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目的探讨运用运动再学习疗法(MRP)结合神经肌肉本体感觉促进法(PNF)肩胛、骨盆模式训练治疗脑梗死偏瘫运动障碍的疗效。方法将2013年10月至2014年12月收治的116例脑梗死偏瘫恢复早期患者随机分为观察组和对照组,各58例。两组均续接神经内科常规药物治疗,并应用针灸、理疗、作业治疗和MRP训练,观察组在每次MRP训练前进行PNF肩胛、骨盆模式训练。在治疗前、治疗4周、8周时对两组患者采用Fugl-Meyer量表评定平衡功能、上下肢运动功能,改良Barthel指数量表评定日常生活活动能力,Holden功能性步行分级标准评定患者步行功能。结果治疗4周,两组患者Fugl-Meyer平衡功能评分均优于治疗前(P均<0.01),但组间比较无统计学差异(P>0.05)。治疗4、8周,两组患者Fugl-Meyer上下肢运动功能评分、改良Barthel指数量表评分均明显优于治疗前(P均<0.01),且观察组治疗8周时均优于对照组(P均<0.01)。治疗8周,两组患者Holden功能性步行分级情况均明显优于治疗前(P均<0.01),且观察组明显优于对照组(P<0.01)。结论 MRP结合PNF肩胛、骨盆模式训练可以显著提高脑梗死偏瘫者的运动功能。
Objective To investigate the therapeutic effect of exercise regain therapy (MRP) and neuromuscular proprioceptive enhancement (PNF) scapular and pelvic training on hemiplegic movement disorders in patients with cerebral infarction. Methods One hundred and sixty-six patients with hemiplegia after cerebral infarction recovered from October 2013 to December 2014 were randomly divided into observation group and control group, with 58 cases in each group. Both groups were continued conventional neurological medicine treatment, and the application of acupuncture, physiotherapy, occupational therapy and MRP training, observation group before each MRP training shoulder and pelvis PNF training. Before treatment, 4 weeks and 8 weeks, Fugl-Meyer scale was used to evaluate the balance function, upper and lower extremities motor function, modified Barthel index scale to assess activities of daily living, Holden functional walking grading scale to evaluate patients walking Features. Results After 4 weeks of treatment, the scores of Fugl-Meyer balance function in both groups were better than those before treatment (all P <0.01), but there was no significant difference between the two groups (P> 0.05). After 4 and 8 weeks of treatment, Fugl-Meyer upper and lower extremity motor function score and modified Barthel index scale were significantly better than those before treatment (P <0.01), and the observation group were better than the control group at 8 weeks <0.01). After 8 weeks of treatment, Holden functional walking grading in both groups was significantly better than before treatment (P <0.01), and the observation group was significantly better than the control group (P <0.01). Conclusions MRP with PNF scapular and pelvic training can significantly improve the motor function of cerebral infarction patients with hemiplegia.