动作观察疗法对重度偏瘫患者上肢运动功能的效果

doi:10.3969/j.issn.1006-9771.2020.01.015

Abstract

Abstract:

Objective To explore the effects of action observation therapy on upper limb severe hemiplegia.
Methods From January to June, 2019, 40 patients with severe hemiplegia after stroke were randomly divided into control group (n = 20) and observation group (n = 20). Before routine rehabilitation training, the observation group watched the videos about activities and movements of arms and hands, and then were asked to imagine their affected arms and hands to complete these movements. The control group watched the videos of orderly geometric figures, letters and others without body and animals. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Motor Assessment Scale-Upper Extremities (MAS-UE) and modified Barthel Index (MBI) before and four weeks after treatment.
Results The scores of FMA-UE, MAS-UE and MBI improved after treatment (t > 2.854, P < 0.05), and improved more in the observation group than in the control group ( F > 4.395, P < 0.05).
Conclusion action observation therapy can further improve upper limb motor function and activities of daily living in patients with severe hemiplegia after stroke.

Key words: stroke, action observation therapy, hemiplegia, upper limbs, motor, activities of daily living

CLC Number:

R743.3

WANG Jian-ping,GUI Pei-jun,XIE Ying. Effect of Action Observation Therapy on Upper Limb Motor Function for Severe Hemiplegics[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(1): 85-88.

