双侧上肢训练对脑卒中病人上肢运动功能的影响

目的观察双侧上肢训练对脑卒中病人上肢运动功能的影响。方法选取56例脑卒中上肢运动功能障碍病人,采用随机、对照、单盲方法分为双侧训练组及对照组,各28例。双侧训练组给予患侧及健侧上肢同时间及同空间相同模式的重复训练并给予双侧上肢中医推拿手法;对照组接受常规以患侧上肢为主的重复训练及中医推拿手法,观察并比较两组治疗前后Fugl-Meyer评分上肢近端(FMA-PUE,包括肩、肘和前臂)及上肢远端(FMA-DUE,包括腕、手)变化。结果治疗后4周,两组上肢运动功能FMA-UE、FMA-PUE及FMA-DUE评分均较治疗前改善,且双侧训练组FMA-UE及FMA-PUE优于对照组(P<0.05)。运动模式方面,双侧训练组肘关节伸展较对照组改善明显(P<0.05)。结论脑卒中病人上肢运动功能障碍采用双侧上肢训练较常规训练可促进上肢运动功能的改善。

Effect of Bilateral Upper Limb Training on Upper Limb Motor Function in Stroke Patients

Objective To observe the effect of bilateral upper limb training on upper limb motor function in stroke patients.Methods Fifty-six stroke patients with upper limb motor dysfunction were randomly divided into bilateral training group and unilateral training group,with 28 cases in each group.The patients in bilateral training group were trained with bilateral upper limbs with the same time and space in the same pattern of repeated training and bilateral upper limbs with the introduction of traditional Chinese medicine massage.The patients in unilateral training group were trained with repetitive training and traditional Chinese massage on the impaired side.Fugl-Meyer assessment of the proximal upper extremity(FMA-PUE,including shoulder,elbow and forearm)and the distal upper extremity(FMA-DUE,including wrist and hand)were compared between two groups.Results After 4 weeks,scores of FMA-UE,FMA-PUE and FMA-DUE in both groups improved compared with those before treatment,and FMA-UE and FMA-PUE in the bilateral training group were better than those in the unilateral training group(P<0.05).Elbow extension in bilateral training group significantly improved compared with that in the unilateral training group.Conclusion The stroke patients with upper limb motor dysfunction who trained with bilateral upper limb training showed better improvement of movement function than patients with conventional training.