智能康复训练系统对脑卒中患者上肢及手功能的效果

doi:10.3969/j.issn.1006-9771.2020.10.013

Abstract

Abstract:

Objective To explore the effect of intelligent rehabilitation training system on upper limb and hand function in patients with stroke.
Methods From December, 2018 to December, 2019, 68 stroke patients were randomly divided into control group (n = 34) and experimental group (n = 34). Both groups were treated with conventional physical and occupational therapy, and scalp acupuncture, while the experimental group accepted intelligent rehabilitation training in addition, for eight weeks. Before treatment and after one week, four weeks and eight weeks of treatment, both group were evaluated with Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Upper Extermities Functional Test (UEFT) and modified Barthel Index (MBI).
Results Before treatment, there was no significant difference in the scores of FMA-UE, UEFT and MBI between two groups (P > 0.05). After treatment, all scores increased in both groups ( F > 11.676, P < 0.001). Four weeks and eight weeks after treatment, all scores were higher in the experimental group than in the control group ( t > 2.122, P < 0.05).
Conclusion Intelligent rehabilitation training system could improve the upper limb and hand function and activities of daily living in stroke patients.

Key words: stroke, scalp acupuncture, intelligent rehabilitation training system, upper limb, hand, motor function

CLC Number:

R743.3

GAO Pin-cao,TANG Fang,YANG Yi,YU Bin. Effect of Intelligent Rehabilitation Training System on Upper Limb and Hand Function of Patients with Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(10): 1198-1203.

