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中华物理医学与康复杂志
中华物理医学与康复杂志

黄晓琳

月刊

0254-1424

cjpmr@tjh.tjmu.edu.cn

027-83662874

430030

湖北省武汉市解放大道1095号同济医院内

中华物理医学与康复杂志/Journal Chinese Journal of Physical Medicine and RehabilitationCSCD北大核心CSTPCD
查看更多>>中华医学会主办。本刊主要内容包括：贯彻党和国家的卫生工作方针政策，理论与实践相结合，提高与普及相结合，积极倡导百花齐放、百家争鸣；全面介绍物理治疗、物理医学与康复领域内领先的科研成果和新理论、新技术、新方法、新经验以及对物理因子治疗、康复临床、疗养等有指导作用，且与康复医学密切相关的基础理论研究，同时密切关注国际康复医学发展的新动向。主要栏目包括论著、综述、研究报告、经验交流、继续教育、讲座、病例报告、会议纪要、书评、国内外学术动态、学术活动预告等。
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    重复经颅磁刺激对慢性抑郁小鼠前额叶皮质和海马区P2X7R及GFAP表达的影响

    曾毅周丽马艳余玲玲...
    97-102页
    查看更多>>摘要：目的 观察重复经颅磁刺激(rTMS)对抑郁小鼠前额叶皮质和海马区嘌呤2X7受体(P2X7R)及胶质纤维酸性蛋白(GFAP)表达的影响。 方法 将30只C57BL/6小鼠分为对照组(10只)和造模组(20只)。对照组小鼠群居饲养(5只/笼)，造模组小鼠在出生21 d后通过断奶独居(1只/笼)饲养6周制作慢性抑郁小鼠模型。采用随机数字表法将16只制模成功小鼠分为模型组及rTMS组，每组8只小鼠。rTMS组小鼠给予10 Hz rTMS干预，每周干预5 d。于rTMS干预4周后观察各组小鼠抑郁样行为改变，并对比各组小鼠前额叶皮质和海马区P2X7R、GFAP表达变化。 结果 与对照组比较，模型组小鼠蔗糖偏好实验(SPT)中糖水偏好量、旷场实验(OFT)中运动距离均显著减少(P<0.05)，悬尾实验(TST)中静止不动时间显著增加(P<0.05)，前额叶皮质和海马区P2X7R表达水平均明显增加(P<0.05)，GFAP表达水平则显著下降(P<0.05)。与模型组比较，rTMS组SPT糖水偏好量[(75.11±4.58)% vs(65.14±4.87)%]、OFT运动距离[(2289.34±100.16)cm vs (2028.90±178.21)cm]均显著增加(P<0.05)，TST静止不动时间[(78.11±10.89)s vs(101.39±10.38)s]明显缩短(P<0.05)，前额叶皮质和海马区P2X7R表达均明显降低(P<0.05)，GFAP表达则显著增强(P<0.05)。 结论 rTMS干预能有效改善早期独居小鼠抑郁状态，其治疗机制可能与抑制前额叶皮质和海马区P2X7R表达、促进GFAP表达有关。 Objective To investigate any effect of repeated transcranial magnetic stimulation (rTMS) on the expression of P2X7 receptor (P2X7R) and glial fibrillary acid protein (GFAP) in the prefrontal cortex and hippocampus of mice modeling depression. Methods Thirty C57BL/6 mice were divided into a control group (n=10) and a depression group (n=20). The mice of the control group were raised in group (five mice per cage), while those of the depression group were kept alone for six weeks to induce depression. Among them, 16 were successfully modeled and randomly divided into a model group (n=8) and an rTMS group (n=8). The rTMS group received five sessions per week of 10Hz rTMS for 4 weeks. Any changes in depression-like behavior were observed and the expression of P2X7R and GFAP in the prefrontal cortex and hippocampus was measured. Results Compared to the control group, a significant decrease was observed in the sucrose consumption rate in the sucrose preference test, in the distance moved in the open field test and in the expression of GFAP protein. But there was a significant increase in the immobile time in the tail suspension test and in the expression of P2X7R protein in the prefrontal cortex and hippocampus in the model group. At the conclusion of the experiment the differences in the sucrose consumption rate, the distance moved, GFAP protein expression, immobile time and P2X7R protein expression between the rTMS and the model group were all statistically significant. Conclusion rTMS can reduce depression-like behavior, at least in mice. That may be related to inhibiting P2X7R expression and promoting GFAP expression in the prefrontal cortex and hippocampus.