Figures/Tables 4

References 25

[1]	王陇德, 刘建民, 杨弋, 等. 我国脑卒中防治仍面临巨大挑战——《中国脑卒中防治报告2018》概要[J]. 中国循环杂志, 2019, 34(2):105-119.
[2]	梁天佳. 脑卒中偏瘫上肢功能障碍康复治疗研究进展[J]. 广西医科大学学报, 2018, 35(7):1026-1028.
[3]	欧阳丽竹, 韦福香. 脑卒中后上肢功能障碍患者康复治疗研究新进展[J]. 临床医药文献电子杂志, 2019, 6(51):191-192.
[4]	Garrison K A, Winstein C J, Aziz-Zadeh L. The mirror neuron system: a neural substrate for methods in stroke rehabilitation[J]. Neurorehabil Neural Repair, 2010, 24(5):404-412. doi: 10.1177/1545968309354536
[5]	Bai Z, Zhang J, Zhang Z, et al. Comparison between movement-based and task-based mirror therapies on improving upper limb functions in patients with stroke: a pilot randomized controlled trial[J]. Front Neurol, 2019, 10(10):288-298. doi: 10.3389/fneur.2019.00288
[6]	Goncalves M G, Piva M, Marques C, et al. Effects of virtual reality therapy on upper limb function after stroke and the role of neuroimaging as a predictor of a better response[J]. Arq Neuropsiquiatr, 2018, 76(10):654-662. doi: 10.1590/0004-282x20180104
[7]	Guerra Z F, Bellose L C, Coelho D M F C, et al. The effects of mental practice based on motor imagery for mobility recovery after subacute stroke: protocol for a randomized controlled trial[J]. Complement Ther Clin Pract, 2018, 33(33):36-42. doi: 10.1016/j.ctcp.2018.08.002
[8]	Noh J S, Lim J H, Choi T W, et al. Effects and safety of combined rTMS and action observation for recovery of function in the upper extremities in stroke patients: a randomized controlled trial[J]. Restor Neurol Neurosci, 2019, 37(3):219-230.
[9]	Young B M, Nigogosyan Z, Walton L M, et al. Dose-response relationships using brain-computer interface technology impact stroke rehabilitation[J]. Front Hum Neurosci, 2015, 9(9):361-396. doi: 10.3389/fpsyg.2018.00361
[10]	Carvalho D, Teixeira S, Lucas M, et al. The mirror neuron system in post-stroke rehabilitation[J]. Int Arch Med, 2013, 6(1):41-58. doi: 10.1186/1755-7682-6-41 pmid: 24134862
[11]	Small S L, Buccino G, Solodkin A. The mirror neuron system and treatment of stroke[J]. Dev Psychobiol, 2012, 54(3):293-310. doi: 10.1002/dev.v54.3
[12]	陈艳, 胡发云, 吴波. 《中国脑血管疾病分类2015》解读[J]. 中国现代神经疾病杂志, 2017, 17(12):865-868.
[13]	鲍亚奇, 肖田身, 陈善佳, 等. 运动功能相关评定量表在国内脑卒中康复临床应用情况调查[J]. 按摩与康复医学, 2018, 9(5):21-24.
[14]	张冬月, 韩薇. 我国脑卒中流行现状及危险因素研究进展[J]. 世界最新医学信息文摘, 2018, 18(80):122-123.
[15]	Feigin V L, Krishnamurthi R V, Parmar P, et al. Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990-2013: The GBD 2013 Study[J]. Neuroepidemiology, 2015, 45(3):161-176. doi: 10.1159/000441085
[16]	Keysers C, Paracampo R, Gazzola V. What neuromodulation and lesion studies tell us about the function of the mirror neuron system and embodied cognition[J]. Curr Opin Psychol, 2018, 24(24):35-40.
[17]	Rizzolatti G, Fabbri-Destro M, Cattaneo L. Mirror neurons and their clinical relevance[J]. Nat Clin Pract Neurol, 2009, 5(1):24-34. doi: 10.1038/ncpneuro0990 pmid: 19129788
[18]	Babiloni C, Del P C, Lopez S, et al. Frontal functional connectivity of electrocorticographic delta and theta rhythms during action execution versus action observation in humans[J]. Front Behav Neurosci, 2017, 11(20):3389-3400.
[19]	Babiloni C, Del P C, Vecchio F, et al. Alpha, beta and gamma electrocorticographic rhythms in somatosensory, motor, premotor and prefrontal cortical areas differ in movement execution and observation in humans[J]. Clin Neurophysiol, 2016, 127(1):641-654. doi: S1388-2457(15)00308-9 pmid: 26038115
[20]	Borges L R, Fernandes A B, Melo L P, et al. Action observation for upper limb rehabilitation after stroke[J]. Cochrane Database Syst Rev, 2018, 10(10):11887-11951.
[21]	Zhang J, Fong K, Welage N, et al. The activation of the mirror neuron system during action observation and action execution with mirror visual feedback in stroke: a systematic review[J]. Neural Plast, 2018, 4(10):1045-1059.
[22]	Page S J, Levine P, Leonard A. Mental practice in chronic stroke: results of a randomized, placebo-controlled trial[J]. Stroke, 2007, 38(4):1293-1297. doi: 10.1161/01.STR.0000260205.67348.2b
[23]	Agnew Z K, Wise R J, Leech R. Dissociating object directed and non-object directed action in the human mirror system; implications for theories of motor simulation[J]. PLoS One, 2012, 7(4):1371-1380.
[24]	Calvo-Merino B, Grezes J, Glaser D E, et al. Seeing or doing? Influence of visual and motor familiarity in action observation[J]. Curr Biol, 2006, 16(19):1905-1910. pmid: 17027486
[25]	Vogt S, Buccino G, Wohlschlager A M, et al. Prefrontal involvement in imitation learning of hand actions: effects of practice and expertise[J]. Neuroimage, 2007, 37(4):1371-1383. doi: 10.1016/j.neuroimage.2007.07.005

组别	n	性别(n)		年龄(岁)	病程(d)	偏瘫侧(n)		卒中性质(n)
组别	n	男	女	年龄(岁)	病程(d)	左侧	右侧	出血	梗死
对照组	20	14	6	64.90±7.77	13.20±2.33	18	2	4	16
观察组	20	15	5	65.10±7.85	13.70±2.52	16	4	3	17
χ²/F值		0.125		0.025	0.035	0.784		0.173
P值		0.723		0.874	0.853	0.376		0.677

组别	n	治疗前	治疗后	t值	P值
对照组	20	8.60±3.12	10.00±3.31	3.621	0.002
观察组	20	8.55±3.07	12.40±3.55	11.244	< 0.001
F值		21.948
P值		< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	20	0.65±0.67	0.95±0.83	2.854	0.010
观察组	20	0.60±0.68	1.30±1.13	4.273	< 0.001
F值		4.395
P值		0.043