Figures/Tables 4

References 38

[1]	Santisteban L, Térémetz M, Bleton J P, et al. Upper limb outcome measures used in stroke rehabilitation studies: a systematic literature review[J]. PLoS One, 2016, 11(5):e0154792. doi: 10.1371/journal.pone.0154792
[2]	Thrane G, Friborg O, Anke A, et al. A meta-analysis of constraint-induced movement therapy after stroke[J]. J Rehabil Med, 2014, 46(9):833-842. doi: 10.2340/16501977-1859 pmid: 25182341
[3]	Avan A, Digaleh H, Di Napoli M, et al. Socioeconomic status and stroke incidence, prevalence, mortality, and worldwide burden: an ecological analysis from the Global Burden of Disease Study 2017[J]. BMC Med, 2019, 17(1):191-221. doi: 10.1186/s12916-019-1397-3
[4]	Franck J A, Smeets R J E M, Seelen H A M. Changes in arm-hand function and arm-hand skill performance in patients after stroke during and after rehabilitation[J]. PLoS One, 2017, 12(6):e0179453. doi: 10.1371/journal.pone.0179453
[5]	Meng Z Y, Song W Q. Low frequency repetitive transcranial magnetic stimulation improves motor dysfunction after cerebral infarction[J]. Neural Regen Res, 2017, 12(4):610-613 doi: 10.4103/1673-5374.205100
[6]	刘阅, 王晓阳, 张长龙, 等. 低频重复经颅磁刺激改善脑卒中后上肢痉挛的任务态功能磁共振研究[J]. 中国康复理论与实践, 2018, 24(7):828-833.
	Liu Y, Wang X Y, Zhang C L, et al. Effects of low-frequency repetitive transcranial magnetic stimulation on upper limb spasticity after stroke: a task-state functional magnetic resonance study[J]. Chin J Rehabil Theory Pract, 2018, 24(7):828-833.
[7]	李冰洁, 李芳, 张通. 不同强度低频重复经颅磁刺激对脑卒中后上肢运动功能障碍的疗效[J]. 中国康复理论与实践, 2016, 22(9):1004-1007.
	Li B J, Li F, Zhang T. Effects of various intensity of repetitive transcranial magnetic stimulation on upper limbs motor function after stroke[J]. Chin J Rehabil Theory Pract, 2016, 22(9):1004-1007.
[8]	潘俊晓, 陈艳萍, 位娜娜. 平衡针结合运动再学习疗法对脑卒中患者上肢功能恢复的影响[J]. 针刺研究, 2018, 43(2):123-126.
	Pan J X, Chen Y P, Wei N N. Improvement of upper limb and hand functions of stroke patients by balancing acupuncture combined with motor relearning training[J]. Acupunc Res, 2018, 43(2):123-126.
[9]	阳运秋, 唐纯志, 崔韶阳, 等. 针灸结合镜像疗法在脑卒中治疗的临床应用现况[J]. 时珍国医国药, 2018, 29(11):2737-2739.
	Yang Y Q, Tang C Z, Cui S Y, et al. Lishizhen Med Materia Medica Res, 2018, 29(11):2737-2739.
[10]	阳运秋, 唐纯志, 崔韶阳, 等. 靳三针结合镜像疗法对脑卒中上肢功能障碍患者脑功能效应的影响[J]. 中医杂志, 2019, 60(8):675-679.
	Yang Y Q, Tang C Z, Cui S Y, et al. Effects of JIN's Three-needle combined with mirror therapy on brain function of patients with stroke and upper limb dysfunction[J]. J Trad Chin Med, 2019, 60(8):675-679.
[11]	党辉, 陈伟荣, 吴清俊, 等. 核心肌群训练联合针刺治疗缺血性脑卒中偏瘫患者的临床效果[J]. 中国医药导报, 2019, 16(14):121-124, 131.
	Dang H, Chen W R, WU Q J, et al. Clinical effect of core muscle training combined with acupuncture in treatment of ischemic stroke patients with hemiplegia[J]. China Medical Herald, 2019, 16(14):121-124, 131.
[12]	中华神经科学会, 中华神经外科学会. 各类脑血管疾病诊断要点[J]. 中华神经科杂志, 1996, 29(6):379-380.
	Chinese Society of Neurology, Chinese Neurosurgical Society. Diagnosis of Cerebral Vascular Diseases[J]. Chin J Neurol, 1996, 29(6):379-380.
[13]	周哲, 沈夏锋, 熊莉, 等. 运动前区高频重复经颅磁刺激对脑卒中上肢功能康复的疗效[J]. 中国康复理论与实践, 2020, 26(6):697-702.
	Zhou Z, Shen X F, Xiong L, et al. Effects of high-frequency repetitive transcranial magnetic stimulation to premotor areas on upper limb motor dysfunction after stroke[J]. Chin J Rehabil Theory Pract, 2020, 26(6):697-702.
[14]	张英, 廖维靖, 郝赤子. 低频重复经颅磁刺激联合作业治疗对脑卒中患者上肢运动功能恢复的临床研究[J]. 中国康复, 2019, 34(3):142-145.
	Zhang Y, Liao W J, Hao C Z. Clinical study of low-frequency repetitive transcranial magnetic stimulation combined with occupational therapy on the recovery of upper limb motor function in stroke patients[J]. Chin J Rehabil, 2019, 34(3):142-145.
[15]	曾萍萍. 化脓灸对脑卒中后中重度认知功能障碍的临床疗效观察[D]. 福州:福建中医药大学, 2015.
	Zeng P P. Clinical Observation on festering moxibustion for the moderate and severe cognitive impairment after stroke[D]. Fuzhou: Fujian University of Traditional Chinese Medicine, 2015.
[16]	张茜. 补肾健脾益智针法治疗小儿脑瘫的临床研究[D]. 昆明:云南中医学院, 2015.
	Zhang Q. Clinical study of tonifying the kidney and spleen to improving intelligence acupuncture method in treating infantile cerebral palsy[D]. Kunming: Yunnan University of Traditional Chinese Medicine, 2015.
[17]	陆寿康. 头皮针[M]. 北京: 北京科学技术出版社, 2006: 13-17.
	Lu S K. Scalp Needle [M]. Beijing: Beijing Science and Technology Press, 2006: 13-17.
[18]	白雪. 头穴电针结合体针治疗缺血性中风恢复期偏瘫的临床观察[D]. 石家庄:河北医科大学, 2018.
	Bai X. Clinical observation of scalp points electroacupuncture combined with acupuncture in the treatment of ischemic stroke convalescent hemiplegia[D]. Shijiazhuang: Hebei Medical University, 2018.
[19]	康冰心. 电针晕听区治疗后循环缺血性眩晕(痰湿中阻型)的临床研究[D]. 郑州:河南中医药大学, 2016.
	Kang B X. Clinical study of post-circulation ischemic vertigo (phlegm dampness resistance type) treated by electroacupuncture halo listening area[D]. Zhengzhou: Henan University of Chinese Medicine, 2016.
