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任务导向性训练联合经颅直流电刺激在恢复期卒中 患者手足运动功能恢复中的应用
李扬孙增鑫
0
()
摘要:
目的 探究任务导向性训练联合经颅直流电刺激在恢复期卒中患者手足运动功能恢复中 的应用。方法 采取便利抽样法,前瞻性连续纳入2016 年7 月至2018 年12 月衡水市人民医院神经内 科收治的恢复期卒中患者100 例为研究对象,按随机数字表法分为对照组和联合组,每组50 例。对照 组患者采用经颅直流电刺激,联合组患者采用任务导向性训练联合经颅直流电刺激。采用Brunnstrom 手分级、Fugl-Meyer 评定(FMA)中的上肢功能评定和手臂动作调查测试表(ARAT)对患者治疗前后的手 运动功能恢复状况进行评价;采用Berg 平衡量表(BBS)评价患者治疗前后的平衡功能,观察治疗前后的 步速和步长,采用Holden 步行功能分级(HWG)评价患者治疗前后的步行能力;采用卒中患者运动功能 评估量表(MAS)评估患者治疗前后的功能活动能力以及改良Barthel 指数(MBI)评价患者治疗前后的日 常生活能力,并记录不良反应。结果 治疗后,联合组患者的Brunnstrom手分级优于对照组(Z=-0.312, P=0.016),FMA 评分[(31.45±9.79)分]、ARAT评分[(35.67±8.71)分]、 BBS 评分[(42.57±9.47)分]、步 速[(44.67±6.89)m/min]、步长[(57.35±13.31)cm]、HWG分级(4.73±0.91)、MAS评分[(27.47±8.93)分]、 MB[I(65.37±19.82)分]均高于对照组[ 分别为(23.83±7.23)分、(20.46±4.67)分、(33.42±7.78)分、 (32.21±6.47)m/min、(46.65±13.34)cm、(3.75±0.88)、(20.52±8.94)分、(54.35±20.51)]分,差异均有统计 学意义(P< 0.01);两组不良反应发生率差异均无统计学意义(均P > 0.05)。结论 任务导向性训练联 合经颅直流电刺激可以有效改善恢复期卒中患者的手足功能,改善日常生活能力。
关键词:  卒中  任务导向性训练  经颅直流电刺激  手足运动功能
DOI:10.3969/j.issn.1009-6574.2020.05.009
基金项目:河北省医学科学研究课题计划(20190367)
Application analysis of task-oriented training combined with transcranial direct current stimulation inthe recovery of hand and foot motor function of stroke patients
Li Yang, Sun Zengxin
()
Abstract:
Objective To explore the application of task-oriented training combined with transcranial direct current stimulation in the recovery of hand and foot motor function of stroke patients. Methods By convenience sampling, 100 patients with stroke in convalescent period admitted to the Department of Neurology of Hengshui People's Hospital from July 2016 to December 2018 were selected as the research objects. They were randomly divided into control group and combined group, with 50 patients in each group. Patients in the control group received transcranial direct current stimulation, while patients in the combined group were given task-oriented training combined with transcranial direct current stimulation. Brunnstrom hand grading and upper limb function evaluation and arm movement survey test form( ARAT) in Fugl-Meyer evaluation( FMA) were used to evaluate the recovery of hand motor function before and after treatment; Berg Balance Scale( BBS) was used to evaluate the balance function, and the pace and length of patients before and after treatment; Holden's Walking Function Classification( HWG) was used to evaluate the walking ability of patients before and after treatment; The Motor Function Evaluation Scale of Stroke Patients( MAS) was used to evaluate the functional activities of patients before and after treatment, and the modified Barthel index( MBI) was used to evaluate patients' daily life ability before and after treatment, and the adverse reactions were recorded. Results After treatment, the Brunnstrom hand grading of the combined group was better than that of the control group( Z=-0.312, P=0.016). FMA score[ (31.45±9.79) points], ARAT score[ (35.67±8.71) points], BBS score[ (42.57±9.47) points], walking speed[ (44.67±6.89) m/min], step length[ (57.35±13.31) cm], HWG grade( 4.73±0.91), MAS score[ (27.47±8.93) points], MBI( 65.37±19.82) in the control group were all better than those in the control group[ (23.83±7.23),( 20.46±4.67),( 33.42±7.78),( 32.21±6.47) m/min,( 46.65±13.34) cm, (3.75±0.88),( 20.52±8.94) points,( 54.35±20.51)], and the difference was statistically significant( P<0.01); There was no significant difference in the incidence of adverse reactions between the two groups( P > 0.05). Conclusions Task-oriented training combined with transcranial direct current stimulation can effectively improve the hand and foot function and the ability of daily life of patients with stroke in recovery period.
Key words:  Stroke  Task-oriented training  Transcranial direct current stimulation  Hand and

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