改良强制性运动疗法对脑卒中患者踝关节运动控制障碍的影响

发布时间：2018-04-16 13:13

本文选题：脑卒中 + 改良强制性运动疗法　；参考：《上海体育学院》2014年硕士论文

【摘要】：研究目的本研究通过三维运动捕捉系统对脑卒中患者mCIMT干预前后生物力学治疗的测定来评估mCIMT对脑卒中患者踝关节运动控制障碍的影响。研究方法选取复旦大学附属华山医院门诊及其分中心符合纳入标准的22名脑卒中患者，随机分为mCIMT组和对照组。mCIMT组进行mCIMT干预，时间为每天2小时，每周5次，共四周。对照组进行常规性运动疗法每天进行45分钟常规性康复治疗，并予以康复治疗教育，剩余时间由家属辅助完成，，时间与mCIMT组相同。利用三维运动捕捉系统在受试者干预前后进行生物力学指标的采集并处理。研究结果 1.脑卒中患者进过mCIMT的干预后，患者步态的基本参数得到了提高。 2.脑卒中患者经过mCIMT干预后患侧踝关节跖屈角度在足尖离地时由24.14±6.32°降低至19.80±4.47°（P=0.043，P0.05），在足尖触地时由31.11±7.50°减小至24.69±6.04°（P=0.01，P0.05）且相对于对照组干预后的29.79±3.87°（P=0.29，P0.05）均出现统计学上显著性差异，促使患者完成足廓清和减小着地期，足掌与地面的冲击。 3.脑卒中患者经过mCIMT干预后患侧胫骨前肌在首次着地期的均方根占MIVCV百分比从28.61±15.60增大至46.61±10.49（P=0.014，P0.05），较于对照组的百分比35.04±11.11（P=0.021，P0.05）均出现显著性差异，在迈步前期患侧胫骨前肌均方根百分比从30.07±11.75到41.28±7.55（P=0.004，P0.01），较于对照组的27.90±9.77（P=0.002，P0.01），均出现统计学上非常显著性差异，提高了患者胫骨前肌和腓肠肌的活动水平。结论 mCIMT可以有效的改善脑卒中患者踝关节运动控制障碍
[Abstract]:research objective
The aim of this study is to evaluate the effect of mCIMT on ankle motion control disorder in stroke patients by three-dimensional motion capture system before and after mCIMT intervention.
research method
Select the outpatient department of Huashan Hospital Affiliated to Fudan University and center with 22 stroke patients included, were randomly divided into mCIMT group and control group.MCIMT group mCIMT intervention, the time is 2 hours a day, 5 times a week, for four weeks. The control group was given routine physical therapy every day for 45 minutes of routine rehabilitation, and rehabilitation treatment the remaining time is completed by family education, assistance, the same time as the mCIMT group. Using 3D motion capture system for biomechanical indexes before and after the intervention subjects collected and processed.
Research results
1. patients with stroke were treated with mCIMT, and the basic parameters of the patient's gait were improved.
2. stroke patients after mCIMT intervention after lateral ankle plantar flexion angle at toe off by 24.14 + 6.32 degrees down to 19.80 + 4.47 degrees (P=0.043, P0.05), in the toe when they hit the ground by 31.11 + 7.50 degrees reduced to 24.69 - 6.04 degrees (P=0.01, P0.05) and compared with the control group after the intervention of 29.79 plus or minus 3.87 degrees (P=0.29, P0.05) showed a statistically significant difference, to patients with foot clearance and reduce the period, foot and ground shock.
3. stroke patients after the intervention of mCIMT ipsilateral tibialis anterior muscle in the first period of the RMS percentage of MIVCV increased to 46.61 from 28.61 + 15.60 + 10.49 (P=0.014, P0.05) compared with the control group, the percentage of 35.04 + 11.11 (P=0.021, P0.05) there were significant differences in the previous step, to the ipsilateral tibia the RMS muscle percentage from 30.07 + 11.75 to 41.28 + 7.55 (P=0.004, P0.01), compared with the control group of 27.90 + 9.77 (P=0.002, P0.01), there were statistically very significant differences, improve patients with tibial anterior muscle and gastrocnemius muscle activity level.
conclusion
MCIMT can effectively improve the malleolus movement control disorder in stroke patients

【学位授予单位】：上海体育学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：G804.6;R743.3

【参考文献】