[20]	董安琴, 曹海燕, 何爱群, 等. 提醒治疗法对脑卒中后功能恢复的效果[J]. 中国康复理论与实践, 2018, 24(3):328-332.
	Dong A Q, Cao H Y, He A Q, et al. Effects of remind- to- move treatment on functional recovery after stroke[J]. Chin J Rehabil Theory Pract, 2018, 24(3):328-332.
[21]	王玉龙. 康复功能评定学(第3版)[M]. 北京: 人民卫生出版社, 2018: 373-374.
	Wang Y L. Rehabilitation function assessment [M]. 3rd ed. Beijing: People's Medical Press, 2018: 373-374.
[22]	张听雨, 贾杰. 电针对脑卒中后偏瘫患者手功能障碍的疗效[J]. 中国康复理论与实践, 2017, 23(1):14-18.
	Zhang T Y, Jia J. Effect of electroacupuncture on hand dysfunction after stroke[J]. Chin J Rehabil Theory Pract, 2017, 23(1):14-18.
[23]	陆操, 金丹丹, 傅晓倩, 等. 低频重复经颅磁刺激联合小组模式康复训练对脑卒中偏瘫患者上肢及手功能的影响[J]. 中国康复, 2018, 33(5):369-372.
	Lu C, Jin D D, Fu X Q, et al. Effect of low-frequency repetitive transcranial magnetic stimulation combined with group rehabilitation therapy on upper limb and hand function in hemiplegic patients after stroke[J]. Chin Rehabil, 2018, 33(5):369-372.
[24]	柏树令. 系统解剖学[M]. 9版. 北京: 人民卫生出版社, 2018: 335-336.
	Bai S L. System Anatomy [M]. 9th ed. Beijing: People's Medical Press, 2018: 335-336.
[25]	林如辉. 电针百会、神庭改善缺血再灌注大鼠学习记忆的小动物影像学研究[D]. 福州:福建中医药大学, 2017.
	Lin R H. Study of the small animal imaging of the learning and memory functions of cerebral ischemia/reperfusion rats by electroacupuncture Baihui and Shenting[D]. Fuzhou: Fujian University of Traditional Chinese Medicine, 2017.
[26]	王婵媛, 路明. 醒脑开窍针法结合头皮针治疗中风后偏身舞蹈症[J]. 中华针灸电子杂志, 2018, 7(2):52-53.
	Wang C Y, Lu M. Xingnao Kaiqiao acupuncture combined with scalp acupuncture for the treatment of post-stroke eccentric chorea[J]. Chin J Acupunc Moxib (Electronic Ed), 2018, 7(2):52-53.
[27]	高春燕, 周志杰. 周志杰头四针配合芒针治疗假性球麻痹经验[J]. 中医药临床杂志, 2017, 29(7):1002-1003.
	Gao C Y, Zhou Z J. Experience of Professor ZHOU Zhijie in treating pseudobulbar palsy with the combination of the First Four Needle and Awn Needle[J]. Clin J Chin Med, 2017, 29(7):1002-1003.
[28]	杨艳梅. 头针配合耳针治疗小儿抽动症的临床研究[D]. 昆明:云南中医学院, 2016.
	Yang Y M. Clinical study of scalp acupuncture combined with ear acupuncture on pediatric tics[D]. Kunming: Yunnan University of Traditional Chinese Medicine, 2016.
[29]	董宝杰. 头、体针并用治疗急性缺血性脑卒中运动性失语的临床观察[D]. 北京:北京中医药大学, 2011.
	Dong B J. Clinical observation of the combined use of head and body acupuncture for the treatment of motor aphasia in acute ischemic stroke[D]. Beijing: Beijing University of Chinese Medicine, 2011.
[30]	谢冬玲, 朱丽芳, 刘惠宇, 等. 头皮针对脑卒中康复期患者认知与运动功能障碍疗效观察[J]. 中国康复理论与实践, 2007, 13(6):542-543.
	Xie D L, Zhu L F, Liu H Y, et al. Effect of scalp acupuncture on cognitive and motor functions of stroke patients in recovery stage[J]. Chin J Rehabil Theory Pract, 2007, 13(6):542-543.
[31]	秦达. 头皮针对脑卒中康复期患者运动功能与认知功能的影响[J]. 中国老年学杂志, 2015, 35(18):5161-5163.
	Qin D. The effect of scalp on motor function and cognitive function of stroke patients in recovery stage[J]. Chin J Gerontol, 2015, 35(18):5161-5163.
[32]	田开宇. «针灸学»教材及头针国家标准中"顶旁1线"和"顶旁2线"的主治疑析[J]. 医学争鸣, 2017, 8(1):46-48, 52.
	Tian K Y. Doubting the indications of Lateral Line 1 and Lateral Line 2 of vertex in Acupuncture textbook and national scalp-acupuncture standard[J]. Negative, 2017, 8(1):46-48, 52.
[33]	饶美林, 肖洪波, 朱宗俊, 等. 头皮针结合任务导向性训练对脑卒中后偏瘫患者手功能恢复的影响[J]. 中医药临床杂志, 2018, 30(5):952-954.
	Rao M L, Xiao H B, Zhu Z J, et al. Effect of scalp acupuncture combined with task oriented training on recovery of hand function in patients with hemiplegia after stroke[J]. Clin J Trad Chin Med, 2018, 30(5):952-954.
[34]	Thieme H, Morkisch N, Mehrholz J, et al. Mirror therapy for improving motor function after stroke[J]. Cochrane Database Syst Rev, 2018, 7(7):CD008449.
[35]	Machado T C, Carregosa A A, Santos M S, et al. Efficacy of motor imagery additional to motor-based therapy in the recovery of motor function of the upper limb in post-stroke individuals: a systematic review[J]. Top Stroke Rehabil, 2019, 26(7):548-553. doi: 10.1080/10749357.2019.1627716
[36]	李蕊, 魏鲁刚, 张萍, 等. 体感模拟训练系统结合运动想象治疗对脑卒中患者偏瘫上肢功能的作用[J]. 中国老年学杂志, 2020, 40(2):260-263.
	Li R, Wei L G, Zhang P, et al. Effect of somatosensory simulation training system combined with motor imaging therapy on upper limb function of hemiplegia patients with stroke[J]. Chin J Gerontol, 2020, 40(2):260-263.
[37]	da Silva P B, Antunes F N, Graef P, et al. Strength training associated with task-oriented training to enhance upper-limb motor function in elderly patients with mild impairment after stroke: a randomized controlled trial[J]. Am J Phys Med Rehabil, 2015, 94(1):11-19. doi: 10.1097/PHM.0000000000000135
[38]	蔡琛, 杨宁, 孙秋芳, 等. 任务导向同步生物反馈治疗脑卒中后上肢功能障碍的临床研究[J]. 中国康复医学杂志, 2020, 35(3):345-347.
	Cai C, Yang N, Sun Q F, et al. Clinical research on task-oriented synchronous biofeedback for upper limb dysfunction after stroke[J]. Chin J Rehabil Med, 2020, 35(3):345-347.

