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唐朝正,陈昌成,丁 政,陈 创,张晓莉,吴 毅,贾 杰.基于镜像神经元理论的动作观察在脑卒中后肩手综合征疼痛康复中的应用[J].中国康复医学杂志,2016,(2):145~149
基于镜像神经元理论的动作观察在脑卒中后肩手综合征疼痛康复中的应用    点此下载全文
唐朝正  陈昌成  丁 政  陈 创  张晓莉  吴 毅  贾 杰
复旦大学附属华山医院康复科,上海市,200040
基金项目:“十二五”国家科技支撑手功能项目(2013BAI10B03);国际合作青年基金项目(31450110072);国家自然科学基金项目(90920014,91120305);上海市科委生物医药重大项目(10DZ1950800)
DOI:
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摘要:
      摘要 目的:观察镜像疗法对早期脑卒中后肩手综合征患者疼痛的影响。 方法:采用随机数字表将22例早期脑卒中偏瘫患者分为镜像组(n=11)和对照组(n=11)。两组患者均接受常规康复治疗,在此基础上,镜像组增加30min动作观察训练,一周5次,共4周。在治疗前和治疗2周、4周后采用休息状态视觉模拟评分(R-VAS)、被动运动视觉模拟评分(P-VAS)、Fug1-Meyer量表上肢部分(FMA-UE)、运动活动日志患手使用频率(MAL-AOU)和贝克抑郁量表(BDI)对两组患者进行评估。 结果:治疗2周后,镜像组R-VAS、P-VAS和BDI评分均较治疗前明显改善(P<0.05),但FMA-UE和MAL-AOU评分与治疗前比较差异无显著性意义(P>0.05);对照组各评分与治疗前比较差异均无显著性意义(P>0.05)。组间比较显示,镜像组R-VAS和P-VAS评分均较对照组明显降低(P<0.05),但FMA-UE、MAL-AOU和BDI评分与对照组比较差异无显著性意义(P>0.05)。治疗4周后,镜像组R-VAS、P-VAS和BDI评分均较治疗前进一步改善(P<0.01),FMA-UE和MAL-AOU评分也较治疗前明显提高(P<0.05);对照组除BDI评分外(P<0.05),其余评分与治疗前比较差异均无显著性意义(P>0.05)。组间比较显示,镜像组R-VAS和P-VAS评分较对照组明显降低(P<0.01),FMA-UE、MAL-AOU和BDI评分也较对照组明显改善(P<0.05),差异均有显著性意义。 结论:基于镜像神经元理论的动作观察能减轻早期脑卒中后肩手综合征患者的疼痛和促进上肢运动功能的恢复。
关键词:镜像神经元  脑卒中  肩手综合征  疼痛
The application of mirror neuron based action observation on pain rehabilitation of shoulder hand syndrome patients after acute stroke    Download Fulltext
Dept. of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai,200040
Fund Project:
Abstract:
      Abstract Objective: To explore the effect of mirror therapy on pain rehabilitation of acute stroke patients with shoulder hand syndrome. Method: Twenty-two patients were randomly divided into the mirror group (n=11) and the control group (n=11) through random number table. All patients in both groups were given conventional rehabilitation. In addition, the patients in mirror group were given mirror therapy for 30min per session, 5 days a week, totally 4 weeks. Resting state visual analogue scale (R-VAS), passive movement state visual analogue scale (P-VAS), Fug1-Meyer assessment of upper extremity (FMA-UE), motor activity log involving affected hand amount of use (MAL-AOU) and Beck depression index( BDI) were used to assess functional changes before and after 2, 4 weeks of treatment. Result: After 2 weeks treatment, scores of R-VAS, P-VAS and BDI in mirror group significantly improved than those before care(P<0.05), and R-VAS, P-VAS scores were better than those in control group (P<0.05). After 4 weeks treatment, all measurements in mirror group were better than those before care(P<0.05), and the BDI scores(P<0.05)in control group improved also, and that in mirror group were better than that in control group compared by all the measurements(P<0.05). Conclusion: Mirror neuron based action observation can reduce pain and improve motor function of upper extremity in acute stroke patients with shoulder hand syndrome.
Keywords:mirror neuron  stroke  shoulder hand syndrome  pain
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