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中国临床研究英文版:2023,36(3):361-365,379
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动作观察疗法结合同步减重训练治疗对脑卒中患者步态和上肢功能恢复的影响
(首都医科大学附属北京康复医院康复诊疗中心,北京 100144)
Effect of action observation therapy combined with synchronized body weight support training on gait and upper limb function in stroke patients
(Rehabilitation Center, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing 100144, China)
摘要
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Received:June 23, 2022   Published Online:March 20, 2023
中文摘要: 目的 探讨在脑卒中后康复治疗中动作观察疗法结合同步减重训练对其步态、上肢功能恢复的影响。方法 2020年8月至2022年3月,选取110例于北京康复医院收治的脑卒中患者,随机分为观察组和对照组,每组55例。两组患者均给予常规康复训练,对照组在此基础上辅以同步减重训练,观察组在对照组基础上提供动作观察疗法,对比两组患者在治疗前后的认知功能[MoCA量表和简明精神状态量表(MMSE)]、运动功能[Berg平衡量表(BBS)和Fugl-Meyer运动功能评定量表(FMA)]、日常生活能力[Barthel指数量表(MBI)]、步态和视觉电生理[闪光-视觉诱发电位(F-VEP)]指标。结果 治疗后,两组患者的MoCA评分、MMSE评分、BBS评分、上肢及下肢的FMA评分、MBI评分较治疗前均升高明显(P<0.05),观察组的MoCA评分、MMSE评分、BBS评分、上肢及下肢的FMA评分、MBI评分较对照组均提高显著(P<0.05);治疗后,两组患者的步频、步长、步速均明显升高,步宽、双支撑相百分比均明显下降,且观察组的各项指标均优于对照组(P<0.05);治疗后,两组患者的F-VEP潜伏期缩短明显,波幅升高显著,观察组的F-VEP潜伏期及波幅水平均明显优于对照组(P<0.05)。结论 采用动作观察疗法结合同步减重训练能够有效提高脑卒中患者的认知与运动功能,提升日常生活能力,改善异常步态和视觉电生理。
Abstract:Objective To explore the curative effect of action observation therapy and synchronized body weight support training on gait and upper limb function in stroke patients. Methods A total of 110 stroke patients admitted to Beijing Rehabilitation Hospital from August 2020 to March 2022 were selected and randomly divided into observation group and control group (n=55, each). Based on the conventional rehabilitation training in two groups, synchronized body weight support training was given in control group, and action observation therapy was supplemented besides synchronized body weight support training in observation group. Before and after treatment, Montreal Cognitive Assessment (MoCA) Scale, Mini-Mental State Examination (MMSE), Berg Balance Scale (BBS) and Fugl-Meyer Assessment (FMA), modified Barthel index (MBI) and flash-visual evoked potential (F-VEP) were measured and compared between two groups. Results After treatment, MoCA score, MMSE score, BBS score, FMA score of upper-limb and lower-limb and MBI score were significantly increased compared with those before treatment in two groups (P<0.05), and they were significantly higher in observation group than those in control group (P<0.05). After treatment, the cadence, stride length and stride speed were significantly increased, and the stride width, percentage of double support phase were significantly decreased in two groups (P<0.05), and the above-mentioned indicators in observation group were superior to those in control group (P<0.05). After treatment, F-VEP latency was significantly shortened, and the amplitude was significantly increased in two groups, and the F-VEP latency and amplitude levels in observation group were significantly superior to those in control group (P<0.05). Conclusion Action observation therapy combined with synchronized body weight support training can effectively improve the cognitive and motor function, the ability of daily living and the abnormal gait and visual electrophysiology of stroke patients.
文章编号:     中图分类号:    文献标志码:A
基金项目:国家重点研发计划课题项目(2020YFC2004303)
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