基于磁共振弥散张量成像和表面肌电评估改良强制性运动疗法对脑卒中患者疗效的研究

关键词：脑卒中  磁共振弥散张量成像  改良强制性运动疗法  肌电

Keywords:stroke  diffusion tensor imaging  modified constraint-induced movement therapy  electromyography

摘要：

      摘要 目的：探讨磁共振弥散张量成像（DTI）和肌电测试技术评估改良强制性运动疗法对脑卒中偏瘫患者训练效果的应用价值。 方法：选择脑卒中偏瘫患者41例，随机分为对照组（n=20）和观察组（n=21），对照组采用常规康复治疗，观察组在对照组基础上加用改良强制性运动疗法直至出院后3个月。分别比较两组治疗3周和3月后FMA、IADL、rFA、ARAT、上肢和手Brunnstrom分期、握力、肌电幅值的变化。 结果：入院时两组患者FMA、IADL、rFA、ARAT、上肢和手Brunnstrom分期、握力、肌电幅值比较，差异无显著性意义（P＞0.05）；治疗3周后，观察组FMA、rFA值、ARAT、上肢和手Brunnstrom分期、握力与对照组比较，差异有显著性意义（P＜0.05），IADL、肌电幅值比较，差异无显著性意义（P＞0.05）；治疗3个月后，观察组FMA、IADL、rFA值、ARAT、上肢和手Brunnstrom分期、握力、肌电幅值与对照组比较，差异均有显著性意义（P＜0.05）。 结论：改良强制性运动疗法短期可以改善脑卒中患者的上肢功能，长期还可以改善患者的生活自理能力。

Abstract:

      Abstract Objective： To explore efficacy of magnetic resonance diffusion tensor imaging （DTI） and electromyography in evaluating the effect of modified constraint-induced movement therapy on stroke patients with hemiplegia. Method： Forty-one stroke patients with hemiplegia were randomly divided into control group （n=20） and observation group （n=21）. The control group received conventional rehabilitation therapy， and the observation group received modified constraint-induced movement therapy on the basis of the control group until 3 months after discharge. The changes in FMA， instrumental activities of daily living， rFA， ARAT， upper limb and hand Brunnstrom classification， grip strength， and electromyographic amplitude were compared between the two groups after 3 weeks and 3 months of treatment. Result： There were no significant differences in FMA， IADL， rFA value， ARAT， upper limb and hand Brunnstrom classification， grip strength， and electromyographic amplitude between the two groups at admission （P>0.05）. After 3 weeks of treatment， the FMA， rFA value， ARAT， upper limb and hand Brunnstrom classification and grip strength in the control group showed significant differences compared with the observation group （P<0.05）， while there were no significant differences in IADL and electromyographic amplitude （P>0.05）. After 3 months of treatment， the FMA， IADL， rFA value， ARAT， upper limb and hand Brunnstrom classification， grip strength in the control group and electromyographic amplitude showed significant differences compared with the observation group （P<0.05）. Conclusion： Modified constraint-induced movement therapy can improve the upper limb function of stroke patients in the short term， and improve the self-care ability of patients in the long term.