改良分级运动表象训练对脑卒中患者上肢运动功能效果的随机对照试验

doi:10.3969/j.issn.1006-9771.2024.09.010

摘要/Abstract

摘要：

目的探讨改良分级运动表象训练(mGMI)对脑卒中患者上肢运动功能的疗效。
方法 2023年6月至12月，选取浙江省立同德医院收治的脑卒中患者68例，随机分为对照组(n = 34)和mGMI组(n = 34)。两组均接受常规康复训练，对照组增加常规运动表象训练，mGMI组增加mGMI，共4周。治疗前后，采用Fugl-Meyer评定量表上肢部分(FMA-UE)、上肢动作研究量表(ARAT)、改良Barthel指数(MBI)进行评定。
结果 mGMI组脱落1例。治疗后，两组FMA-UE、ARAT和MBI评分均明显提高(t > 3.448, P < 0.01)，mGMI组各项评分均显著高于对照组(t > 7.504, P < 0.001)。
结论 mGMI有助于提高脑卒中患者上肢运动功能和日常生活活动能力。

关键词: 脑卒中, 上肢, 运动功能, 运动表象, 随机对照试验

Abstract:

Objective To explore the effect of modified graded motor imagery (mGMI) on upper limb motor function for stroke patients.
Methods From June to December, 2023, 68 stroke patients from Zhejiang Tongde Hospital were randomly divided into control group (n = 34) and mGMI group (n = 34). Both groups received routine rehabilitation, and the control group received routine motor imagery, while mGMI group received mGMI, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT) and modified Barthel Index (MBI) before and after treatment.
Results One case dropped down in mGMI group. The scores of FMA-UE, ARAT and MBI increased in both groups after treatment (t > 3.448, P < 0.01), and they were higher in mGMI group than in the control group (t > 7.504, P < 0.001).
Conclusion mGMI is more effective on upper limb motor function and activities of daily living for stroke patients than routine motor imagery.

Key words: stroke, upper limbs, motor function, motor imagery, randomized controlled trial

中图分类号:

R743.3

王敏, 方篮天, 黄晨燚. 改良分级运动表象训练对脑卒中患者上肢运动功能效果的随机对照试验[J]. 《中国康复理论与实践》, 2024, 30(9): 1069-1073.

WANG Min, FANG Lantian, HUANG Chenyi. Effect of modified graded motor imagery on upper limb motor function for stroke patients: a randomized controlled trial[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(9): 1069-1073.

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组别	n	性别(男/女)/n	年龄/岁	病程/d	卒中类型(出血/缺血)/n	患侧(左/右)/n	MMSE评分
对照组	34	20/14	57.10±6.23	45.13±7.02	11/23	16/18	26.63±1.39
mGMI组	33	23/10	58.73±7.05	43.70±5.96	8/25	13/20	26.45±1.43
χ²/t值		0.861	1.010	0.905	0.542	0.401	0.522
P值		0.353	0.316	0.368	0.461	0.527	0.603

组别	n	测试	$\bar{x}±s$	t值	P值
对照组	34	前测	22.30±3.41	7.140	< 0.001
		后测	28.15±3.63
mGMI组	33	前测	21.64±3.28	21.492	< 0.001
		后测	37.90±2.95
治疗前两组均差值			-0.61±0.38	-1.310	0.179
治疗后两组均差值			9.77±1.50	7.504	< 0.001

组别	n	测试	$\bar{x}±s$	t值	P值
对照组	34	前测	12.57±2.30	3.448	0.001
		后测	14.69±2.75
mGMI组	33	前测	12.14±2.09	10.741	< 0.001
		后测	17.72±2.13
治疗前两组均差值			-0.45±0.28	0.473	0.638
治疗后两组均差值			3.08±0.76	4.052	< 0.001

组别	n	测试	$\bar{x}±s$	t值	P值
对照组	34	前测	45.70±5.83	8.825	< 0.001
		后测	59.06±6.55
mGMI组	33	前测	46.14±6.07	13.589	< 0.001
		后测	68.52±7.30
治疗前两组均差值			0.43±0.22	0.340	0.735
治疗后两组均差值			9.80±2.15	5.671	< 0.001