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目的:探讨在康复训练中结合运动想象对偏瘫患者下肢功能恢复的影响。方法:选择脑卒中慢性期偏瘫患者20例,随机分为先运动想象组(A组)和后运动想象组(B组),两组进行两阶段(阶段Ⅰ和阶段Ⅱ)交叉实验。在实验过程中,所有患者均由治疗师采用神经生理学疗法以及运动再学习等技术进行常规康复训练,45min/次,1次/天,5天/周。A组在第Ⅰ阶段、B组在第Ⅱ阶段于常规康复训练前跟随指导语录音进行运动想象,想象内容包括患肢负重和快速步行,10～15min/次。分别评测每一阶段实验前后Rivermead运动指数(RMI)、Fugl-Meyer运动功能评定(FMA)(下肢部分)、10m最快步行速度(10mMWS)及单位体重患腿最大承重值。对A、B两组在常规康复训练结合运动想象阶段与仅常规康复训练阶段治疗前后的差值进行交叉对照比较。结果:与仅常规康复训练阶段相比,结合运动想象阶段RMI、10mMWS及单位体重患腿最大承重值提高明显(P<0.01或P<0.05);FMA差异无统计学意义(P>0.05)。结论:在康复训练中结合运动想象练习可以促进慢性期偏瘫患者下肢功能的改善。
Objective: To explore the effect of combining motor imagination on recovery of lower extremity function in patients with hemiplegia during rehabilitation training. Methods: Twenty patients with hemiplegia in chronic phase of stroke were randomly divided into pre-exercise imaging group (A group) and post-exercise imaging group (B group). The two groups were performed in two stages (phase I and phase II). During the experiment, all patients received routine rehabilitation training by the therapist using neurophysiological therapy and motor re-learning techniques, 45 min / time, 1 time / day and 5 days / week. Group A was in stage I. Group B was followed up with instructional recordings for motor imaging in stage II before routine rehabilitation training. The imaging contents included limb burden and rapid walking at 10-15 minutes. The RMI, Fugl-Meyer motor function assessment (FMA) (lower extremity), the fastest walking speed of 10m (10mMWS) and the maximum weight per unit weight of affected leg were measured before and after each experiment. The cross-comparison of the difference between before and after treatment in groups A and B was made between the conventional rehabilitation training combined with motor imaging and the conventional rehabilitation training only. Results: Compared with the routine rehabilitation training, the maximal bearing weight of leg affected by RMI, 10 mM WS and unit weight increased significantly (P <0.01 or P <0.05). There was no significant difference in FMA between the two groups (P> 0.05). Conclusion: Combining motor imagination exercises in rehabilitation training can promote the improvement of lower extremity function in patients with hemiplegia in chronic phase.