强制性运动训练对脑卒中后单侧空间忽略患者运动功能恢复的研究

Therapy for Recovery of Motor Function in Patients with Unilateral Spatial Neglect after Stroke

摘要: 目的：探讨强制性运动训练疗法在脑卒中后单侧空间忽略患者运动功能恢复中的临床应用价值；方法：选取2007年4月至2012年4月间于我院诊治的脑卒中后单侧空间忽略患者42例，按其诊治顺序进行编号并随机分为对照组(21例)和观察组(21例)，对照组患者接受传统常规治疗，观察组患者在传统常规治疗基础上接受强制性运动疗法，观察两组患者各运动功能指标并行统计对比分析；结果：观察组患者MAS量表(仰卧–健侧卧、仰卧–坐床、坐位、坐位–站立、上肢功能、手部功能、手精细功能、步行)评分均明显高于对照组患者，组间差异在统计学上均有意义(P < 0.05)；观察组患者Fugl-Meyer评分、ADL评分均明显高于对照组患者相应指标，组间差异在统计学上均有意义(P < 0.05)；结论：在脑卒中后单侧空间忽略患者运动功能恢复治疗中，强制性运动训练疗法疗效确认安全有效，有利于改善患者肢体运动功能，改善预后及转归，利于提高患者生活能力及质量，值得推广。

Abstract: Objective: To investigate the clinical application value of constraint-induced movement therapy for recovery of motor function in patients with unilateral spatial neglect after stroke. Methods: 42 cases of patients with unilateral spatial neglect after stroke were selected from April 2007 to April 2012 in our hospital, which were numbered according to the treatment sequence and randomly divided into two groups: control group (21 cases) which received conventional treatment and observation group (21 cases) which received constraint-induced movement therapy based on conventional treatment. The movement function parameters of two groups were statistically analyzed and compared. Results: 1) MAS scores (supine, supine healthy side-sitting bed, sitting, standing, sitting upper limb function, hand function, fine hand function, walking) in observation group were significantly higher than those in the control group, and the differences between groups were sta-tistically significant (P < 0.05); 2) Corresponding parameters of Fugl-Meyer score and ADL score in observation group were significantly higher than those in control group, and differences between groups were statistically significant (P < 0.05). Conclusion: In the treatment for patients with un-ilateral spatial neglect after stroke, constraint-induced movement therapy is safe, effective, and beneficial to improve motor function in patients, promote the prognosis and outcome, and enhance the patients’ life quality. It is worthy of promotion.