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中风后偏瘫步态康复中的运动想象

Motor imagery for gait rehabilitation in post-stroke hemiparesis.

作者信息

Dickstein Ruth, Dunsky Ayelet, Marcovitz Emanuel

机构信息

Department of Physical Therapy, Faculty of Social Welfare and Health Studies, The University of Haifa, Mount Carmel, Haifa 31905, Israel.

出版信息

Phys Ther. 2004 Dec;84(12):1167-77.

Abstract

BACKGROUND AND PURPOSE

Reports have described the contribution of motor imagery (MI) practice for improving upper-extremity functions in patients with hemiparesis following stroke. The purpose of this case report is to describe the use of MI practice to attempt to improve walking in an individual with hemiparesis.

CASE DESCRIPTION

A 69-year-old man with left hemiparesis received MI gait practice for 6 weeks. Intervention focused on task-oriented gait and on impairments of the affected lower limb. Preintervention, midterm, postintervention, and follow-up measurements of temporal-distance stride parameters and sagittal kinematics of the knee joint were taken.

MAIN OUTCOMES

At 6 weeks postintervention, the patient had a 23% increase in gait speed and a 13% reduction in double-support time. An increase in range of motion of the knees also was observed. No changes in gait symmetry were noted.

DISCUSSION

The outcomes suggest that MI may be useful for the enhancement of walking ability in patients following stroke. Because improvement was mainly in temporal-distance gait variables and knee movement, imagery practice probably should focus on its specific impairments during gait in order to affect the performance of the paretic lower extremity.

摘要

背景与目的

有报告描述了运动想象(MI)练习对改善中风后偏瘫患者上肢功能的作用。本病例报告的目的是描述使用MI练习来尝试改善一名偏瘫患者的步行能力。

病例描述

一名69岁的左侧偏瘫男性接受了为期6周的MI步态练习。干预重点在于任务导向性步态以及患侧下肢的功能障碍。在干预前、中期、干预后以及随访时测量了时间-距离步幅参数和膝关节矢状面运动学指标。

主要结果

干预后6周,患者步态速度提高了23%,双支撑时间减少了13%。还观察到膝关节活动范围增加。未发现步态对称性有变化。

讨论

结果表明,MI可能有助于提高中风后患者的步行能力。由于改善主要体现在时间-距离步态变量和膝关节运动方面,想象练习可能应专注于步态期间的特定功能障碍,以影响患侧下肢的表现。

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