CAJ | 학술논문

目的：探讨太极拳“云手”运动想象疗法对脑卒中偏瘫患者手功能恢复的影响。方法选择2012年10月-2013年3月在上海市某三甲医院康复科住院的符合入选标准的32例脑卒中偏瘫患者，运用交叉对照设计方法随机分为A组（16例）和B组（16例）。第1～3周A组进行常规康复训练和太极拳“云手”运动想象疗法相结合的训练、B组仅进行常规康复训练。第4～5周A、B两组均不进行正规的运动想象疗法及常规康复训练，称为洗脱期。第6～8周A组仅进行常规康复训练、B组进行常规康复训练结合太极拳“云手”运动想象疗法的训练。实验前和实验后第3，5，8周时均用Fugl-Meyer运动功能量表（FMA）、改良的Barthel指数（MBI）和偏瘫上肢功能测试（香港版）（FTHUE-HK）对两组患者上肢以及手的精细功能进行评定。结果 A、B两组患者治疗前FMA、MBI和FTHUE-HK评分差异无统计学意义（P＞0．05）。每阶段结束后A、B两组的以上各项评分较实验前均有改善（P＜0．01）；B组FMA评分在8周末时为（50．31±7．69）分，明显高于A组（42．50±10．09）分，差异有统计学意义（t＝-2．46， P＜0．05）；A组MBI评分在3周末为（24．69±2．87）分，明显高于B组（20．63±3．10）分，差异有统计学意义（t＝3．85，P＜0．01）；B组FTHUE-HK评分在5周末和8周末时均高于A组，差异有统计学意义（t分别为-2．14，-4．40；P＜0．05）。结论在常规训练的基础上，随干预时间的延长，太极拳“云手”运动想象疗法有助于脑卒中偏瘫患者手功能的恢复，提高康复训练的效果。
목적：탐토태겁권“운수”운동상상요법대뇌졸중편탄환자수공능회복적영향。방법선택2012년10월-2013년3월재상해시모삼갑의원강복과주원적부합입선표준적32례뇌졸중편탄환자，운용교차대조설계방법수궤분위A조（16례）화B조（16례）。제1～3주A조진행상규강복훈련화태겁권“운수”운동상상요법상결합적훈련、B조부진행상규강복훈련。제4～5주A、B량조균불진행정규적운동상상요법급상규강복훈련，칭위세탈기。제6～8주A조부진행상규강복훈련、B조진행상규강복훈련결합태겁권“운수”운동상상요법적훈련。실험전화실험후제3，5，8주시균용Fugl-Meyer운동공능량표（FMA）、개량적Barthel지수（MBI）화편탄상지공능측시（향항판）（FTHUE-HK）대량조환자상지이급수적정세공능진행평정。결과 A、B량조환자치료전FMA、MBI화FTHUE-HK평분차이무통계학의의（P＞0．05）。매계단결속후A、B량조적이상각항평분교실험전균유개선（P＜0．01）；B조FMA평분재8주말시위（50．31±7．69）분，명현고우A조（42．50±10．09）분，차이유통계학의의（t＝-2．46， P＜0．05）；A조MBI평분재3주말위（24．69±2．87）분，명현고우B조（20．63±3．10）분，차이유통계학의의（t＝3．85，P＜0．01）；B조FTHUE-HK평분재5주말화8주말시균고우A조，차이유통계학의의（t분별위-2．14，-4．40；P＜0．05）。결론재상규훈련적기출상，수간예시간적연장，태겁권“운수”운동상상요법유조우뇌졸중편탄환자수공능적회복，제고강복훈련적효과。
Objective To study the effect of Taijiquan “yunshou” action motor imagery on hand motor function in hemiplegic patients after stroke .Methods From October 2012 to March 2013, 32 hospitalized hemiplegic stroke patients met the inclusion criteria in rehabilitation ward of a hospital in Shanghai were randomly divided into group A and group B .At the first of 1 -3 weeks, group A were treated routine rehabilitation training and Taijiquan “yunshou” action motor imagery therapy , group B were treated only routine rehabilitation training .At the 4-5 weeks , both of the groups haven't got the regular motor imagery therapy and routine rehabilitation training , known as the washout period .At the last of 6-8 weeks, group A were treated only routine rehabilitation training , group B were treated routine rehabilitation training and Taijiquan “yunshou”action motor imagery therapy .Patients were assessed with Fugl-Meyer Motor Assessment ( FMA) , Modified Barthel Index(MBI) and Hong Kong Edition of Functional Test for the Hemiplegic Upper Extremity Scale (FTHUE-HK) before the experiment, 3 weeks, 5 weeks and 8 weeks after rehabilitation therapy.Results Before the experiment , the differences between the A , B groups from scores of the FMA , MBI and FTHUE-HK were not statistically significant (P>0.05), while both of the groups had a significant improvement after the end of each stage than before the experiment (P<0.01).FMA score of group B at the 8 weeks was significantly higher than that of group A[(50.31 ±7.69) vs (42.50 ±10.09);t=-2.46,P<0.05].The MBI score was significantly higher in group A than B at the 3 weeks [(24.69 ±2.87)vs(20.63 ±3.10),t=3.85,P<0.01].The score of FTHUE-HK of group B was significantly higher than that of group A at the 3,8 weeks (t=-2.14,-4.40,respectively;P <0.05).Conclusions With the time extend, the outcomes suggested that on the basic of routine rehabilitation training , Taijiquan “yunshou” action motor imagery therapy is very helpful to the recovery of hand function of stroke patients with hemiplegia .