上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

运动想象疗法对脑卒中偏瘫患者步行功能的影响

章惠英1，帕孜力亚1，章雅青1，查丽偲2，徐 云1，袁晓玲1，金 娜1，王 燕1   

  1. 上海交通大学 1.护理学院， 2.医学院附属瑞金医院卢湾分院康复科病房， 上海 200025
  • 出版日期:2013-09-28 发布日期:2013-09-29
  • 通讯作者: 章雅青, 电子信箱: zhangyqf@yahoo.com.cn。
  • 作者简介:章惠英（1961—），女，副教授，硕士; 电子信箱: zhwwhy@126.com。
  • 基金资助:

    2012年度上海交通大学医学院护理学科重点项目（JYHZ1201）

Effect of motor imagery therapy on walking ability in patients with stoke and hemiplegia

ZHANG Hui-ying1, PAZI Li-ya1, ZHANG Ya-qing1, ZHA Li-si2, XU Yun1, YUAN Xiao-ling1, JIN Na1, WANG Yan1   

  1. 1.School of Nursing, Shanghai Jiaotong University, Shanghai200025, China; 2.Department of Rehabilitation, Ruijin Hospital Luwan Branch, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2013-09-28 Published:2013-09-29
  • Supported by:

    Foundation of Shanghai Jiaotong University School of Medicine, JYHZ1201

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摘要：

目的 观察运动想象疗法对脑卒中偏瘫患者步行功能的影响。方法 36例脑卒中偏瘫患者按入院顺序编号的奇、偶数分为A、B两组，每组18例。第1～3周A组在常规康复训练的基础上辅以运动想象疗法，B组仅给予常规康复训练；第4～5周两组均不进行正规的康复训练及运动想象疗法（洗脱期）；第6～8周B组在常规康复训练的基础上辅以运动想象疗法，A组仅给予常规康复训练。治疗前、治疗3周、5周和8周末分别运用Fugl-Meyer运动功能量表（FMA）、功能性步行分级（FAC）和Tinetti步态评估量表（TGA）对患者步行功能进行评定。结果 治疗前，两组FMA、FAC和TGA评分差异均无统计学意义（P>0.05）；治疗3周、5周和8周末，两组各量表评分均显著高于治疗前（P<0.01）；治疗3周末，A组各量表评分均显著高于B组（P<0.01）；治疗8周末，B组各量表评分均显著高于A组（P<0.01）。结论 在常规康复训练基础上辅以运动想象疗法，可进一步改善脑卒中偏瘫患者的步行功能，提高康复训练的疗效。

关键词: 运动想象疗法, 脑卒中, 偏瘫, 步行障碍, 康复训练

Abstract:

Objective To investigate the effect of motor imagery therapy on walking ability in patients with stroke and hemiplegia. Methods Thirty-six patients with stroke and hemiplegia were divided into group A and group B based on the odd or even admission number, with 19 patients in each group. From the first to the third week, patients in group A were treated with conventional rehabilitation therapy combined with motor imaginary therapy, and those in group B only received conventional rehabilitation therapy. During the fourth and fifth week (washout period), both patients in group A and group B did not receive formal conventional rehabilitation therapy and motor imaginary therapy. In the sixth to eighth week, patients in group B received conventional rehabilitation therapy combined with motor imaginary therapy, and those in group A only received conventional rehabilitation therapy. The walking ability of patients in two groups was assessed with lower extremity Fugl-Meyer motor assessment(FMA), functional ambulation category (FAC) and Tinetti gait assessment (TGA) scales before treatment, and at the end of the third week, fifth week and eighth week. Results There was no significant difference in FMA, FAC and TGA scores between two groups before treatment (P>0.05). The scores of each scale at the end of the third week, fifth week and eighth week were significantly higher than those before treatment in two groups (P<0.01). At the end of the third week, the score of each scale in group A was significantly higher than that in group B (P<0.01). At the end of the eighth week, the score of each scale in group B was significantly higher than that in group A (P<0.01). Conclusion On the basis of conventional rehabilitation therapy, motor imagery therapy can further improve the walking ability in patients with stroke and hemiplegia and enhance the efficacy of rehabilitation training.

Key words: motor imaginary therapy, stroke, hemiplegia, dysbasia, rehabilitation training