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目的探讨强制性使用运动疗法(CIMT)在不同程度上肢运动障碍的脑卒中患者中的康复效力。方法27例脑卒中偏瘫患者(平均病程8.3个月)参与此研究。在CIMT治疗期间,要求患者健侧穿戴吊带和夹板来限制健侧肢体动作,每天清醒时固定时间不少于90%,连续12 d。同时接受塑形训练,密集地训练患侧肢体活动,完成日常生活中的动作,连续两周共10个工作日。在接受CIMT治疗前和治疗后用上肢功能测验(UEFT)评价患者的上肢运动功能。根据CIMT治疗前UEFT评定结果进行上肢运动功能障碍程度分类。结果在CIMT治疗后,上肢运动功能障碍重度组和中度组患者的UEF得分较治疗前均显著提高(P<0.001),而且CIMT在重度组患者中比在中度组患者显现出更大的康复效力(ES分别为2.2和1.8)。在UEFT的改善值方面,重度组和中度组患者间无显著性差异(P>0.05)。结论CIMT可以有效地改善不同障碍程度脑卒中患者的上肢运动功能,特别是在上肢运动功能障碍严重的脑卒中患者中显现出更大的康复效力。
Objective To investigate the rehabilitation efficacy of forced exercise therapy (CIMT) in stroke patients with varying degrees of upper extremity dyskinesia. Methods 27 stroke patients with hemiplegia (mean duration 8.3 months) participated in this study. During CIMT treatment, the patient is required to wear braces and splints on the contralateral side to limit contralateral limb movements, holding a fixed time of not less than 90% every day for 12 days. At the same time accept the plastic training, intensive training of ipsilateral limb activity, to complete the daily life of the action, a total of 10 working days for two weeks. Patients were assessed for upper extremity motor function using the Upper Extremity Function Test (UEFT) before and after CIMT treatment. According to CIMT UEFT assessment results before the classification of upper extremity motor dysfunction. Results After CIMT, the scores of UEF in severe and moderate dysfunction patients with upper extremity dysfunction were significantly higher than those before treatment (P <0.001), and CIMT showed more significant in the severe group than in the moderate group Rehabilitation efficacy (ES 2.2 and 1.8, respectively). There was no significant difference in the improvement of UEFT between the severe and moderate groups (P> 0.05). Conclusions CIMT can effectively improve the function of upper extremity in stroke patients with different degree of disorder, especially in stroke patients with severe upper extremity motor dysfunction.