推拿联合分级运动想象对脑卒中后偏瘫患者上肢运动功能和生活质量的影响

• 作 者: 刘泽江 洪珏
• 出 处: 针灸推拿医学（英文版）
• 发表日期: 2022年1期
• 关键词: Tuina Massage Graded Motor Imagery Poststroke Syndrome Hemiplegia Motor Function

目的:观察推拿联合分级运动想象(GMI)对脑卒中后偏瘫患者上肢运动功能和生活质量的影响.方法:选择216例脑卒中后偏瘫患者,采用抛硬币法随机分为两组,每组108例.对照组采用GMI治疗,观察组在对照组干预基础上加用推拿治疗.共治疗4周.观察两组治疗前后上肢Fugl-Meyer运动功能量表上肢部分(FMA-UE)评分、上肢/手Brunnstrom分期评分、手部组块测试(BBT)、上肢肌群共同收缩率(CR)、肩部疼痛视觉模拟量表(VAS)评分、改良Ashworth痉挛量表(MAS)评分、改良Barthel指数(MBI)及简明健康测量量表(SF-36)评分差异.结果:两组治疗后FMA-UE、上肢/手Brunnstrom分期、手部BBT、MBI及SF-36评分均较治疗前增加(P<0.05),屈曲位肱二头肌CR、伸展位肱三头肌CR、VAS及MAS评分均较治疗前降低(P<0.05).观察组治疗后FMA-UE、上肢/手Brunnstrom分期评分及手部BBT均高于对照组(P<0.05),屈曲位肱二头肌CR及伸展位肱三头肌CR均低于对照组(P<0.05).观察组治疗后MBI及SF-36评分均高于对照组(P<0.05),VAS及MAS评分均低于对照组(P<0.05).结论:推拿联合GMI可更好改善脑卒中后偏瘫患者上肢运动功能,提高其生活质量.“,”Objective: To observe the effects of Tuina (Chinese therapeutic massage) combined with graded motor imagery (GMI) on the upper-limb motor function and quality of life (QOL) in patients with poststroke hemiplegia.Methods: A total of 216 patients with hemiplegia caused by stroke were randomized into two groups by tossing a coin, with 108 cases in each group. The control group was treated with GMI, and the observation group was given additional Tuina treatment for four weeks in total. Before and after the treatment, the Fugl-Meyer assessment for upper extremity (FMA-UE), supper-limb/hand Brunnstrom staging, box and block test (BBT) for hand, co-contraction ratio (CR) of the upper-limb muscles, visual analog scale (VAS) for shoulder pain, modified Ashworth scale (MAS), modified Barthel index (MBI), and short-form 36-item health survey (SF-36) were adopted for observation of the two groups. Results: After the treatment, the scores of FMA-UE, upper-limb/hand Brunnstrom staging, hand BBT, MBI, and SF-36 increased (P<0.05), and the CR of biceps brachii at flexion, the CR of triceps brachii at extension, and the scores of VAS and MAS decreased in both groups (P<0.05). The scores of FMA-UE, upper-limb/hand Brunnstrom staging, and hand BBT were higher in the observation group than in the control group after the intervention (P<0.05); the CR of biceps brachii at flexion and the CR of triceps brachii at extension were lower in the observation group than in the control group (P<0.05). After the treatment, the scores of MBI and SF-36 were higher in the observation group than in the control group (P<0.05), and the scores of VAS and MAS were lower in the observation group than in the control group (P<0.05). Conclusion: Tuina combined with GMI can produce more significant effects in improving the upper-limb motor function and QOL in patients with hemiplegia after stroke.