复合式腕手矫形器辅助疗法对脑卒中后腕手功能障碍的效果

doi:10.3969/j.issn.1006-9771.2020.12.013

Abstract

Abstract:

Objective To observe the efficacy of compound wrist-hand orthosis-assisted training on wrist-hand dysfunction in patients with convalescent stroke.Methods From June, 2018 to December, 2019, 34 stroke patients in our hospital were randomly divided into control group (n = 17) and experimental group (n = 17). Both groups received basic treatment and routine occupational therapy, while the experimental group wore a compound wrist-hand orthosis during and after the daily occupational therapy. The occupational therapy was carried out 30 minutes a time, twice a day for 14 days, and the non-training time orthosis wearing was carried out cumulative five hours a day for 14 days. Before and after treatment, the Brunnstrom stage (upper limb and hand) and Fugl-Meyer Assessment (FMA) (wrist and hand) were used to assess the motor function of the upper limbs and hands, while the modified Ashworth Scale (MAS) and modified Barthel Index (MBI) were separately used to assess the wrist tension and activities of daily living.Results Two cases dropped out in the control group. There was no significant difference in Brunnstrom stage, FMA score, MAS score, and MBI score between two groups before treatment (P> 0.05). After treatment, the scores of FMA and MBI significantly improved in both groups (|Z| > 3.420, P< 0.01), and the improvement was higher in the experimental group than in the control group (Z = -2.895, t = 4.331, P< 0.01); while, no significant difference was found in Brunnstrom stages and MAS score in both groups (P> 0.05).Conclusion The compound wrist-hand orthosis-assisted therapy could improve the wrist-hand motor function and activities of daily living in patients with convalescent stroke.

Key words: stroke, wrist-hand dysfucntion, compound wrist-hand orthosis, occupational therapy, activities of daily living

CLC Number:

R743.3

HUANG Chu-hong,ZENG Qing,CHEN Huan,LI Yu-qi,HUANG Guo-zhi. Efficacy of Compound Wrist-hand Orthosis-assisted Therapy on Wrist-hand Dysfunction after Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(12): 1446-1452.

Figures/Tables 7

References 31

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项目		对照组(n = 17)	试验组(n= 17)	t/Z/χ²值	P值
性别(n)	男	16	14		0.601^a
性别(n)	女	1	3		0.601^a
年龄(岁)		54.12±16.07	52.76±11.25	-0.284	0.778
病程(d)		30.00(30.00, 90.00)	60.00(30.00, 120.00)	-0.693	0.488
体质量指数(kg/m²)		20.57(19.87, 21.24)	21.00(20.21, 21.79)	-0.551	0.581
偏瘫侧(n)	左	8	10		0.732^a
偏瘫侧(n)	右	9	7		0.732^a
卒中类型(n)	脑梗死	11	8		0.491^a
卒中类型(n)	脑出血	6	9		0.491^a
基础疾病(n)
高血压	有	11	10		1.000^a
高血压	无	6	7		1.000^a
糖尿病	有	2	1		1.000^a
糖尿病	无	15	16		1.000^a
高血脂	有	3	2		1.000^a
高血脂	无	14	15		1.000^a

组别	n	治疗前			治疗后			Z值	P值
组别	n	Ⅲ期	Ⅳ期	V期	Ⅲ期	Ⅳ期	V期	Z值	P值
对照组	15	10	3	2	10	3	2	0.000	1.000
试验组	17	9	7	1	8	8	1	-1.000	0.317
Z值		-0.520			-0.790
P值		0.603			0.429

组别	n	治疗前			治疗后			Z值	P值
组别	n	Ⅲ期	Ⅳ期	V期	Ⅲ期	Ⅳ期	V期	Z值	P值
对照组	15	9	3	3	8	4	3	-1.000	0.317
试验组	17	9	6	2	7	7	3	-1.732	0.083
Z值		-0.127			-0.450
P值		0.899			0.652

组别	n	治疗前	治疗后	差值	Z值	P值
对照组	15	6.00(5.00, 8.00)	15.00(15.00, 16.00)	9.00(8.00, 10.00)	-3.420	0.001
试验组	17	7.00(5.00, 12.00)	22.00(15.00, 24.00)	12.00(9.50, 12.00)	-3.653	< 0.001
Z值		-0.852	-2.254	-2.895
P值		0.394	0.024	0.004

组别	n	治疗前				治疗后				Z值	P值
组别	n	0	1	1⁺	2	0	1	1⁺	2	Z值	P值
对照组	15	2	6	6	1	4	5	5	1	-1.127	0.260
试验组	17	3	8	6	0	5	9	2	1	-1.292	0.196
Z值		-0.753				-0.863
P值		0.451				0.388

Efficacy of Compound Wrist-hand Orthosis-assisted Therapy on Wrist-hand Dysfunction after Stroke

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组别	n	治疗前	治疗后	差值	Z值	P值
对照组	15	35.00(30.00, 35.00)	45.00(40.00, 50.00)	15.00±9.45	-3.426	0.001
试验组	17	30.00(22.50, 35.00)	55.00(50.00, 65.00)	27.06±6.14	-3.652	< 0.001
Z/t值		-1.750	-2.714	4.331
P值		0.080	0.007	< 0.001

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