悬吊下数字作业疗法系统训练对脑卒中偏瘫患者上肢运动功能的效果

doi:10.3969/j.issn.1006-9771.2022.11.004

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (11): 1259-1264.doi: 10.3969/j.issn.1006-9771.2022.11.004

• 专题脑卒中上肢功能康复 • 上一篇下一篇

悬吊下数字作业疗法系统训练对脑卒中偏瘫患者上肢运动功能的效果

童心,卢燕,张永卿,俞蔼晏,段再扬,徐磊()

蚌埠医学院第一附属医院康复医学科，安徽蚌埠市 233000

收稿日期:2022-06-29 修回日期:2022-09-09 出版日期:2022-11-25 发布日期:2022-12-20
通讯作者: 徐磊 E-mail:xuleibyfy@163.com
作者简介:童心(1996-)，男，汉族，四川泸州市人，硕士研究生，治疗师，主要研究方向：神经康复-手功能。|徐磊(1981-)，男，汉族，安徽蚌埠市人，博士，副主任医师、副教授，主要研究方向：神经康复。
基金资助:
安徽省高校自然科学研究项目(KJ2019A0397)

Effects of Digital Occupational Therapy System training under suspension on upper limb motor function for stroke patients with hemiplegia

TONG Xin,LU Yan,ZHANG Yongqing,YU Aiyan,DUAN Zaiyang,XU Lei()

Department of Rehabilitation Medicine, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233000, China

Received:2022-06-29 Revised:2022-09-09 Published:2022-11-25 Online:2022-12-20
Contact: XU Lei E-mail:xuleibyfy@163.com
Supported by:
Anhui University Natural Science Research Project(KJ2019A0397)

摘要/Abstract

摘要：

目的观察悬吊下数字作业疗法(OT)评估训练系统训练对脑卒中后上肢运动功能障碍的影响。

方法 2021年2月至2022年2月，蚌埠医学院第一附属医院脑卒中偏瘫上肢运动功能障碍患者90例随机数字表法分为常规组、数字OT组和悬吊组，每组30例。三组均行常规上肢康复训练和药物治疗，并予传统OT治疗；数字OT组行上肢数字OT系统训练，悬吊组在上肢悬吊状态下行数字OT系统训练，共4周。治疗前后，采用Fugl-Meyer评定量表上肢部分(FMA-UE)、改良Barthel指数(MBI)进行评定，表面肌电图(sEMG)检测桡侧腕背伸肌收缩时的平均肌电值(AEMG)、均方根值(RMS)、中位频率(MF)和平均功率频率(MPF)。

结果治疗后，3组FMA-UE评分、MBI评分、AEMG、RMS、MF和MPF均显著改善(|t| > 9.202, P < 0.001)，悬吊组各项指标最优(F > 8.791, P < 0.001)。

结论悬吊下数字OT系统训练能进一步改善脑卒中偏瘫患者上肢运动功能，提高日常生活活动能力，提高上肢肌肉功能。

关键词: 脑卒中, 上肢, 悬吊训练, 作业疗法, 康复

Abstract:

Objective To observe the effect of Digital Occupational Therapy (OT) System training under suspension on upper limb motor function after stroke.

Methods From February, 2021, to February, 2022, 90 stroke hemiplegic patients with upper limb motor dysfunction from the First Affiliated Hospital of Bengbu Medical College were randomly divided into routine group (n = 30), digital OT group (n = 30) and suspension group (n = 30). All the groups received routine upper limb rehabilitation, medication, and routine OT, while the digital OT group received the upper limb training of Digital OT System and the suspension group received the upper limb training of Digital OT System with the upper limb suspended. They were assessed with Fugl-Meyer Assessement-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and four weeks after treatment, while the mean electromyography (AEMG), root mean square (RMS), median frequency (MF) and mean power frequency (MPF) of the radial extensor carpi dorsi muscle during contraction were measured with surface electromyography (sEMG).

Results The FMA-UE score, MBI score, AEMG, RMS, MF and MPF improved after treatment in all the groups (|t| > 9.202, P < 0.001), and all the indexes were the best in the suspension group (F > 8.791, P < 0.001).

Conclusion Digital OT System training under suspension can promote the recovery of upper limb motor function for stroke patients, as well as the activities of daily living and the upper limb muscle function.

Key words: stroke, upper limbs, suspension, occupational therapy, rehabilitation

中图分类号:

R743.3

童心,卢燕,张永卿,俞蔼晏,段再扬,徐磊. 悬吊下数字作业疗法系统训练对脑卒中偏瘫患者上肢运动功能的效果[J]. 《中国康复理论与实践》, 2022, 28(11): 1259-1264.

TONG Xin,LU Yan,ZHANG Yongqing,YU Aiyan,DUAN Zaiyang,XU Lei. Effects of Digital Occupational Therapy System training under suspension on upper limb motor function for stroke patients with hemiplegia[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(11): 1259-1264.

图/表 7

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组别	n	性别(男/女)/n	年龄/岁	病程/d	患侧(左/右)/n	性质(出血/梗死)/n
常规组	30	21/9	58.33±10.11	65.57±23.01	14/16	13/17
数字OT组	30	22/8	57.63±10.24	68.77±20.75	17/13	15/15
悬吊组	30	21/9	56.63±9.88	70.27±13.80	15/15	14/16
χ²/F值 P值		0.108 0.947	0.216 0.806	0.451 0.639	0.623 0.733	0.268 0.875

组别	n	治疗前	治疗后	t值	P值
常规组	30	31.90±8.63	35.37±8.05	-9.202	< 0.001
数字OT组	30	32.27±7.34	40.30±6.91^a	-10.918	< 0.001
悬吊组	30	32.60±8.83	44.20±5.99^a,b	-12.028	< 0.001
F值		0.053	11.883
P值		0.948	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	30	59.00±13.86	65.33±12.52	-11.894	< 0.001
数字OT组	30	58.83±13.94	71.00±10.62^a	-11.439	< 0.001
悬吊组	30	58.50±12.17	76.67±7.69^a,b	-11.626	< 0.001
F值		0.011	8.791
P值		0.989	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	30	16.37±6.00	30.33±6.47	-12.995	< 0.001
数字OT组	30	16.70±5.68	34.17±6.53^a	-21.665	< 0.001
悬吊组	30	15.77±5.14	38.83±4.75^a,b	-29.955	< 0.001
F值		0.213	15.232
P值		0.809	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	30	31.37±8.45	46.23±7.75	-19.902	< 0.001
数字OT组	30	31.73±6.68	49.97±5.90^a	-26.076	< 0.001
悬吊组	30	32.03±8.66	54.30±5.93^a,b	-20.647	< 0.001
F值		0.053	11.287
P值		0.949	< 0.001

悬吊下数字作业疗法系统训练对脑卒中偏瘫患者上肢运动功能的效果

Effects of Digital Occupational Therapy System training under suspension on upper limb motor function for stroke patients with hemiplegia

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组别	n	治疗前	治疗后	t值	P值
常规组	30	71.13±7.91	84.43±7.12	-20.960	< 0.001
数字OT组	30	73.17±5.98	87.93±5.09^a	-35.402	< 0.001
悬吊组	30	72.40±7.65	91.40±5.26^a,b	-25.113	< 0.001
F值		0.605	10.471
P值		0.548	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	30	91.33±7.41	105.40±9.69	-11.421	< 0.001
数字OT组	30	92.23±5.42	110.03±6.03^a	-25.534	< 0.001
悬吊组	30	92.23±6.95	114.80±8.16^a,b	-20.787	< 0.001
F值		0.183	10.107
P值		0.833	< 0.001

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