《中国康复理论与实践》 ›› 2018, Vol. 24 ›› Issue (8): 930-937.doi: 10.3969/j.issn.1006-9771.2018.08.012

• 临床研究 • 上一篇    下一篇

动作观察疗法对脑卒中后单侧忽略的效果

申嘉怡1, 张通1,2,3, 胡雪艳2, 王文竹3   

  1. 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神经康复中心,北京市 100068;
    3.神经损伤与康复北京市重点实验室,北京市 100068
  • 收稿日期:2018-05-07 修回日期:2018-07-23 出版日期:2018-08-25 发布日期:2018-08-20
  • 通讯作者: 张通。E-mail: tom611@126.com
  • 作者简介:申嘉怡(1991-),女,汉族,山西临汾市人,硕士研究生,主要研究方向:脑卒中后康复治疗技术。通讯作者:张通(1961-),男,博士,教授,博士生导师,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(重大科学研究引导基金项目)(No. 2016CZ-5; No. 2018CZ-2)

Effect of Action Observation Therapy on Unilateral Spatial Neglect after Stroke

SHEN Jia-yi1, ZHANG Tong1,2,3, HU Xue-yan2, WANG Wen-zhu3   

  1. 1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China;
    2. Neurorehabilitation Center, Beijing Bo'ai Hospital, China Rehabilitation Research Centre, Beijing 100068, China;
    3. Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing 100068, China
  • Received:2018-05-07 Revised:2018-07-23 Published:2018-08-25 Online:2018-08-20
  • Contact: ZHANG Tong. E-mail: tom611@126.com

摘要: 目的 探讨动作观察疗法对于脑卒中后单侧忽略的治疗效果。方法 2017年3月至2018年4月,44例脑卒中后左侧单侧忽略患者随机分为对照组(n=22)和试验组(n=22)。在常规康复训练的基础上,对照组接受动态风景视频观察训练,试验组接受动作观察训练。分别于训练前、训练1周和训练3周后用中国行为性忽略测试-香港版(CBIT-HK)常规测试中的4项(短线划销、字母划销、星星划销、二分线段)进行评估,并比较简易精神状态检查(MMSE)、Fugl-Meyer评定量表(FMA)及日常生活活动能力量表(ADL)评分。结果 训练1周后,两组CBIT-HK常规测试4项分数大多较训练前改善(t>2.712, P<0.05),且试验组线段二等分百分比显著优于对照组(t=4.822, P<0.001);训练3周后,两组CBIT-HK常规测试4项分数及MMSE、FMA、ADL评分均较训练前改善(t>1.596, P<0.05),试验组的短线划销、字母划销及线段二等分百分比明显低于对照组(t>3.577, P<0.01)。结论 动作观察训练有助于改善脑卒中后患者单侧忽略症状。

关键词: 脑卒中, 偏侧空间忽略, 动作观察疗法, 镜像神经元系统

Abstract: Objective To explore the effect of action observation therapy on unilateral spatial neglect after stroke.Methods From March, 2017 to April, 2018, 44 patients with left-sided neglect due to unilateral right-sided vascular brain lesions were randomly divided into control group (n=22) and experimental group (n=22). The control group received the dynamic landscape video observation training, and the experimental group received the action observation training, based on routine rehabilitation, for three weeks. Before treatment, one week and three weeks after treatment, they were evaluated with Chinese Behavioral Inattention Test-Hong Kong version (CBIT-HK) routine tests (short line cancellation test, letter cancellation test, star cancellation test and line segment bisect), and the scores of Mini-Mental State Examination (MMSE), Fugl-Meyer Assessment (FMA) and Activities of Daily Living (ADL) were compared.Results One week after treatment, four scores of CBIT routine tests almost improved (t>2.712, P<0.05), and the score of line segment bisect was significantly better in the experiment group than in the control group (t=4.822, P<0.001). Three weeks after treatment, four scores of CBIT routine tests and the scores of MMSE, FMA and ADL improved in both groups (t>1.596, P<0.05), and the scores of short line cancellation test, letter cancellation test and line segment bisect were significantly lower in the experiment group than in the control group (t>3.577, P<0.01).Conclusion The action observation therapy could faciliate to improve the lateral neglect of patients after stroke.

Key words: stroke, unilateral spatial neglect, action observation therapy, mirror neuron system

中图分类号: