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镜像疗法联合任务导向性训练对脑卒中偏瘫患者肢体功能恢复的影响

Effects of Mirror Therapy Combined With Task-Oriented Training on Limb Function Recovery in Stroke Patients With Hemiplegia

  • 摘要:
      目的   探究镜像疗法联合任务导向性训练对脑卒中偏瘫患者肢体功能恢复的影响。
      方法   选取2020年3月–2022年3月南阳市第三人民医院接诊的304例老年脑卒中后偏瘫患者作为观察对象,按系统随机法分为干预组和对照组,每组各152例。其中对照组使用常规药物、任务导向性训练进行治疗,干预组在此基础上联合镜像疗法,两组均持续治疗3个月。比较两组患者治疗前、治疗3个月后神经功能 〔神经元特异性烯醇化酶(neuron-specific enolase, NSE)和中枢神经特异性蛋白(central nervous system specific protein, S100β)水平)〕、上肢和下肢运动功能〔Fugl-Meyer运动量表(Fugl-Meyer Assessment, FMA)评分〕、平衡能力 〔Berg平衡量表(Berg Balance Scale, BBS) 评分和股四头肌、腓肠肌、胫骨前肌的表面肌电值(integrated electromyography, iEMG)〕、三维步态时空与时相参数、生活质量〔美国研究院脑卒中量表 (National Institute of Stroke Scale, NIHSS)和脑卒中生活质量量表(Stroke-Specific Quality of Life Scale, SS-QOL)评分〕的变化。
      结果   治疗3个月后,干预组FMA评分、 BBS评分及三维步态时空与时相参数变化优于对照组,且差异有统计学意义(P均<0.05)。
      结论   镜像疗法联合任务导向性训练能促进老年脑卒中后偏瘫患者患肢功能的恢复,有效改善患者运动功能和生活质量,有利于患者预后。

     

    Abstract:
      Objective  To explore the effects of mirror therapy combined with task-oriented training on limb function recovery in stroke patients with hemiplegia.
      Methods  A total of 304 older patients with post-stroke hemiplegia who received treatment in Nanyang Third People's Hospital between March 2020 and March 2022 were enrolled as the subjects. They were assigned to the intervention group and the control group through a systematic randomization method, with 152 patients in each group. The control group was treated with conventional medication and task-oriented training, while the intervention group received a combined mirror therapy in addition to the treatment given to the control group. Both groups received continuous treatment for 3 months. The pre-treatment findings and those obtained after 3 month of treatment were compared between the two groups in the following areas, the neurological functions, including the levels of neuron-specific enolase (NSE) and S100β, a central nervous system specific protein, upper and lower limb motor function as reflected by Fugl-Meyer Assessment (FMA) score, balance ability as measured by Berg Balance Scale (BBS), and the integrated electromyography (iEMG) values of quadriceps femoris, gastrocnemius, and tibialis anterior muscles, three-dimensional gait spatiotemporal parameters, and quality of life as reflected by the assessment results for the National Institute of Stroke Scale (NIHSS) and Stroke-Specific Quality of Life Scale (SS-QOL). The findings were compared to identify changes.
      Results   After 3 months of treatment, the FMA and BBS scores and three-dimensional gait spatio-temporal parameters in the intervention group were significantly better than those in the control group (all P<0.05).
      Conclusion   Mirror therapy combined with task-oriented training promotes the function recovery of the affected limbs in older patients with post-stroke hemiplegia, effectively improves their motor function and quality of life, and helps improve patient prognosis.

     

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