作业疗法基础上结合镜像疗法对脑卒中后异己手综合征的效果

doi:10.3969/j.issn.1006-9771.2024.11.014

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (11): 1359-1427.doi: 10.3969/j.issn.1006-9771.2024.11.014

• 应用研究 • 上一篇

作业疗法基础上结合镜像疗法对脑卒中后异己手综合征的效果

高修明¹^,²^,³, 孟文文¹, 杨娜³, 雷兆峰³()

1.徐州医科大学附属医院康复医学科，江苏徐州市 221002
2.徐州医科大学附属第三医院康复科，江苏徐州市 221002
3.商洛市商州区人民医院康复科，陕西商洛市 726099

收稿日期:2024-08-26 修回日期:2024-10-30 出版日期:2024-11-25 发布日期:2024-12-05
通讯作者: 雷兆峰(1992-)，男，汉族，陕西渭南市人，主治医师，主要研究方向：认知康复。E-mail： 1436473934@qq.com
作者简介:高修明(1984-)，男，汉族，江苏徐州市人，博士研究生，副主任医师，主要研究方向：神经康复。
基金资助:
徐州市科技局重点研发计划项目(社会发展)(KC22131);徐州市卫生健康委青年科技创新重点项目(XWKYSL20210164);徐州医科大学附属医院课题(2020KB003)

Effect of mirror therapy based on occupational therapy on alien hand syndrome after stroke

GAO Xiuming¹^,²^,³, MENG Wenwen¹, YANG Na³, LEI Zhaofeng³()

1. Department of Rehabilitation Medicine, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
2. Department of Rehabilitation Medicine, the Third Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
3. Department of Rehabilitation Medicine, Shangluo City Shangzhou District People's Hospital, Shangluo, Shaanxi 726099, China

Received:2024-08-26 Revised:2024-10-30 Published:2024-11-25 Online:2024-12-05
Contact: LEI Zhaofeng, E-mail: 1436473934@qq.com
Supported by:
Key R & D Plan of Xuzhou Science and Technology Bureau (Social Development)(KC22131);Youth Science and Technology Innovation Key Project of Xuzhou Health Commission(XWKYSL20210164);Project of Affiliated Hospital of Xuzhou Medical University(2020KB003)

摘要/Abstract

摘要：

目的探讨作业疗法基础上结合镜像疗法对脑卒中后异己手综合征(AHS)患者的疗效。

方法 2022年1月至2023年12月，徐州医科大学附属医院AHS患者20例，随机分为对照组(n = 10)和观察组(n = 10)。两组均予常规OT，观察组在此基础上给予镜像疗法，每次30 min，每天2次，共4周。治疗前后，采用Wolf运动功能测试量表(WMFT)、Fugl-Meyer评定量表-手功能(FMA-H)和改良Barthel指数(MBI)进行评估。

结果治疗后，观察组WMFT (t = 5.771, P < 0.001)、FMA-H (t = 7.875, P < 0.001)和MBI评分 (t = 9.544, P < 0.001)均显著改善，且均明显优于对照组(|t| > 3.129, P < 0.01)。

结论镜像疗法结合作业疗法可以改善AHS患者手部自主运动控制能力，提高日常活动活动能力。

关键词: 异己手综合征, 镜像疗法, 作业疗法, 手功能

Abstract:

Objective To explore the effect of mirror therapy (MT) based on occupational therapy (OT) on alien hand syndrome (AHS).

Methods From January, 2022 to December, 2023, 20 AHS patients from the Affiliated Hospital of Xuzhou Medical University were randomly divided into control group (n = 10) and observation group (n = 10). Both groups received conventional OT, while the observation group additionally received MT, 30 minutes per session, twice a day, for four weeks. They were assessed with Wolf Motor Function Test (WMFT), Fugl-Meyer Assessment-Hand (FMA-H), and modified Barthel Index (MBI) before and after treatment.

Results The scores of WMFT (t = 5.771, P < 0.001), FMA-H (t = 7.875, P < 0.001) and MBI (t = 9.544, P < 0.001) improved in the observation group after treatment, and they were better in the observation group than in the control group (t > 3.129, P < 0.01).

Conclusion MT based on OT may improve hand motor control and activities of daily living in AHS patients.

Key words: alien hand syndrome, mirror therapy, occupational therapy, hand function

中图分类号:

R743.3

高修明, 孟文文, 杨娜, 雷兆峰. 作业疗法基础上结合镜像疗法对脑卒中后异己手综合征的效果[J]. 《中国康复理论与实践》, 2024, 30(11): 1359-1427.

GAO Xiuming, MENG Wenwen, YANG Na, LEI Zhaofeng. Effect of mirror therapy based on occupational therapy on alien hand syndrome after stroke[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(11): 1359-1427.

图/表 4

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组别	n	性别 (男/女)/n	年龄/岁	病程/d	NIHSS评分	偏瘫侧 (左/右)/n	AHS分型 (额叶/胼胝体)/n
对照组	10	6/4	59.80±9.69	10.70±2.31	9.40±1.07	3/7	8/2
观察组	10	5/5	60.10±8.60	11.70±1.95	9.20±1.40	2/8	9/1
χ²/t值			-0.073	-1.046	0.359
P值		1.000^a	0.942	0.309	0.724	1.000^a	1.000^a

组别	n	测试	$\overline{x}\pm s$	t值	P值
对照组	10	前测	30.90±4.63	5.409	< 0.001
		后测	37.60±3.03
观察组	10	前测	31.80±3.55	5.771	< 0.001
		后测	41.70±2.83
治疗前两组均值差			0.90±1.85	0.488	0.632
治疗后两组均值差			4.10±1.31	3.129	0.006

组别	n	测试	$\overline{x}\pm s$	t值	P值
对照组	10	前测	7.30±0.95	8.510	< 0.001
		后测	9.90±0.99
观察组	10	前测	7.70±0.95	7.875	< 0.001
		后测	11.90±1.37
治疗前两组均值差			0.40±0.42	0.943	0.358
治疗后两组均值差			2.00±0.54	3.735	0.002

组别	n	测试	$\overline{x}\pm s$	t值	P值
对照组	10	前测	41.00±6.58	4.881	0.001
		后测	56.00±6.15
观察组	10	前测	38.00±5.87	9.544	< 0.001
		后测	66.50±4.74
治疗前两组均值差			3.00±2.79	1.076	0.296
治疗后两组均值差			10.50±2.46	4.277	< 0.001

作业疗法基础上结合镜像疗法对脑卒中后异己手综合征的效果

Effect of mirror therapy based on occupational therapy on alien hand syndrome after stroke

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