本文選題：卒中 + 偏癱　； 參考：《中國(guó)腦血管病雜志》2016年11期

【摘要】：目的探討神經(jīng)康復(fù)機(jī)器手對(duì)慢性期卒中偏癱患者上肢功能的療效。方法回顧性連續(xù)納入2012年3月至2015年3月首都醫(yī)科大學(xué)宣武醫(yī)院康復(fù)門診卒中偏癱患者31例,根據(jù)采用康復(fù)治療的方式,將患者分為機(jī)器手康復(fù)組(16例)和一般康復(fù)組(15例)。一般康復(fù)組接受一般性康復(fù)訓(xùn)練,3次/周,30 min/次,同時(shí)進(jìn)行家庭康復(fù)訓(xùn)練,5次/周,1 h/次;機(jī)器手康復(fù)組接受一般性康復(fù)訓(xùn)練,3次/周,30 min/次,同時(shí)進(jìn)行機(jī)器手輔助訓(xùn)練,5次/周,1 h/次。兩組訓(xùn)練周期均為4周。分別于康復(fù)治療前及治療后4周,對(duì)兩組患者上肢運(yùn)動(dòng)功能進(jìn)行Wolf運(yùn)動(dòng)功能評(píng)價(jià)(WMFT)和Fugl-Meyer上肢運(yùn)動(dòng)功能評(píng)價(jià)(FMA-UE),對(duì)上肢肌張力評(píng)價(jià)采用改良Ashworth評(píng)分(MAS)。結(jié)果經(jīng)過4周的治療后,與同組治療前相比,機(jī)器手康復(fù)組中位數(shù)時(shí)間明顯縮短[7.1(2.4,93.8)s比13.1(3.7,99.5)s],功能評(píng)分明顯提升[(45±13)分比(38±11)分],上肢功能評(píng)分明顯提高[(28±7)分比(25±7)分],腕手部中位數(shù)評(píng)分明顯提高[15(10,19)分比9(5,14)分],FMA-UE總分明顯提高[(46±12)分比(38±12)分],MAS評(píng)分明顯降低[3(2,5)分比5(4,8)分],治療前后差異均有統(tǒng)計(jì)學(xué)意義(均P0.05);一般康復(fù)組各項(xiàng)指標(biāo)治療前后差異均無統(tǒng)計(jì)學(xué)意義(均P0.05)。4周康復(fù)訓(xùn)練后,機(jī)器手康復(fù)組比一般康復(fù)組腕手部中位數(shù)評(píng)分[15(10,19)分比6(5,12)分]、治療效應(yīng)[-5.5(-10.8,-3.2)比0.0(-1.0,3.0)]、MAS[3(2,5)分比5(4,6)分]均有改善,組間差異均有統(tǒng)計(jì)學(xué)意義(均P0.05)。結(jié)論神經(jīng)康復(fù)機(jī)器手可有效提高卒中后慢性期偏癱患者上肢運(yùn)動(dòng)功能,對(duì)腕手部運(yùn)動(dòng)功能提升有明顯效果,并可控制上肢肌張力的增高。
[Abstract]:Objective to investigate the effect of neurorehabilitation machine hand on upper limb function of chronic stroke patients with hemiplegia. Methods from March 2012 to March 2015, 31 patients with hemiplegia were enrolled in the rehabilitation clinic of Xuanwu Hospital of Capital Medical University. According to the rehabilitation treatment, the patients were divided into two groups: the robotic hand rehabilitation group (n = 16) and the general rehabilitation group (n = 15). The general rehabilitation group received general rehabilitation training 3 times a week for 30 min/ and family rehabilitation training for 5 times a week for 1 hour per week, while the robotic hand rehabilitation group received general rehabilitation training 3 times a week for 30 min/. At the same time, the robot hand training was carried out 5 times a week for 1 hour. The training period of both groups was 4 weeks. Before and 4 weeks after rehabilitation treatment, Wolf motor function evaluation and Fugl-Meyer upper limb motor function evaluation were performed in the two groups. The upper limb muscle tension was evaluated with modified Ashworth score. Results after 4 weeks of treatment, compared with the same group before treatment, The median time of the rehabilitation group was significantly shortened [7.1 鹵2.4 鹵93.8s vs 13.1 鹵3.799. 5s], the functional score was significantly improved [45 鹵13 vs 38 鹵11], the score of upper limb function was significantly increased [28 鹵7 vs 25 鹵7], the median score of wrist and hand was significantly increased [151019 vs 9: 514] FMA-UE total score was significantly increased. The increase of [46 鹵12] scores compared with 38 鹵12 scores was significantly lower than that of 38 鹵12 scores (P < 0.05). The scores of MAS were significantly lower than those of control group (P < 0.05), and the differences before and after treatment were statistically significant (P < 0.05), but there was no significant difference between the two groups before and after treatment (all P0.05.4 weeks after rehabilitation training, all P 0.05.4 weeks after rehabilitation training), there was no significant difference between the two groups before and after treatment (all P0.05.4 weeks after rehabilitation training). The median score of wrist and hand in the robotic hand rehabilitation group was better than that in the general rehabilitation group [15: 10: 19 vs 6: 512], the therapeutic effect was (-5.5) -10.8 ~ (-3.2) vs 0.0-1.0 ~ 3.0)] Mas [3 ~ 2 ~ 2 ~ 5 vs 5 ~ 4 ~ 6], and the difference between the two groups was statistically significant (P < 0.05). Conclusion the neural rehabilitation robot hand can effectively improve the motor function of upper extremity in patients with chronic hemiplegia after stroke, has obvious effect on the motor function of wrist and hand, and can control the increase of muscle tension of upper limb.
【作者單位】： 首都醫(yī)科大學(xué)宣武醫(yī)院康復(fù)醫(yī)學(xué)科;中國(guó)康復(fù)研究中心北京博愛醫(yī)院;
【分類號(hào)】：R743.3;R49

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