上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 专题报道（护理实践与管理） • 上一篇    下一篇

太极拳步法运动想象对脑卒中偏瘫患者步行能力的影响

章惠英1，卿阳洋1，章雅青1，王 凯2，何 雯2，袁晓玲1，陈 蓄1   

  1. 1.上海交通大学 护理学院, 上海 200025; 2.上海静安区老年医院康复科, 上海 200040
  • 出版日期:2014-09-28 发布日期:2014-09-26
  • 通讯作者: 章雅青, 电子信箱: zhangyqf@163.com。
  • 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:

    上海交通大学医学院护理学科重点项目（JYHZ1201）

Effects of Tai-ji exercise motor imagery on walk function of patients with hemiplegia after stroke

ZHANG Hui-ying1, QING Yang-yang1, ZHANG Ya-qing1, WANG Kai2, HE Wen2, YUAN Xiao-ling1, CHEN Xu1   

  1. 1.School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China; 2.Department of Rehabilitation, Shanghai Jing-an Geriatric Hospital, Shanghai 200040, China
  • Online:2014-09-28 Published:2014-09-26
  • Supported by:

    Key Project of Nursing Discipline of Shanghai Jiao Tong University School of Medicine, JYHZ1201

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摘要：

目的 观察太极拳步法运动想象对脑卒中偏瘫患者步行能力的影响。方法 运用交叉对照设计方法将符合入选标准的脑卒中偏瘫住院患者40例分为A组（20例）和B组（20例）。实验分为Ⅰ、Ⅱ、Ⅲ 3个阶段，时间分别为1～3周、4～5周、6～8周。A组第Ⅰ阶段在常规康复训练基础上进行太极拳步法运动想象疗法，第Ⅲ阶段仅进行常规训练；B组在第I阶段仅进行常规康复训练，第Ⅲ阶段进行常规训练结合太极拳步法运动想象疗法；第Ⅱ阶段为洗脱期,两组患者均不进行系统正规的康复训练及运动想象疗法。干预前及干预后3、5、8周，用Fugl-Meyer运动功能量表（FMA）下肢部分、功能性步行分级量表（FAC）和Tinetti步态评估量表（TGA）分别对患者的步行能力进行评估。结果 A、B两组3项评分在干预后比干预前均明显提高，干预后3、5及8周之间两两比较，差异有统计学意义（P<0.05）。干预前A、B两组间3项评分的差异无统计学意义（P>0.05）；干预3周后A组3项评分均高于B组，差异有统计学意义（P<0.05或P<0.01）；干预5周后两组评分比较，差异无统计学意义（P>0.05）；干预8周后B组3项评分均高于A组，差异具有统计学意义（P<0.05或P<0.01）。结论 在常规训练的基础上，随干预时间的延长，太极拳步法运动想象疗法有助于脑卒中偏瘫患者步行功能的恢复，提高康复训练的效果。

关键词: 脑卒中, 偏瘫, 太极拳步法, 运动想象, 步行能力, 康复训练

Abstract:

Objective To observe the effects of Tai-ji exercise motor imagery on the walk function of patients with hemiplegia after stroke. Methods A total of 40 hospitalized patients with hemiplegia after stroke who met the inclusion criteria were selected and divided into the group A (n=20) and group B (n=20) by the cross control design method. The experiment was divided into phaseⅠ (week 1 to 3), phaseⅡ (week 4 to 5), and phase Ⅲ (week 6 to 8). For group A, patients were treated with routine rehabilitation training combined with Tai-Ji exercise motor imagery therapy at the phase Ⅰ and routine training at the phase Ⅲ. For group B, patients were treated with routine rehabilitation training at the phase Ⅰ and routine training combined with Tai-Ji exercise motor imagery therapy at the phase Ⅲ. Phase Ⅱ was the washout period and patients of two groups were not treated with routine rehabilitation training or motor imagery therapy during phase Ⅱ. The walk function of patients was evaluated by the lower extremity part of Fugl-Meyer motor assessment (FMA), functional ambulation category (FAC), and Tinetti Gait Assessment (TGA) before the experiment and 3, 5, and 8 weeks after the intervention. Results Scores of three items of the group A and B increased significantly after the intervention. The differences of scores of 3, 5, and 8 weeks after the intervention were statistically significant (P<0.05). The differences of scores of three items of the group A and B before the intervention were not statistically significant (P>0.05). Scores of three items of the group A 3 weeks after the intervention were higher than those of the group B and the differences were statistically significant (P<0.05 or P<0.01). The differences of scores 5 weeks between the two groups after the intervention were not statistically significant (P>0.05). Scores of three items of the group B 8 weeks after the intervention were higher than those of the group A and the differences were statistically significant (P<0.05 or P<0.01). Conclusion With the increase of intervention time, Tai-ji exercise motor imagery therapy is more helpful for the recovery of walk function of patients with hemiplegia after stroke on the basis of routine rehabilitation training and improves the effect of rehabilitation training.

Key words: stroke, hemiplegia, footwork of Taijiquan, motor imagery, walk function, rehabilitation training