神经康复机器手对慢性期卒中偏瘫患者上肢功能康复的疗效分析

发布时间：2018-05-05 20:42

本文选题：卒中 + 偏瘫　；参考：《中国脑血管病杂志》2016年11期

【摘要】：目的探讨神经康复机器手对慢性期卒中偏瘫患者上肢功能的疗效。方法回顾性连续纳入2012年3月至2015年3月首都医科大学宣武医院康复门诊卒中偏瘫患者31例,根据采用康复治疗的方式,将患者分为机器手康复组(16例)和一般康复组(15例)。一般康复组接受一般性康复训练,3次/周,30 min/次,同时进行家庭康复训练,5次/周,1 h/次;机器手康复组接受一般性康复训练,3次/周,30 min/次,同时进行机器手辅助训练,5次/周,1 h/次。两组训练周期均为4周。分别于康复治疗前及治疗后4周,对两组患者上肢运动功能进行Wolf运动功能评价(WMFT)和Fugl-Meyer上肢运动功能评价(FMA-UE),对上肢肌张力评价采用改良Ashworth评分(MAS)。结果经过4周的治疗后,与同组治疗前相比,机器手康复组中位数时间明显缩短[7.1(2.4,93.8)s比13.1(3.7,99.5)s],功能评分明显提升[(45±13)分比(38±11)分],上肢功能评分明显提高[(28±7)分比(25±7)分],腕手部中位数评分明显提高[15(10,19)分比9(5,14)分],FMA-UE总分明显提高[(46±12)分比(38±12)分],MAS评分明显降低[3(2,5)分比5(4,8)分],治疗前后差异均有统计学意义(均P0.05);一般康复组各项指标治疗前后差异均无统计学意义(均P0.05)。4周康复训练后,机器手康复组比一般康复组腕手部中位数评分[15(10,19)分比6(5,12)分]、治疗效应[-5.5(-10.8,-3.2)比0.0(-1.0,3.0)]、MAS[3(2,5)分比5(4,6)分]均有改善,组间差异均有统计学意义(均P0.05)。结论神经康复机器手可有效提高卒中后慢性期偏瘫患者上肢运动功能,对腕手部运动功能提升有明显效果,并可控制上肢肌张力的增高。
[Abstract]:Objective to investigate the effect of neurorehabilitation machine hand on upper limb function of chronic stroke patients with hemiplegia. Methods from March 2012 to March 2015, 31 patients with hemiplegia were enrolled in the rehabilitation clinic of Xuanwu Hospital of Capital Medical University. According to the rehabilitation treatment, the patients were divided into two groups: the robotic hand rehabilitation group (n = 16) and the general rehabilitation group (n = 15). The general rehabilitation group received general rehabilitation training 3 times a week for 30 min/ and family rehabilitation training for 5 times a week for 1 hour per week, while the robotic hand rehabilitation group received general rehabilitation training 3 times a week for 30 min/. At the same time, the robot hand training was carried out 5 times a week for 1 hour. The training period of both groups was 4 weeks. Before and 4 weeks after rehabilitation treatment, Wolf motor function evaluation and Fugl-Meyer upper limb motor function evaluation were performed in the two groups. The upper limb muscle tension was evaluated with modified Ashworth score. Results after 4 weeks of treatment, compared with the same group before treatment, The median time of the rehabilitation group was significantly shortened [7.1 卤2.4 卤93.8s vs 13.1 卤3.799. 5s], the functional score was significantly improved [45 卤13 vs 38 卤11], the score of upper limb function was significantly increased [28 卤7 vs 25 卤7], the median score of wrist and hand was significantly increased [151019 vs 9: 514] FMA-UE total score was significantly increased. The increase of [46 卤12] scores compared with 38 卤12 scores was significantly lower than that of 38 卤12 scores (P < 0.05). The scores of MAS were significantly lower than those of control group (P < 0.05), and the differences before and after treatment were statistically significant (P < 0.05), but there was no significant difference between the two groups before and after treatment (all P0.05.4 weeks after rehabilitation training, all P 0.05.4 weeks after rehabilitation training), there was no significant difference between the two groups before and after treatment (all P0.05.4 weeks after rehabilitation training). The median score of wrist and hand in the robotic hand rehabilitation group was better than that in the general rehabilitation group [15: 10: 19 vs 6: 512], the therapeutic effect was (-5.5) -10.8 ~ (-3.2) vs 0.0-1.0 ~ 3.0)] Mas [3 ~ 2 ~ 2 ~ 5 vs 5 ~ 4 ~ 6], and the difference between the two groups was statistically significant (P < 0.05). Conclusion the neural rehabilitation robot hand can effectively improve the motor function of upper extremity in patients with chronic hemiplegia after stroke, has obvious effect on the motor function of wrist and hand, and can control the increase of muscle tension of upper limb.
【作者单位】：首都医科大学宣武医院康复医学科;中国康复研究中心北京博爱医院;
【分类号】：R743.3;R49

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