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目的观察基于等速技术的感觉运动训练对脑卒中患者上肢和手功能的影响。方法按随机数字表法将符合纳入和排除标准的脑卒中患者42例随机分为等速组22例和对照组20例。2组患者均接受常规药物和康复治疗
对照组同时辅以感觉运动训练
等速组则辅以基于等速技术的感觉运动训练。基于等速技术的感觉运动训练每日1次
每次45 min
每周治疗5 d
连续治疗4周。于治疗前和治疗4周后(治疗后)采用单丝触觉(SWME)、两点辨别觉(2-PD)、腕关节本体感觉分别评估2组患者的上肢和手的触觉、复合感觉、本体感觉功能;同时采用Fugl-Meyer上肢运动功能(FMA-UE)和简易上肢功能评价(STEF)评定2组患者上肢和手的运动功能。结果治疗后
2组患者示指的SWME评分和2-PD距离、大鱼际的SWME评分和2-PD距离、运动觉(屈曲30°)的角度、FMA-UE评分、STEF评分较组内治疗前均显著改善
差异均有统计学意义(P<0.05)
且等速组运动觉(伸展30°)的角度较组内治疗前亦显著降低(P<0.05)。治疗后
等速组示指的SWME评分[5.50(5.00
6.00)分]、大鱼际的SWME评分[6.00(5.00
6.00)分]、FMA-UE评分[58.00(53.50
63.00)分]和STEF评分[75.00(56.75
80.00)分]均显著高于对照组治疗后(P<0.05)
且运动觉(屈曲30°)的角度亦显著优于对照组治疗后(P<0.05)。结论基于等速技术的感觉运动训练可显著改善脑卒中恢复期(Brunnstrom Ⅳ期以上)患者的触觉和运动觉
提高其粗大运动和精细动作能力。
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