组别	n	治疗前	治疗后	t值	P值
对照组	20	17.50±5.50	28.50±7.96	7.936	< 0.001
观察组	20	16.00±5.03	39.50±5.60	21.476	< 0.001
F值		47.236
P值		< 0.001

Effect of Action Observation Therapy on Upper Limb Motor Function for Severe Hemiplegics

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 4

References 25

Related Articles 15

Metrics

Comments

Recommended 0

[1]	SONG Yiling, REN Yuanchun, ZHU Feilong, KUANG Dongqing, CAO Qingjiu, LIN Yang, WANG Fang. Characteristics and relationship between the development of gross motor skills and executive function in children with attention deficit hyperactivity disorder [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 1-9.
[2]	ZHOU Zhining, ZHOU Rong, XIAO Yanwen, WANG Bowen, LÜ Jiaojiao, LIU Yu. Effect of multi-target transcranial direct current stimulation on performance of working memory-postural control dual-task in healthy adults [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 21-28.
[3]	LIN Na, GAO Hanlu, LU Huiping, CHEN Yanqing, ZHENG Junfan, CHEN Shurong. Effect of virtual reality on upper limb function after stroke: a study of diffusion tensor imaging [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 61-67.
[4]	WANG Haoyi, SHI Yawei, LU Jun, XU Guangxu. Impact of subjective vertical perception impairment on function in stroke patients: a retrospective study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 68-73.
[5]	CHEN Junwen, CHEN Qian, CHEN Cheng, LI Shuyue, LIU Lingling, WU Cunshu, GONG Xiang, LU Jun, XU Guangxu. Effect of modified Baduanjin exercise on cardiopulmonary function, motor function and activities of daily living for stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 74-80.
[6]	HU Yonglin, MA Ying, DOU Chao, LU Anmin, JIANG Xiaoge, SONG Xinjian, XIAO Yuhua. Effect of neural mobilization based on shoulder control training on shoulder pain and upper limb function in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 81-86.
[7]	WEI Mengli, ZHONG Yaping, ZHOU Yiwen, GUI Huixian, GUAN Yeming, YU Tingting. Difference in bilateral lower limb muscle synergy mode for gait in patients after unilateral anterior cruciate ligament reconstruction [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 95-104.
[8]	BI Xiaoyu, ZHU Xiaotong, ZHU Feilong, KUANG Dongqing, SONG Yiling, FAN Biyao, REN Yuanchun. Sex difference of fine motor skills of school-age children with attention deficit hyperactivity disorder [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1029-1034.
[9]	WANG He, HAN Liang, KAN Mengfan, YU Shaohong. Efficacy of electrical stimulation on shoulder-hand syndrome after stroke: a systematic review and meta-analysis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1048-1056.
[10]	HU Xiaoshi, ZHANG Qi, YUE Qing, LIANG Yanhua, LI Xiaosong, FENG Amei, ZHANG Yanqing. Effect of orthopedic elastic bandages on gait symmetry and walking ability in children with spastic hemiplegic cerebral palsy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1083-1089.
[11]	SUN Tengfang, REN Mengting, YANG Lin, WANG Yaoting, WANG Hongyu, YAN Xingzhou. Effect of hyperbaric oxygen therapy combined with repetitive peripheral magnetic stimulation on ankle motor function and balance of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 875-881.
[12]	WANG Ya'nan, LIU Xihua. Correlation and predictive effect of subjective and objective balance function measurements in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 890-895.
[13]	WEI Xiaowei, YANG Jian, WEI Chunyan, HE Qiling. Adapted physical education programs for psychomotor development in school settings for children with intellectual and developmental disabilities: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 910-918.
[14]	WANG Haiyun, WANG Yin, ZHOU Xinjie, HE Aiqun. Effect of transcranial direct current stimulation combined with acupuncture on central and upper limb function in stroke patients based on central-peripheral-central theory [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 919-925.
[15]	CHEN Yiting, WANG Qian, CUI Shenhong, LI Yingcai, ZHANG Siyu, WEI Yanxu, REN Hui, LENG Jun, CHEN Bin. Effect of bilateral sequential repetitive transcranial magnetic stimulation on motor function of upper limbs in stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 926-932.