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目的:本研究旨在对镜像训练引导的运动想象疗法是否能够更有效地改善急性缺血性脑卒中后偏瘫患者的上肢功能以及日常生活能力进行评价。方法:研究对象为2014年1月1日—2016年6月30日符合病例选择标准的76例急性缺血性脑卒中后偏瘫患者。将76例患者随机分入镜像训练引导的运动想象疗法组(38例)和单纯的运动想象疗法组(38例),在常规康复训练的基础上,分别接受镜像训练引导的运动想象疗法和单纯的运动想象疗法,共治疗4周。对2组治疗前后的美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、Barthel指数、上肢动作研究量表(Action Research Arm Test,ARAT)评分和Fugl-Meyer上肢运动功能评分进行比较。结果:2组患者治疗后的NIHSS评分、Barthel指数、ARAT评分和Fugl-Meyer上肢运动功能评分均较治疗前显著改善(P值均<0.05)。镜像训练引导的运动想象疗法组治疗后的NIHSS评分、Barthel指数、ARAT评分和Fugl-Meyer上肢运动功能评分的改善幅度均显著大于单纯的运动想象疗法组(P值均<0.05)。结论:镜像训练引导的运动想象疗法应用于急性缺血性脑卒中后偏瘫患者上肢功能的康复治疗,与单纯的运动想象疗法相比,可以更好地改善患者的上肢功能和生活自理能力。
OBJECTIVE: The purpose of this study was to evaluate whether motion-imaging therapy guided by image training can more effectively improve upper limb function and daily living ability in patients with hemiplegia after acute ischemic stroke. Methods: A total of 76 patients with post-stroke hemiplegia after acute cerebral infarction who met the criteria of case selection from January 1, 2014 to June 30, 2016 were enrolled. Sixty-seven patients were randomly divided into two groups according to the image training-guided sports imaging therapy group (38 cases) and the simple motor imaging therapy group (38 cases). On the basis of routine rehabilitation training, Sports imaging therapy for a total of 4 weeks. The National Institutes of Health Stroke Scale (NIHSS) score, Barthel Index, Action Research Arm Test (ARAT) score, and Fugl-Meyer upper extremity motor function Score for comparison. Results: NIHSS score, Barthel index, ARAT score and Fugl-Meyer upper limb motor function score of two groups were significantly improved after treatment (P <0.05). The NIHSS score, Barthel index, ARAT score and Fugl-Meyer upper extremity motor function score improved significantly in MIP group after mirror training than those in Moximax group (all P <0.05). CONCLUSIONS: Image-based training-guided motor imaging therapy can be applied to the rehabilitation of upper extremity function in patients with hemiplegia after acute ischemic stroke. Compared with pure motor imagination therapy, the motor imaging therapy can better improve patients’ upper extremity function and self-care ability.