CAJ | 학술논문

目的观察虚拟厨房上肢训练结合常规作业治疗对不同类型脑卒中(脑出血和脑梗死)恢复期患者偏瘫上肢功能康复的临床疗效.方法选取脑卒中恢复期偏瘫患者60例,按随机数字表法随机分为治疗组(30例)和对照组(30例).对照组接受常规作业治疗,治疗组在常规作业治疗基础上增加虚拟厨房上肢训练.2组患者均于治疗前和治疗3周后(治疗后)进行上肢运动功能评定(FMA-UE)及以改良巴氏指数(MBI)评定日常生活活动能力,同时记录患肘屈曲/伸展最大等长收缩(MIVC)时肱二、三头肌的表面肌电信号(sEMG),计算相应的协同收缩率(CR),并比较2组的疗效.结果治疗后,2组患者各项指标与组内治疗前比较,差异均有统计学意义(P＜0.05).治疗后,治疗组的FMA-UE和MBI评分分别为(45.97 ±6.30)分和(70.03±10.62)分,与对照组治疗后的(40.33±8.23)分和(61.87±10.85)分比较,差异均有统计学意义(P＜0.05);治疗后,2组患者患肘屈曲肱二头肌和患肘伸展肱三头肌CR组间比较,差异均无统计学意义(P＞0.05).2组按病变性质分型比较,治疗后,2组中脑出血和脑梗死患者的各项指标与组内同型治疗前比较,差异均有统计学意义(P＜0.05);治疗组脑卒中和脑梗死患者的FMA-UE和MBI评分与对照组同型治疗后比较,差异均有统计学意义(P＜0.05);但2组中脑出血和脑梗死患者的患肘屈曲肱二头肌和患肘伸展肱三头肌CR组间同型比较,差异均无统计学意义(P＞0.05).结论虚拟厨房上肢康复训练结合常规作业治疗可显著改善不同病变性质脑卒中(脑出血和脑梗死)患者偏瘫上肢的运动功能和日常生活活动能力.
목적 관찰허의주방상지훈련결합상규작업치료대불동류형뇌졸중(뇌출혈화뇌경사)회복기환자편탄상지공능강복적림상료효.방법 선취뇌졸중회복기편탄환자60례,안수궤수자표법수궤분위치료조(30례)화대조조(30례).대조조접수상규작업치료,치료조재상규작업치료기출상증가허의주방상지훈련.2조환자균우치료전화치료3주후(치료후)진행상지운동공능평정(FMA-UE)급이개량파씨지수(MBI)평정일상생활활동능력,동시기록환주굴곡/신전최대등장수축(MIVC)시굉이、삼두기적표면기전신호(sEMG),계산상응적협동수축솔(CR),병비교2조적료효.결과 치료후,2조환자각항지표여조내치료전비교,차이균유통계학의의(P＜0.05).치료후,치료조적FMA-UE화MBI평분분별위(45.97 ±6.30)분화(70.03±10.62)분,여대조조치료후적(40.33±8.23)분화(61.87±10.85)분비교,차이균유통계학의의(P＜0.05);치료후,2조환자환주굴곡굉이두기화환주신전굉삼두기CR조간비교,차이균무통계학의의(P＞0.05).2조안병변성질분형비교,치료후,2조중뇌출혈화뇌경사환자적각항지표여조내동형치료전비교,차이균유통계학의의(P＜0.05);치료조뇌졸중화뇌경사환자적FMA-UE화MBI평분여대조조동형치료후비교,차이균유통계학의의(P＜0.05);단2조중뇌출혈화뇌경사환자적환주굴곡굉이두기화환주신전굉삼두기CR조간동형비교,차이균무통계학의의(P＞0.05).결론 허의주방상지강복훈련결합상규작업치료가현저개선불동병변성질뇌졸중(뇌출혈화뇌경사)환자편탄상지적운동공능화일상생활활동능력.
Objective To observe the effect of upper extremity training in a virtual kitchen combined with conventional occupational therapy on the hemiplegic upper extremity function of patients with hemorrhagic and ischemic stroke in the convalescent phase.Methods Sixty convalescing stroke patients with hemiplegia were divided into a therapy group (n =30) and a control group (n =30) using a random number table.The control group accepted conventional occupational therapy.The therapy group accepted virtual kitchen training in addition.Before the experiment and after 3 weeks of therapy,surface electromyogram (sEMG) signals over the biceps and triceps brachii during maximum isometric voluntary contractions (MIVCs) flexing and extending the affected elbow were recorded.The Fugl-Meyer assessment for the upper extremities (FMA-UE),the modified Barthel index (MBI) and the relevant cocontraction ratio (CR) were used as outcome measures.Results Compared with pre-training,both groups showed significant improvements post-training on all of the measures.But the therapy group showed significantly greater improvement in terms of both average FMA-UE score and average MBI.Both hemorrhagic and ischemic stroke patients showed these significant improvements.Conclusion Conventional occupational therapy for retraining the upper limbs after stroke may be more effective when combined with training using a virtual kitchen.