改良强制性使用运动疗法对亚急性期脑卒中患者日常生活活动能力康复疗效的评价

doi:10.13481/j.1671-587x.20160626

吉林大学学报(医学版) ›› 2016, Vol. 42 ›› Issue (06): 1183-1188.doi: 10.13481/j.1671-587x.20160626

改良强制性使用运动疗法对亚急性期脑卒中患者日常生活活动能力康复疗效的评价

李贺¹, 柴文刚², 徐国兴¹, 李贞兰¹

1. 吉林大学第一医院康复科, 吉林长春 130021;
2. 吉林大学第一医院肝胆胰外科, 吉林长春 130021

收稿日期:2016-04-01 出版日期:2016-11-28 发布日期:2016-12-02
通讯作者: 李贞兰,副教授,硕士研究生导师(Tel:0431-88782932,E-mail:zhnelanli66@163.com) E-mail:zhnelanli66@163.com
作者简介:李贺(1985-),女,吉林省长春市人,医师,医学硕士,主要从事大脑神经可塑性方面的研究。
基金资助:
吉林省科技厅自然科学基金资助课题（201015135）

Evaluation on curative effect of modified constraint-induced movement therapy in rehabilitation of activity of daily living in patients with sub-acute stroke

LIHe¹, CHAI Wengang², XU Guoxing¹, LI Zhenlan¹

1. Department of Rehabilition, First Hospital, Jilin University, Changchun 130021, China;
2. Department of Hepatic and Biliary Pancreatic Surgery, Jilin University, Changchun 130021, China

Received:2016-04-01 Online:2016-11-28 Published:2016-12-02

摘要/Abstract

摘要：

目的：观察改良强制性使用运动疗法（CIMT）和任务-导向性作业疗法（OT）对亚急性期脑卒中患者上肢运动功能和日常生活活动能力（ADL）的康复疗效，探讨改良CIMT是否适用于亚急性期脑卒中患者ADL的康复。方法：将90例亚急性期脑卒中患者分为治疗组（48例）和对照组（42例），其中10例患者脱落，共收集治疗组42例和对照组38例患者的临床资料。治疗组患者采用CIMT，对照组患者采用任务-导向性为主的OT进行治疗。于治疗前、治疗21d后和治疗结束后30d随访评估2组患者的Wolf运动功能（WMFT）评分、Fugl-Meyer运动功能（FMA）评分及Barthel指数（BI）评分。结果：治疗21 d后组内比较，2组患者WMFT评分、FMA评分和BI评分均较治疗前明显升高（P<0.05）；治疗21 d后组间比较，治疗组患者WMFT评分、FMA评分和BI评分高于对照组（P<0.05）。治疗结束后30d，治疗组患者WMFT评分和BI评分较治疗21 d后升高（P<0.05），FMA评分无明显变化（P>0.05）；对照组患者各评分未见明显变化（P>0.05）。结论：改良CIMT对脑卒中患者ADL的康复疗效明显优于任务-导向性OT，适用于亚急性期脑卒中患者。

关键词: 改良强制性使用运动疗法, 脑卒中, 日常生活活动能力, 上肢运动功能, 康复

Abstract:

Objective: To observe the curative effects of modified constraint-induced movement therapy(CIMT) and task-oriented occupation therapy(OT) in the rehabilitation of activity of daily living (ADL) in the patients with sub-acute stroke,and to discuss whether the modified CIMT was suitable for the improvment of ADL.Methods: A total of 90 sub-acute stroke patients were divided into CIMT group(n=48) and control group(n=42),and there were 10 patients dripped out during the study,so there were 42 patients in CIMT group and 38 patients in control group at last.The patients in CIMT group were treated with CIMT,and the patients in control group were treated with task-oriented OT.The scores of Wolf Motor Function Test(WMFT),Fugl-Meyer assesment (FMA) and Barthel index(BI) of the patients in two groups were assessed before treatment and 21 d after treatment,and 30 d after the end of treatment.Results: Compared with before treatment,the WMFT,FMA, and BI scores of the patients in CIMT and control groups after treatment were improved significantly (P<0.05).Compared with control group,the WMFT, FMA,and BI scores of the patients 21 d after treatment in CIMT group were improved (P<0.05).Compared with 21 d after treatment,the WMFT and BI scores of the patients in CIMT group were increased 30 d after the end of treatment (P<0.05),but the FMA score had no change(P>0.05); there were no changes of WMFT,FMA,and BI scores of the patients in control group(P>0.05).Conclusion: The curative effect of modified CIMT in the rehabilitation of ADL in the patients with sub-acute-stroke is superior to task-oriented OT.CIMT could be applied in rehabilitation of the sub-acute stroke patients.

Key words: modified constraint-induced movement therapy, sub-acute stroke, activity of daily living, upper extremity motor function, rehabilitation

中图分类号:

R338.21

李贺, 柴文刚, 徐国兴, 李贞兰. 改良强制性使用运动疗法对亚急性期脑卒中患者日常生活活动能力康复疗效的评价[J]. 吉林大学学报(医学版), 2016, 42(06): 1183-1188.

LIHe, CHAI Wengang, XU Guoxing, LI Zhenlan. Evaluation on curative effect of modified constraint-induced movement therapy in rehabilitation of activity of daily living in patients with sub-acute stroke[J]. Journal of Jilin University Medicine Edition, 2016, 42(06): 1183-1188.

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改良强制性使用运动疗法对亚急性期脑卒中患者日常生活活动能力康复疗效的评价

Evaluation on curative effect of modified constraint-induced movement therapy in rehabilitation of activity of daily living in patients with sub-acute stroke

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