Statement of the Problem: Upper limb hemiparesis is a common impairment underlying disability after Stroke. Transfer of treatment to daily functioning remains a question for traditional approaches used in treatment of...Statement of the Problem: Upper limb hemiparesis is a common impairment underlying disability after Stroke. Transfer of treatment to daily functioning remains a question for traditional approaches used in treatment of upper extremity hemiparesis. Approaches based on Motor Learning principles may facilitate the transfer of treatment to activities of daily living. Methodology: Forty one subjects with chronic stroke, attending department of occupational therapy, National Institute for the Orthopaedically Handicapped, Kolkata, West Bengal, India participated in a single blinded randomized pre-test and post-test control group training study. Subjects were randomized over three intervention groups receiving modified Constraint Induced Movement Therapy (n = 13), Bilateral Arm training (n = 14), and an equally intensive conventional treatment program (n = 14). Subjects in the bilateral arm training group participated in bilateral symmetrical activities, where as subjects in constraint induced movement therapy group performed functional activities with the affected arm only and conventional group received conventional Occupational Therapy. Each group received intensive training for 1 hour/day, 5 days/week, for 8 weeks. Pre-treatment and post-treatment measures included the Fugl-Meyer measurement of physical performance (FMA- upper extremity section), action research arm test, motor activity log. Assessments were administered by a rater blinded to group assignment. Result: Both m-CIMT (p = 0.01) and bilateral arm training (p = 0.01) group showed statistically significant improvement in upper extremity functioning on Action Research Arm Test score in comparison to the conventional therapy group (p = 0.33). The bilateral arm training group had significantly greater improvement in upper arm function (Proximal Fugl-Meyer Assessment score, p = 0.001);while the constraint induced movement therapy group had greater improvement of hand functions (Distal Fugl-Meyer Assessment score, p = 0.001. There is an improvement seen in Qualit展开更多
目的观察醒脑开窍针法联合改良强制性运动疗法(modified constraint induced movement therapy,mCIMT)治疗脑梗死的临床疗效以及对血清铁代谢的影响。方法选取2020年7月—2022年10月68例脑梗死患者随机分为综合治疗组(34例)和mCIMT组(34...目的观察醒脑开窍针法联合改良强制性运动疗法(modified constraint induced movement therapy,mCIMT)治疗脑梗死的临床疗效以及对血清铁代谢的影响。方法选取2020年7月—2022年10月68例脑梗死患者随机分为综合治疗组(34例)和mCIMT组(34例)。mCIMT组予强化训练患侧上肢和限制健侧上肢康复技术治疗;综合治疗组在mCIMT组基础上予醒脑开窍针法治疗。比较两组脑梗死患者临床疗效、美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评分、简化Fugl-Meyer评定法(Fugl-Meyer Assessment,FMA)评分、改良Barthel指数(modified Barthel index,MBI)评分、血清铁蛋白(ferritin,FE)、血清转铁蛋白(transferrin,TRF)、血清总铁结合力(total iron-binding capacity,TIBC)水平。结果治疗后,两组脑梗死患者NIHSS评分、血清FE水平均低于治疗前(P<0.01),FMA评分、MBI评分、血清TRF水平、血清TIBC水平均高于治疗前(P<0.01);综合治疗组NIHSS评分、血清FE水平均低于mCIMT组,FMA评分、MBI评分、血清TRF水平、血清TIBC水平均高于mCIMT组(P<0.01)。综合治疗组临床有效率高于mCIMT组[91.18%(31/34)vs 70.59%(24/34)](P<0.05)。结论醒脑开窍针法联合mCIMT治疗脑梗死患者疗效确切,能够改善神经缺损程度、运动功能、日常生活能力和血清铁代谢水平,值得临床进一步推广应用。展开更多