组别	n	年龄(岁)	性别(n)		病程(d)	病变类别(n)		偏瘫侧(n)
组别	n	年龄(岁)	男	女	病程(d)	脑出血	脑梗死	左侧	右侧
对照组	34	58.85±9.284	18	16	45.12±7.044	14	20	16	18
试验组	34	59.03±8.144	20	14	42.91±8.350	12	22	14	20
t/χ²值		0.582	0.239		2.765	0.249		0.239
P值		0.934	0.625		0.243	0.618		0.625

组别	n	治疗前	治疗1周后	治疗4周后	治疗8周后	F值	P值
对照组	34	15.44±3.16	16.65±3.15	22.41±4.20^a	31.24±4.69^a	16.292	< 0.001
试验组	34	15.26±3.74	17.44±3.89^a	25.29±5.72^a	36.21±6.53^a	16.220	< 0.001
t值		-0.210	0.924	2.369	3.604
P值		0.834	0.359	0.021	0.001

组别	n	治疗前	治疗1周后	治疗4周后	治疗8周后	F值	P值
对照组	34	31.85±5.45	32.85±5.65	40.68±6.17^a	52.24±8.57^a	11.705	< 0.001
试验组	34	33.12±5.58	34.74±5.62	44.06±6.57^a	58.26±11.25^a	11.676	< 0.001
t值		0.945	1.377	2.187	2.486
P值		0.348	0.173	0.032	0.015

组别	n	治疗前	治疗1周后	治疗4周后	治疗8周后	F值	P值
对照组	34	38.24±5.81	38.79±5.71	48.50±6.71^a	57.12±7.38^a	11.721	< 0.001
试验组	34	37.82±6.54	39.24±6.73	52.53±8.78^a	61.26±8.86^a	12.574	< 0.001
t值		-0.274	0.291	2.126	2.122
P值		0.785	0.772	0.037	0.038

Effect of Intelligent Rehabilitation Training System on Upper Limb and Hand Function of Patients with Stroke

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 4

References 38

Related Articles 15

Metrics

Comments

Recommended 0

[1]	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.
[2]	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.
[3]	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.
[4]	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.
[5]	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.
[6]	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.
[7]	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.
[8]	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.
[9]	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.
[10]	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.
[11]	LI Zhenya, SUN Jie, GUO Pengfei, WANG Guangming. Correlation between changes of swallowing function in oral and pharyngeal phases, and aspiration in stroke patients based on videofluroscopic swallowing study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 933-939.
[12]	LI Fang, HUO Su, DU Jubao, LIU Xiuzhen, LI Xiaoshuang, SONG Weiqun. Effect of transcranial direct current stimulation combined with task-oriented rehabilitation training on forelimb motor dysfunction in rats with spinal cord injury [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 777-781.
[13]	CUI Yao, CONG Fang, HUANG Fubiao, ZENG Ming, YAN Ruxiu. Brain and muscle activation under mirror neuron-based training strategies: a near-infrared spectroscopy and surface electromyography study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 782-790.
[14]	HUA Ling, ZHANG Yi'nan, ZHENG Yu, SUN Qiaoyi, FANG Hui, SONG Da. Effect of hand controlled rhythm music therapy on unilateral spatial neglect after stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 833-838.
[15]	JIANG Xiaocui, LIU Zhen, SU Qinglun, ZHAO Qin, XIA Xiaomei, LU Fei. Effect of intermittent theta burst transcranial magnetic stimulation on non-fluent aphasia after stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 839-843.