康复机器手对脑卒中后手功能恢复疗效的研究

发布时间：2018-01-06 13:17

本文关键词：康复机器手对脑卒中后手功能恢复疗效的研究　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:评价智能康复机器手的临床康复疗效,形成基于脑卒中Brunnstrom分期特点的智能康复机器手临床康复方案,为脑卒中患者手部康复提供有针对性的、易于接受和掌握的训练内容和方法,为临床应用提供科学依据。方法:选取手功能处于软瘫期、痉挛期、恢复期的脑卒中患者,每期各选40例,每期患者随机分为对照组和实验组各20例,对照组采用常规上肢功能训练技术,每天上、下午各进行1次,45分/次,5天/周,其余时间由家属酌情按技术要求帮助患者训练。实验组上午进行1次常规作业治疗,下午进行1次智能康复机器手治疗,智能康复机器手治疗据患者病情选择针对性的3个游戏,每个游戏15分钟,共45min,5次/周,其中软瘫期和痉挛期采用机器手被动训练,恢复期采用机器手主动训练,两组患者均在治疗前,治疗2周、4周后,对布氏手分级、Fugl-Meyer上肢功能评分(Fugl-Meyer assessment,FMA)、改良巴氏指数(modified Barthel index,MBI)进行评定。结果:治疗前,每期患者的手布氏分级、FMA、MBI患者评分差异均无统计学意义(P0.05);经治疗2周、4周后的手布氏分级有效率、MBI及FMA评分随治疗时间延长呈上升趋势;在软瘫期和恢复期,两种治疗方法治疗患者2周、4周后手布氏分级有效率、MBI及FMA评分无显著差异性(P0.05),而痉挛期差异具有统计学意义(P0.05),实验组优于对照组。结论:康复机器手对提高软瘫期、痉挛期、恢复期脑卒中患者手功能恢复及日常生活活动能力均有效;对处于软瘫期和恢复期的脑卒中患者康复机器手治疗配合常规作业治疗与常规作业治疗相比疗效相当,而对处于痉挛期的脑卒中其疗效优于常规作业治疗。
[Abstract]:Objective: to evaluate the clinical rehabilitation effect of intelligent rehabilitation robot hand and to form a clinical rehabilitation scheme of intelligent rehabilitation machine hand based on the characteristics of Brunnstrom stages of stroke. For stroke patients hand rehabilitation to provide targeted, easy to accept and master the training content and methods for clinical application to provide scientific basis. Methods: select the hand function in the period of paralysis, spasmodic stage. 40 patients with cerebral apoplexy were randomly divided into control group (n = 20) and experimental group (n = 20). The control group (n = 20) received routine upper limb function training technique every day and one time in the afternoon. The rest of the time was trained by the family according to the technical requirements. The experimental group was treated with routine operation once in the morning and once in the afternoon with the intelligent rehabilitation robot hand therapy. Intelligent rehabilitation machine hand therapy according to the patient's condition of targeted three games, each game 15 minutes, a total of 45 minutes / week, in which paralysis and spasticity stage with the machine hand passive training. The patients in both groups were divided into two groups before and after 2 weeks and 4 weeks of treatment. Fugl-Meyer upper limb function score and Fugl-Meyer assessment. The modified Barthel index (MBI) was evaluated. Results: before treatment, the hand brucellide grade of each stage of the patients was evaluated. There was no significant difference in the scores of MBI patients (P 0.05). After 2 weeks and 4 weeks of treatment, the effective rate of hand bruclear grading and FMA scores showed an increasing trend with the prolongation of treatment time. In the period of palsy and convalescence, there was no significant difference in the effective rate of hand brucellitic grading and FMA scores between the two treatment methods (P 0.05) after 2 weeks and 4 weeks of treatment. The difference in spasticity stage was statistically significant (P 0.05), and the experimental group was superior to the control group. Conclusion: rehabilitation machine hands can improve the stage of palsy and spasm. The recovery of hand function and activity of daily living were effective in convalescent stroke patients. The curative effect of rehabilitation machine hand therapy combined with routine work therapy for stroke patients in the period of palsy and convalescence is similar to that of the routine operation treatment, but the curative effect for stroke in spasmodic stage is better than that in routine work therapy.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3;R496

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