动作观察疗法对重度偏瘫患者上肢运动功能的效果

doi:10.3969/j.issn.1006-9771.2020.01.015

《中国康复理论与实践》 ›› 2020, Vol. 26 ›› Issue (1): 85-88.doi: 10.3969/j.issn.1006-9771.2020.01.015

动作观察疗法对重度偏瘫患者上肢运动功能的效果

王建平,桂沛君,谢瑛()

首都医科大学附属北京友谊医院康复医学科,北京市 100050

收稿日期:2019-09-05 修回日期:2019-10-17 出版日期:2020-01-25 发布日期:2020-02-07
通讯作者: 谢瑛 E-mail:xieying_rehab@hotmail.com
作者简介:王建平(1986-),女,汉族,北京市人,硕士研究生,康复治疗师,主要研究方向：神经康复。|谢瑛(1971-),女,湖南娄底市人,博士,主任医师、教授,硕士生导师,主要研究方向：神经康复。
基金资助:
1.首都临床特色应用研究项目(Z161100000516146);2.首都医科大学基础临床合作项目(15JL31)

Effect of Action Observation Therapy on Upper Limb Motor Function for Severe Hemiplegics

WANG Jian-ping,GUI Pei-jun,XIE Ying()

Department of Rehabilitation Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

Received:2019-09-05 Revised:2019-10-17 Published:2020-01-25 Online:2020-02-07
Contact: XIE Ying E-mail:xieying_rehab@hotmail.com
Supported by:
Capital Clinical Application Research Program(Z161100000516146);Capital Medical University Basic-Clinical Cooperation Program(15JL31)

摘要/Abstract

摘要：

目的探讨动作观察疗法在重度偏瘫上肢功能康复中的应用。
方法 2019年1月至6月,40例脑卒中后重度偏瘫患者随机分为对照组和观察组,各20例。常规康复训练前,观察组观看有关手臂与手日常生活活动和动作的视频,嘱患者想象自己患侧上肢和手完成这些动作;对照组观看有序的几何图形、字母及没有人和动物的视频。治疗前和治疗4周后,两组采用Fugl-Meyer评定量表上肢部分(FMA-UE)、运动评定量表上肢部分(MAS-UE)和改良Barthel指数(MBI)进行评定。
结果治疗后,两组FMA-UE、MAS-UE和MBI评分均提高(t > 2.854, P < 0.05);观察组优于对照组( F > 4.395, P < 0.05)。
结论动作观察疗法可进一步改善脑卒中后重度偏瘫患者上肢运动功能和日常生活活动能力。

关键词: 脑卒中, 动作观察疗法, 偏瘫, 上肢, 运动, 日常生活活动能力

Abstract:

Objective To explore the effects of action observation therapy on upper limb severe hemiplegia.
Methods From January to June, 2019, 40 patients with severe hemiplegia after stroke were randomly divided into control group (n = 20) and observation group (n = 20). Before routine rehabilitation training, the observation group watched the videos about activities and movements of arms and hands, and then were asked to imagine their affected arms and hands to complete these movements. The control group watched the videos of orderly geometric figures, letters and others without body and animals. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Motor Assessment Scale-Upper Extremities (MAS-UE) and modified Barthel Index (MBI) before and four weeks after treatment.
Results The scores of FMA-UE, MAS-UE and MBI improved after treatment (t > 2.854, P < 0.05), and improved more in the observation group than in the control group ( F > 4.395, P < 0.05).
Conclusion action observation therapy can further improve upper limb motor function and activities of daily living in patients with severe hemiplegia after stroke.

Key words: stroke, action observation therapy, hemiplegia, upper limbs, motor, activities of daily living

中图分类号:

R743.3

王建平,桂沛君,谢瑛. 动作观察疗法对重度偏瘫患者上肢运动功能的效果[J]. 《中国康复理论与实践》, 2020, 26(1): 85-88.

WANG Jian-ping,GUI Pei-jun,XIE Ying. Effect of Action Observation Therapy on Upper Limb Motor Function for Severe Hemiplegics[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(1): 85-88.

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组别	n	性别(n)		年龄(岁)	病程(d)	偏瘫侧(n)		卒中性质(n)
组别	n	男	女	年龄(岁)	病程(d)	左侧	右侧	出血	梗死
对照组	20	14	6	64.90±7.77	13.20±2.33	18	2	4	16
观察组	20	15	5	65.10±7.85	13.70±2.52	16	4	3	17
χ²/F值		0.125		0.025	0.035	0.784		0.173
P值		0.723		0.874	0.853	0.376		0.677

组别	n	治疗前	治疗后	t值	P值
对照组	20	8.60±3.12	10.00±3.31	3.621	0.002
观察组	20	8.55±3.07	12.40±3.55	11.244	< 0.001
F值		21.948
P值		< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	20	0.65±0.67	0.95±0.83	2.854	0.010
观察组	20	0.60±0.68	1.30±1.13	4.273	< 0.001
F值		4.395
P值		0.043

组别	n	治疗前	治疗后	t值	P值
对照组	20	17.50±5.50	28.50±7.96	7.936	< 0.001
观察组	20	16.00±5.03	39.50±5.60	21.476	< 0.001
F值		47.236
P值		< 0.001

动作观察疗法对重度偏瘫患者上肢运动功能的效果

Effect of Action Observation Therapy on Upper Limb Motor Function for Severe Hemiplegics

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