Bobath技术对缓解偏瘫上肢屈肌痉挛即刻效应的作用

关键词：Bobath压手  痉挛  偏瘫  压力与体重比

Keywords:Bobath hand positioning  spasticity  hemiplegia  percentage of pressure/body weight

摘要：

      摘要 目的：观察健康人采用Bobath压手时手部的压力及其压力/体重的百分比、性别、利手的关系；同时观察压力大小与缓解偏瘫患者上肢痉挛即刻效应之间的关系。 方法：健康人组共27例，分成男、女两个组；偏瘫组患者共14例，分别测量Bobath压手时的手部压力、压力/体重百分比和体重。评估采用机械性健康秤测量体重和手部压力，用改良的Ashworth量表（Modified Ashworth Scale, MAS），对偏瘫患者上肢肱二头肌牵伸前后的张力进行评估，分析即刻效应。 结果：健康男性组利手的压力大于非利手，差异具有显著性意义（P<0.05）。健康男、女两组之间的手部压力、压力/体重的差异亦具有显著性（P<0.05）。偏瘫组中缓解痉挛有效与无效组之间的手部压力，虽有差异但无显著性意义（P>0.05）；而在偏瘫组中，解痉有效组中的中青年男性患者手部压力、压力/体重比值均大于解痉无效组，且差异具有显著性意义（P<0.05）。 结论：Bobath压手时的手部压力、压力/体重百分比直接影响偏瘫患者的解痉效果。其中年龄、性别、利手因素可能影响Bobath压手的效果。

Abstract:

      Abstract Objective: To observe relationships between hand pressures，percentages of pressure/body weight，gender and handedness of healthy people using Bobath hand positioning; to observe the relationships between the pressures and immediate effects in relieving spasticity of upper limb flexors in hemiplegic patients. Method: Twenty-seven healthy adults（control group，divided into two groups of males and females）and 14 hemiplegic patients participated in this study; hand pressure, percentage of pressure/body weight，body weight and spasticity were measured in all the subjects. Mechanical health scale was used to test weights and hand pressures， modified Ashworth scale was used to evaluate tone changes of patients' brachial biceps muscles. Result: The pressures of healthy male adults' handedness were greater than that of non-handedness (P<0.05). There were significant differences between groups of males and females in hand pressure and percentages of pressure/body weight (P<0.05). In hemiplegic patients there was no significant difference in hand pressures on relaxing spasticity between effective patients and ineffective patients; and in young male patients, there were significant differences in hand pressures and percentages of pressure/body weight on relaxing spasticity between effective patients and ineffective patients(P<0.05). Conclusion: When using Bobath hand positioning, hand pressures and percentages of pressure/body weight directly influenced the effects of relieving spasticity，and age，gender and handedness could also affect the effects.