系统评价与Meta分析[J]. 《中国康复理论与实践》, 2023, 29(9): 1048-1056.
[8]	张冠聪, 黄秋晨, 顾蕊, 刘四海, 胡春英, 刘克敏. 不同神经肌肉训练方法对早期膝骨关节炎患者疼痛和运动功能效果的比较[J]. 《中国康复理论与实践》, 2023, 29(9): 1090-1097.
[9]	孙藤方, 任梦婷, 杨琳, 王耀霆, 王红雨, 闫兴洲. 高压氧治疗联合重复外周磁刺激干预脑卒中患者踝运动功能和平衡能力的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 875-881.
[10]	王亚楠, 刘西花. 脑卒中偏瘫患者主观和客观平衡功能测量的相关性及预测效能[J]. 《中国康复理论与实践》, 2023, 29(8): 890-895.
[11]	魏晓微, 杨剑, 魏春艳, 贺启令. 学校环境下适应性体育课程促进智力与发展性残疾儿童心理运动发展的系统综述[J]. 《中国康复理论与实践》, 2023, 29(8): 910-918.
[12]	王海云, 王寅, 周信杰, 何爱群. 基于“中枢-外周-中枢”理论的经颅直流电刺激结合针刺干预脑卒中患者中枢及上肢功能的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 919-925.
[13]	陈怡婷, 王倩, 崔慎红, 李映彩, 张思鈺, 魏衍旭, 任慧, 冷军, 陈斌. 双侧序贯重复经颅磁刺激干预脑卒中患者上肢运动功能的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 926-932.
[14]	李振亚, 孙洁, 郭鹏飞, 王光明. 脑卒中患者口期和咽期吞咽功能改变与误吸的相关性：基于电视透视吞咽检查[J]. 《中国康复理论与实践》, 2023, 29(8): 933-939.
[15]	武广艳, 张冉, 王璐, 于歌, 陈亚平. 核心肌群运动控制训练对产后腹直肌分离的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 948-953.