CAJ | 학술논문

目的探讨强制性运动疗法(CIMT)对脑卒中亚急性早期偏瘫患者上肢功能恢复的影响.方法采用随机数字表法将入选脑卒中偏瘫患者分为治疗组及对照组.治疗组患者给予2周CIMT治疗,每日连续治疗3h,每周治疗5d,共治疗2周;对照组则给予以神经发育疗法为主的传统康复治疗.于治疗前、疗程结束1d时及疗程结束6个月时分别采用Wolf运动功能试验(WMFT)、Fugl-Meyer运动功能量表(FMA)上肢部分评价偏瘫侧上肢运动功能情况,并采用运动活动记录表上肢使用数量(MAL-AU)和运动活动记录表上肢动作质量(MAL-HW)评定偏瘫侧上肢使用能力.结果疗程结束1d时治疗组FMA、WMFT、MAL-AU和MAL-HW评分分别为(53.81±2.59)分、(66.68土3.54)分、(1.89±0.88)和(3.26土0.65);对照组分别为(48.61±4.48)分、(62.10±7.97)分、(1.25±0.64)和(2.65±0.93).疗程结束6个月时治疗组FMA、WMFT、MAL-AU和MAL-HW评分分别为(57.53±2.01)分、(69.57±3.00)分、(3.00±0.82)和(3.84±0.69),对照组分别为(53.30±2.88)分、(66.20±3.59)分、(2.20±1.06)和(3.25±0.64).经统计学比较,发现上述时间点治疗组FMA、WMFT及MAL评分均较对照组明显提高,组间差异均具有统计学意义(P＜0.05).结论 CIMT治疗能进一步促进亚急性早期脑卒中患者上肢功能改善,且其疗效至少持续半年,该疗法值得临床推广、应用.
목적 탐토강제성운동요법(CIMT)대뇌졸중아급성조기편탄환자상지공능회복적영향.방법 채용수궤수자표법장입선뇌졸중편탄환자분위치료조급대조조.치료조환자급여2주CIMT치료,매일련속치료3h,매주치료5d,공치료2주;대조조칙급여이신경발육요법위주적전통강복치료.우치료전、료정결속1d시급료정결속6개월시분별채용Wolf운동공능시험(WMFT)、Fugl-Meyer운동공능량표(FMA)상지부분평개편탄측상지운동공능정황,병채용운동활동기록표상지사용수량(MAL-AU)화운동활동기록표상지동작질량(MAL-HW)평정편탄측상지사용능력.결과 료정결속1d시치료조FMA、WMFT、MAL-AU화MAL-HW평분분별위(53.81±2.59)분、(66.68토3.54)분、(1.89±0.88)화(3.26토0.65);대조조분별위(48.61±4.48)분、(62.10±7.97)분、(1.25±0.64)화(2.65±0.93).료정결속6개월시치료조FMA、WMFT、MAL-AU화MAL-HW평분분별위(57.53±2.01)분、(69.57±3.00)분、(3.00±0.82)화(3.84±0.69),대조조분별위(53.30±2.88)분、(66.20±3.59)분、(2.20±1.06)화(3.25±0.64).경통계학비교,발현상술시간점치료조FMA、WMFT급MAL평분균교대조조명현제고,조간차이균구유통계학의의(P＜0.05).결론 CIMT치료능진일보촉진아급성조기뇌졸중환자상지공능개선,차기료효지소지속반년,해요법치득림상추엄、응용.
Objective To investigate the effects of constraint-induced movement therapy (CIMT) on the function of hemiplegic upper extremity in the early subacute stroke patients.Methods A prospective,single-blinded,randomized controlled study was conducted.Forty-seven stroke patients with hemiplegic upper limb dysfunction were randomly divided into 2 groups:a CIMT group and a control group.The CIMT group received constraintinduced movement therapy and the control group was treated with conventional rehabilitation therapy.Both groups were treated 3 h daily,5 d a week for 2 weeks.The Wolf motor function test (WMFT) and Fugl-Meyer Assessment (FMA) were used to evaluate upper extremity motor function,and motor activity log (MAL) was used to assess upper extremity ability in activities.WMFT,FMA and MAL were measured before and after 1 day and 6 months of treatment.Results After 1 day of treatment,FMA,WMFT,MAL-AU and MAL-HW were 53.81 ± 2.59,66.68 ± 3.54,1.89 ± 0.88 and 3.26 ± 0.65,respectively,in the CIMT group,and 48.61 ± 4.48,62.10 ± 7.97,1.25 ± 0.64 and 2.65 ± 0.93,respectively,in the control group.After 6 months of treatment,FMA,WMFT,MAL-AU and MAL-HW were 57.53 ±2.01,69.57 ± 3.00,3.00 ±0.82 and 3.84 ±0.69,respectively,in the CIMT group,and 53.30 ± 2.88,66.20 ±3.59,2.20 ± 1.06 and 3.25 ±0.64,respectively,in the control group.The scores of FMA,WMFT,MAL in the CIMT group were all higher than those in the control group at 1 day and 6 months post-treatment,and the differences were statistically significant (P ＜ 0.05).Conclusion Constraint-induced movement therapy can significantly improve the patients' hand function in the early stage of subacute stroke,which maintain up to 6 months of follow-up.