运动表象训练对脑卒中患者手功能和运动表象能力的影响

doi:10.3969/j.issn.1006-9771.2023.04.014

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (4): 479-484.doi: 10.3969/j.issn.1006-9771.2023.04.014

运动表象训练对脑卒中患者手功能和运动表象能力的影响

李芳¹^,², 张通¹^,²(), 李冰洁¹^,², 赵军¹^,², 张豪杰²

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

收稿日期:2022-08-18 修回日期:2022-11-02 出版日期:2023-04-25 发布日期:2023-05-19
通讯作者: 张通，男，博士，主任医师，博士研究生导师，主要研究方向：神经康复。E-mail： tom611@126.com
作者简介:李芳(1986-)，女，汉族，河南新乡市人，博士，主治医师，主要研究方向：神经康复。
基金资助:
1.国家重点研发计划项目(2020YFC2007604);国家重点研发计划项目(2020YFC2008503);2.中国康复研究中心青年基金项目(2018ZX-Q6);中国康复研究中心青年基金项目(2019ZX-Q4)

Effect of motor imagery therapy on hand function and motor imagery ability of patients after stroke

LI Fang¹^,², ZHANG Tong¹^,²(), LI Bingjie¹^,², ZHAO Jun¹^,², ZHANG Haojie²

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

Received:2022-08-18 Revised:2022-11-02 Published:2023-04-25 Online:2023-05-19
Contact: ZHANG Tong, E-mail: tom611@126.com
Supported by:
National Key Research and Development Program(2020YFC2007604);National Key Research and Development Program(2020YFC2008503);China Rehabilitation Research Center Research Project (Young Fund)(2018ZX-Q6);China Rehabilitation Research Center Research Project (Young Fund)(2019ZX-Q4)

摘要/Abstract

摘要：

目的观察运动表象训练对脑卒中患者手功能及运动表象能力的影响。
方法选择2018年3月至2020年3月北京博爱医院脑卒中患者41例，随机分为对照组(n = 20)和观察组(n = 21)，两组均进行常规康复训练，观察组在此基础上进行运动表象训练。共4周。训练前后分别比较Fugl-Meyer评定量表手部分(FMA-H)评分、运动和视觉想象问卷-10 (KVIQ-10)评分和心理旋转试验正确率。
结果观察组1例脱落。训练前，两组FMA-H评分、KVIQ评分和心理旋转试验正确率均无显著性差异(P > 0.05)。训练后，两组各指标均显著改善(t > 6.611, P < 0.001)；观察组FMA-H评分(t = 3.742, P < 0.001)、KVIQ评分(t = 4.122, P < 0.001)、心理旋转试验正确率(t = 2.075, P < 0.05)均高于对照组。
结论运动表象训练有利于改善脑卒中后手功能障碍和运动表象能力。

关键词: 脑卒中, 手功能障碍, 运动表象训练, 心理旋转试验, 运动表象能力

Abstract:

Objective To observe the effect of motor imagery therapy on hand function and motor imagery ability of stroke patients.
Methods From March, 2018 to March, 2020, 41 stroke patients in Beijing Bo'ai Hospital were selected and randomly divided into control group (n = 20) and observation group (n = 21). Both groups received conventional rehabilitation training, and the observation group received motor imagery therapy in addition, for four weeks. Before and after training, the scores of Fugl-Meyer Assessment-Hand (FMA-H) and Kinesthetic and Visual Imagery Questionnaire-10 (KVIQ-10), and the accuracy of mental rotation task were compared between two groups.
Results One patient in the observation group dropped down. Before training, there was no significant difference in the scores of FMA-H and KVIQ, and the accuracy of mental rotation task between two groups (P > 0.05). After training, all the indexes improved in both groups (t > 6.611, P < 0.001), and the scores of FMA-H (t = 3.742, P < 0.001) and KVIQ (t = 4.122, P < 0.001), and the accuracy of mental rotation task (t = 2.075, P < 0.05) were higher in the observation group than in the control group.
Conclusion Motor imagery therapy could facilliate the recovery of hand dysfunction and improve the motor imagery ability of stroke patients.

Key words: stroke, hand dysfunction, motor imagery therapy, mental rotation task, motor imagery ability

中图分类号:

R743.3

李芳, 张通, 李冰洁, 赵军, 张豪杰. 运动表象训练对脑卒中患者手功能和运动表象能力的影响[J]. 《中国康复理论与实践》, 2023, 29(4): 479-484.

LI Fang, ZHANG Tong, LI Bingjie, ZHAO Jun, ZHANG Haojie. Effect of motor imagery therapy on hand function and motor imagery ability of patients after stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(4): 479-484.

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参考文献 29

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组别	n	性别(男/女)/n	年龄/岁	病程/月	偏瘫侧
对照组	20	14/6	50.25±7.65	2.26±0.49	右侧
观察组	21	12/9	51.46±6.81	2.17±0.42	右侧
χ²/t值		0.730^a	0.539	0.591
P值		0.393	0.593	0.558

组别	n	训练前	训练后	t值	P值
对照组	20	8.55±2.24	10.35±2.16	6.990	< 0.001
观察组	20	8.85±2.25	13.00±2.32	10.208	< 0.001
t值		0.423	3.742
P值		0.675	< 0.001

组别	n	训练前	训练后	t值	P值
对照组	20	32.15±3.28	34.55±3.30	9.798	< 0.001
观察组	20	32.05±3.72	39.75±4.58	11.160	< 0.001
t值		0.090	4.122
P值		0.929	< 0.001

组别	n	训练前	训练后	t值	P值
对照组	20	87.66±3.30	89.25±3.00	6.611	< 0.001
观察组	20	87.63±3.10	91.15±2.79	20.274	< 0.001
t值		0.037	2.075
P值		0.971	0.045

组别	n	训练前	训练后	t值	P值
对照组	20	87.05±4.17	87.65±3.44	1.552	0.137
观察组	20	87.25±3.96	89.2±3.96	7.610	< 0.001
t值		0.155	1.323
P值		0.877	0.194

运动表象训练对脑卒中患者手功能和运动表象能力的影响

Effect of motor imagery therapy on hand function and motor imagery ability of patients after stroke

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组别	n	训练前	训练后	t值	P值
对照组	20	90.2±3.58	91.6±3.17	4.626	< 0.001
观察组	20	90.6±3.65	94.2±2.98	6.385	< 0.001
t值		0.350	2.671
P值		0.728	0.011

组别	n	训练前	训练后	t值	P值
对照组	20	85.5±4.12	87.1±3.85	5.446	< 0.001
观察组	20	84.75±3.35	88.5±3.44	8.399	< 0.001
t值		0.631	1.212
P值		0.532	0.233

组别	n	训练前	训练后	t值	P值
对照组	20	87.9±3.45	90.65±3.69	7.180	< 0.001
观察组	20	87.9±3.51	92.7±2.74	14.236	< 0.001
t值		0.000	1.996
P值		1.000	0.053

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