PNF拉伸训练联合Bobath握手训练对脑卒中偏瘫患者神经功能及上肢运动功能的影响

目的:探讨本体感觉神经肌肉促进疗法(proprioceptive neuromuscular facilitation,PNF)拉伸训练联合Bobath握手训练对脑卒中偏瘫患者神经功能及上肢运动功能的影响。方法:选取2019年1月至2020年12月安徽医科大学附属宿州医院神经内科收治的脑卒中偏瘫患者100例为研究对象,随机分为对照组(n=50)与观察组(n=50);对照组予以常规康复治疗,观察组予以PNF拉伸训练联合Bobath握手训练,两组均连续治疗20d;于治疗前后采用临床神经功能缺损评定表(China Stroke Scale,CSS)、美国国立卫生研究院卒中量表(the National Institute of Health Stroke Scale,NIHSS)、Fugl-Meyer评定量表上肢部分(Fugl-Meyer Assessment-Upper Extremities,FMA-UE)、改良Ashworth量表(Modified Ashworth Scale,MAS)、手臂动作调查测试(Action Research Arm Test,ARAT)、改良Barthel指数量表(Modified Barthel Index,MBI)及功能独立性评定量表(Functional Independence Measure,FIM)评估患者神经功能、上肢运动功能、手功能及日常生活能力。结果:治疗后,观察组FMA-EU、ARAT、MBI、FIM评分高于对照组,CSS、MAS评分低于对照组,差异有统计学意义(P<0.05)。结论:PNF拉伸训练联合Bobath握手训练可有效改善脑卒中偏瘫患者神经功能上肢运动功能及手功能,促进日常生活能力提高。

Effects of PNF stretching training combined with Bobath handshake training on neurological function and upper limb motor function of stroke patients with hemiplegia

Objective:To investigate the effects of proprioceptive neuromuscular facilitation(PNF)stretching training and Bobath handshake training on the neurological function and upper limb movement function of stroke patients with hemiplegia.Methods:A total of 100 stroke patients with hemiplegia treated by neurology department of our hospital from January 2019 to December 2020 were randomly divided into a control group(n=50)and an observation group(n=50).The control group was given routine rehabilitation treatment,the observation group was given PNF stretching training combined with Bobath handshake training,and the two groups were treated for 20 days continuously.Before and after treatment,the China Stroke Scale(CSS),the National Institute of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Modified Ashworth Scale(MAS),Action Research Arm Test(ARAT),Modified Barthel Index(MBI)and Functional Independence Measure(FIM)were used to evaluate the neurological function,upper limb motor function,hand function,and activities of daily living.Results:After treatment,the scores of FMA-EU,ARAT,MBI and FIM in the observation group were higher than that of the control group;CSS,NIHSS and MAS scores were lower than that of the control group(P<0.05).Conclusion:PNF stretching training combined with Bobath handshake training can effectively improve the motor function of upper limb and hand function of stroke patients with hemiplegia,and improve the ability of daily living.