多模态镜像疗法对脑卒中患者上肢及手功能的效果

doi:10.3969/j.issn.1006-9771.2023.01.011

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (1): 77-81.doi: 10.3969/j.issn.1006-9771.2023.01.011

多模态镜像疗法对脑卒中患者上肢及手功能的效果

孙凤宝¹^,², 章晓峰², 刘勇², 徐智韬², 金振华²()

1.浙江中医药大学，浙江杭州市 310053
2.浙江省人民医院康复中心，浙江省康复与运动医学研究所，浙江省人民医院康复医学科，杭州医学院附属人民医院，浙江杭州市 310014

收稿日期:2022-10-25 修回日期:2022-12-08 出版日期:2023-01-25 发布日期:2023-02-17
通讯作者: 金振华，男，硕士，主管技师，主要研究方向：神经康复、肌骨康复，E-mail： 441707836@qq.com。
作者简介:孙凤宝(1992-)，男，汉族，浙江杭州市人，硕士研究生，技师，主要研究方向：神经康复、心肺康复。
基金资助:
浙江省自然科学基金公益技术应用研究项目(LGF21H170005)

Effect of multimodal mirror therapy on upper limb and hand function for stroke patients

SUN Fengbao¹^,², ZHANG Xiaofeng², LIU Yong², XU Zhitao², JIN Zhenhua²()

1. Zhejiang University of Chinese Medicine, Hangzhou, Zhejiang 310053, China
2. Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang 310014, China

Received:2022-10-25 Revised:2022-12-08 Published:2023-01-25 Online:2023-02-17
Contact: JIN Zhenhua, E-mail: 441707836@qq.com
Supported by:
Natural Science Foundation of Zhejiang Public Welfare Technology Application Research Project(LGF21H170005)

摘要/Abstract

摘要：

目的探讨多模态镜像疗法对脑卒中患者上肢及手功能的效果。

方法选取2021年4月至2022年8月浙江省人民医院康复医学科住院治疗的脑卒中患者60例，随机分为A组、B组和C组，各20例。3组均予常规康复，B组增加镜像疗法，C组增加多模态镜像疗法，共6周。治疗前后采用Fugl-Meyer评定量表上肢部分(FMA-UE)、Carroll手功能评定(UEFT)、患手最大握力和捏力、改良Barthel指数(MBI)进行评定。

结果治疗后，3组FMA-UE评分、UEFT评分、患手最大握力和捏力、MBI评分均显著提高(|t| > 7.878, P < 0.001)，C组各项成绩均最优(F > 12.563, P < 0.001)。

结论多模态镜像疗法能进一步改善脑卒中患者上肢运动功能和手功能，提高患手肌力和患者日常生活活动能力。

关键词: 脑卒中, 镜像疗法, 上肢功能, 手功能

Abstract:

Objective To investigate the effect of multimodal mirror therapy on upper limb and hand function in stroke patients.

Methods From April, 2021 to August, 2022, 60 stroke patients from the Department of Rehabilitation Medicine of Zhejiang Provincial People's Hospital were randomly divided into group A (n = 20), group B (n = 20) and group C (n = 20). All the patients accepted routine rehabilitation, while group B accepted mirror therapy, and group C accepted multimodal mirror therapy, in addition, for six weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Upper Extremity Function Test (UEFT) and modified Barthel Index (MBI), while the maximum grip strength and pinch strength of the affected hand were measured.

Results The FMA-UE score, UEFT score, maximum hand grip strength and pinch strength, and MBI scores improved in all groups after treatment (|t| > 7.878, P < 0.001), and it was the most in group C (F> 12.563, P< 0.001).

Conclusion Multimodal mirror therapy may further improve the upper limb motor function and hand function of stroke patients, as well as the strength of the affected hand and the activities of daily living.

Key words: stroke, mirror therapy, upper limb function, hand function

中图分类号:

R743.3

孙凤宝, 章晓峰, 刘勇, 徐智韬, 金振华. 多模态镜像疗法对脑卒中患者上肢及手功能的效果[J]. 《中国康复理论与实践》, 2023, 29(1): 77-81.

SUN Fengbao, ZHANG Xiaofeng, LIU Yong, XU Zhitao, JIN Zhenhua. Effect of multimodal mirror therapy on upper limb and hand function for stroke patients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(1): 77-81.

图/表 6

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组别	n	性别(男/女)/n	年龄/岁	病程/d	病变性质(梗死/出血)/n	偏瘫侧别(左/右)/n
A组	20	11/9	55.95±12.30	26.10±6.71	13/7	8/12
B组	20	10/10	59.85±9.16	26.65±5.06	12/8	9/11
C组	20	12/8	59.50±11.39	27.45±5.25	9/11	11/9
χ²/F值		0.404	0.766	0.282	1.765	0.938
P值		0.817	0.470	0.756	0.414	0.626

组别	n	治疗前	治疗后	t值	P值
A组	20	16.85±3.30	26.45±4.07	-33.720	< 0.001
B组	20	17.55±3.65	30.05±4.40^a	-32.275	< 0.001
C组	20	17.40±3.66	34.65±4.02^a,b	-98.098	< 0.001
F值		0.217	19.483
P值		0.806	< 0.001

组别	n	治疗前	治疗后	t值	P值
A组	20	15.25±5.64	23.45±5.06	-8.654	< 0.001
B组	20	15.75±6.43	28.95±6.48^a	-16.568	< 0.001
C组	20	15.40±5.25	34.45±8.14^a,b	-22.314	< 0.001
F值		0.039	13.562
P值		0.962	< 0.001

组别	n	治疗前	治疗后	t值	P值
A组	20	3.43±1.33	7.37±2.86	-11.354	< 0.001
B组	20	3.48±1.31	13.35±4.56^a	-13.081	< 0.001
C组	20	3.49±1.23	17.24±5.26^a,b	15.034	< 0.001
F值		0.012	26.22
P值		0.988	< 0.001

组别	n	治疗前	治疗后	t值	P值
A组	20	1.89±0.70	2.53±0.81	-7.878	< 0.001
B组	20	1.87±0.73	3.82±1.32^a	-10.385	< 0.001
C组	20	1.97±0.82	7.97±2.28^a,b	16.189	< 0.001
F值		0.103	63.87
P值		0.902	< 0.001

多模态镜像疗法对脑卒中患者上肢及手功能的效果

Effect of multimodal mirror therapy on upper limb and hand function for stroke patients

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组别	n	治疗前	治疗后	t值	P值
A组	20	35.25±6.62	49.05±7.08	-60.393	< 0.001
B组	20	35.95±6.26	54.90±7.72^a	-45.836	< 0.001
C组	20	34.90±6.03	60.70±7.24^a,b	-25.896	< 0.001
F值		0.144	12.563
P值		0.867	< 0.001

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