目的观察头电针结合强制性运动对缺血性脑卒中患者上肢功能的影响。方法采用随机数字表法将80例脑卒中患者分为常规康复组、头电针组、强制运动组(constraint-induced movement therapy,CIMT)及综合干预组(头电针+CIMT),常规康复组采用...目的观察头电针结合强制性运动对缺血性脑卒中患者上肢功能的影响。方法采用随机数字表法将80例脑卒中患者分为常规康复组、头电针组、强制运动组(constraint-induced movement therapy,CIMT)及综合干预组(头电针+CIMT),常规康复组采用神经发育疗法(Bobath技术为主,Brunnstrom技术为辅)强化患侧上肢训练;头电针组采用焦氏头针结合电刺激疗法;强制运动组限制健侧上肢,强化患肢训练;综合干预组采用头电针联合强制运动法进行治疗。分别在治疗前及治疗4、12周观察患者偏瘫上肢FuglMeyer运动功能评分(Fugl-Meyer assessment scale,FMA)、腕关节活动度及手功能分级。结果与本组治疗前比较,治疗4周后,各组患者偏瘫上肢FMA评分明显升高,腕关节活动度及手功能分级均明显改善(P<0.05,P<0.01);但除综合干预组偏瘫腕关节活动度在腕关节背伸及桡偏两个活动方向上较常规康复组明显改善(P<0.05)外,其他各组间FMA评分及手功能分级比较,差异均无统计学意义(P>0.05)。治疗12周后,与常规康复组比较,综合干预组FMA评分升高,偏瘫腕关节活动度及手功能分级均明显改善(P<0.05)。结论常规康复、头电针及强制性运动训练对缺血性脑卒中患者偏瘫上肢功能均有较好的康复效果,但头电针联合CIMT训练作用最为明显,且显效最早。展开更多
文摘Statement of the Problem: Upper limb hemiparesis is a common impairment underlying disability after Stroke. Transfer of treatment to daily functioning remains a question for traditional approaches used in treatment of upper extremity hemiparesis. Approaches based on Motor Learning principles may facilitate the transfer of treatment to activities of daily living. Methodology: Forty one subjects with chronic stroke, attending department of occupational therapy, National Institute for the Orthopaedically Handicapped, Kolkata, West Bengal, India participated in a single blinded randomized pre-test and post-test control group training study. Subjects were randomized over three intervention groups receiving modified Constraint Induced Movement Therapy (n = 13), Bilateral Arm training (n = 14), and an equally intensive conventional treatment program (n = 14). Subjects in the bilateral arm training group participated in bilateral symmetrical activities, where as subjects in constraint induced movement therapy group performed functional activities with the affected arm only and conventional group received conventional Occupational Therapy. Each group received intensive training for 1 hour/day, 5 days/week, for 8 weeks. Pre-treatment and post-treatment measures included the Fugl-Meyer measurement of physical performance (FMA- upper extremity section), action research arm test, motor activity log. Assessments were administered by a rater blinded to group assignment. Result: Both m-CIMT (p = 0.01) and bilateral arm training (p = 0.01) group showed statistically significant improvement in upper extremity functioning on Action Research Arm Test score in comparison to the conventional therapy group (p = 0.33). The bilateral arm training group had significantly greater improvement in upper arm function (Proximal Fugl-Meyer Assessment score, p = 0.001);while the constraint induced movement therapy group had greater improvement of hand functions (Distal Fugl-Meyer Assessment score, p = 0.001. There is an improvement seen in Qualit
文摘目的观察头电针结合强制性运动对缺血性脑卒中患者上肢功能的影响。方法采用随机数字表法将80例脑卒中患者分为常规康复组、头电针组、强制运动组(constraint-induced movement therapy,CIMT)及综合干预组(头电针+CIMT),常规康复组采用神经发育疗法(Bobath技术为主,Brunnstrom技术为辅)强化患侧上肢训练;头电针组采用焦氏头针结合电刺激疗法;强制运动组限制健侧上肢,强化患肢训练;综合干预组采用头电针联合强制运动法进行治疗。分别在治疗前及治疗4、12周观察患者偏瘫上肢FuglMeyer运动功能评分(Fugl-Meyer assessment scale,FMA)、腕关节活动度及手功能分级。结果与本组治疗前比较,治疗4周后,各组患者偏瘫上肢FMA评分明显升高,腕关节活动度及手功能分级均明显改善(P<0.05,P<0.01);但除综合干预组偏瘫腕关节活动度在腕关节背伸及桡偏两个活动方向上较常规康复组明显改善(P<0.05)外,其他各组间FMA评分及手功能分级比较,差异均无统计学意义(P>0.05)。治疗12周后,与常规康复组比较,综合干预组FMA评分升高,偏瘫腕关节活动度及手功能分级均明显改善(P<0.05)。结论常规康复、头电针及强制性运动训练对缺血性脑卒中患者偏瘫上肢功能均有较好的康复效果,但头电针联合CIMT训练作用最为明显,且显效最早。
