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基于活动的镜像疗法对脑卒中患者下肢运动功能恢复和步态的影响:一项随机对照试验。

Effect of activity-based mirror therapy on lower limb motor-recovery and gait in stroke: A randomised controlled trial.

机构信息

a Pandit Deendayal Upadhayaya National Institute for Persons with Physical Disabilities , New Delhi , India.

出版信息

Neuropsychol Rehabil. 2019 Sep;29(8):1193-1210. doi: 10.1080/09602011.2017.1377087. Epub 2017 Sep 26.

DOI:10.1080/09602011.2017.1377087
PMID:28949281
Abstract

To determine the effect of activity-based mirror therapy (MT) on motor recovery and gait in chronic poststroke hemiparetic subjects. A randomised, controlled, assessor-blinded trial. Rehabilitation institute. Thirty-six chronic poststroke (15.89 ± 9.01 months) hemiparetic subjects (age: 46.44 ± 7.89 years, 30 men and functional ambulation classification of median level 3). Activity-based MT comprised movements such as ball-rolling, rocker-board, and pedalling. The activities were provided on the less-affected side in front of the mirror while hiding the affected limb. The movement of the less-affected lower limb was projected as over the affected limb. Conventional motor therapy based on neurophysiological approaches was also provided to the experimental group. The control group received only conventional management. Brunnstrom recovery stages (BRS), Fugl-Meyer assessment lower extremity (FMA-LE), Rivermead visual gait assessment (RVGA), and 10-metre walk test (10-MWT). Postintervention, the experimental group exhibited significant and favourable changes for FMA-LE (mean difference = 3.29, 95% CI = 1.23-5.35,  = .003) and RVGA (mean difference = 5.41, 95% CI = 1.12-9.71,  = .015) in comparison to the control group. No considerable changes were observed on 10-MWT. Activity-based MT facilitates motor recovery of the lower limb as well as reduces gait deviations among chronic poststroke hemiparetic subjects.

摘要

目的

观察基于活动的镜像疗法(MT)对慢性期脑卒中偏瘫患者运动功能恢复和步态的影响。

方法

一项随机对照、评估者盲法的临床试验。

地点

康复研究所。

对象

36 例慢性期脑卒中(15.89±9.01 个月)偏瘫患者(年龄:46.44±7.89 岁,30 名男性,功能性步行分级中位数为 3 级)。

干预

基于活动的 MT 包括滚球、摇板和踏车等运动。活动在镜子前的非瘫痪侧进行,同时隐藏瘫痪肢体。将非瘫痪侧下肢的运动投影到瘫痪侧下肢上。实验组还接受基于神经生理方法的常规运动疗法,对照组仅接受常规治疗。

评估

Brunnstrom 恢复阶段(BRS)、Fugl-Meyer 评估下肢(FMA-LE)、Rivermead 视觉步态评估(RVGA)和 10 米步行测试(10-MWT)。

结果

干预后,实验组 FMA-LE(平均差值=3.29,95%可信区间=1.23-5.35,  = .003)和 RVGA(平均差值=5.41,95%可信区间=1.12-9.71,  = .015)的改善明显优于对照组,但 10-MWT 无显著变化。

结论

基于活动的 MT 能促进慢性期脑卒中偏瘫患者下肢运动功能的恢复,减少步态偏差。

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