    重复经颅磁刺激抑郁症嘌呤2X7受体胶质纤维酸性蛋白社会隔离

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    环境富集对坐骨神经挤压伤模型小鼠神经再生的影响

    李响陈运峰邵士光张洪蕊...
    103-108页
    查看更多>>摘要：目的 探讨环境富集对坐骨神经挤压伤模型小鼠神经再生的作用及机制。 方法 首先对22只C57BL/6小鼠进行坐骨神经挤压建立动物模型，随后按随机数字表法将模型小鼠分为干预组和对照组，干预组小鼠置于具备环境富集的鼠笼内进行干预，对照组置于标准鼠笼中饲养。造模成功2周后，2组小鼠均行坐骨神经电生理检查和步态分析，并应用甲苯胺蓝染色观察坐骨神经有髓神经纤维的比例，采用免疫荧光测定2组坐骨神经中的生长相关蛋白43(GAP43)、髓鞘碱性蛋白(MBP)以及p75神经营养素受体(p75NTR)表达的差异。 结果 ①坐骨神经电生理检测显示，干预组小鼠坐骨神经复合肌肉动作电位(CMAP)的潜伏期[(1.05±0.04)ms]较对照组[(1.98±0.30)ms]明显缩短(P<0.05)，而其波幅[干预组(10.63±0.90)mV]则明显高于对照组[(6.58±1.25)mV]，且组间差异有统计学意义(P<0.05)；②小鼠步态分析显示，干预组小鼠的平均接触强度[(160.60±20.45)AU]、步幅[(5.11±0.58)cm]和步速[(53.06±7.20)cm/s] 均较对照组[(122.70±15.04)AU、(4.00±0.61)cm、(39.38±9.61)cm/s]有明显增加(P<0.05)，而其步轴角[(21.88±2.13)°]则较对照组[(30.74±5.93)°]明显减小(P<0.05)；③经甲苯胺蓝染色镜下观，干预组神经纤维排列相对整齐、密集，有髓纤维数量较对照组明显增多(P<0.05)；④免疫荧光染色定量分析显示，干预组坐骨神经中的MBP、GAP43、p75NTR水平均较对照组明显提高(P<0.05)。 结论 环境富集可通过促进施万细胞的增殖、形成髓鞘而促进坐骨神经挤压伤小鼠模型中损伤神经的再生和功能的恢复。 Objective To document any effect of environmental enrichment on nerve regeneration in a mouse model of sciatic nerve compression and explore its mechanism. Methods A crushed sciatic nerve model was successfully established in 22 C57BL/6 mice, and they were then randomly divided into an intervention group and a control group. The mice of the intervention group were raised in a cage with an enriched environment, while those of the control group were kept in a standard cage. Two weeks later, both groups′ gait was analyzed and the compound muscle action potential (CMAP) of the sciatic nerve was measured. The proportion of myelinated sciatic nerve fibers was examined using toluidine blue staining, and the expression of myelin basic protein (MBP), growth associated protein-43 (GAP43) and p75 neurotrophin receptor (p75NTR) was measured using immunofluorescence intensity. Results ①The latency of the CMAP [(1.05±0.04)ms] was significantly shortened in the intervention group compared with the control group and the amplitude was significantly higher. ②Gait analysis showed a significant increase in the average contact intensity, stride length and stride rate of the intervention group compared with the control group. However, the step axis angle of the intervention group was significantly smaller than in the control group on average. ③The stained nerve fibers in the intervention group were orderly and dense, and the average number of myelinated fibers was significantly greater than in the control group. ④Quantitative analysis of the immunofluorescence showed that the levels of MBP, GAP43 and p75NTR in the sciatic nerves of the intervention group were, on average, significantly higher than in the control group. Conclusion An enriched environmental can promote the regeneration and functional recovery of crushed sciatic nerves by promoting the proliferation and myelination of Schwann cells.

    坐骨神经神经再生环境富集

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    单侧穿戴式外骨骼机器人训练对亚急性期脑卒中患者平衡和步行功能的影响

    李飏安陈泽健夏楠顾明辉...
    109-113页
    查看更多>>摘要：目的 探讨单侧穿戴式外骨骼机器人训练对亚急性期脑卒中偏瘫患者下肢运动功能的影响。 方法 将符合纳入和排除标准的脑卒中患者40例采用随机数字表法分为机器人组和对照组，每组20例。对照组患者采用常规下肢康复训练，机器人组则进行外骨骼辅助下肢运动训练，每日训练40 min，每周训练6 d，连续训练3周。于治疗前和治疗3周后(治疗后)采用功能性步行分级(FAC)、简式Fugl-Meyer运动功能量表下肢部分(FMA-LE)、Berg平衡量表(BBS)和改良Barthel指数量表(MBI)分别评估2组患者的步行能力、下肢功能、平衡能力和日常生活活动能力，并采用坐站转移任务时，双下肢股直肌和胫前肌的健侧与患侧积分肌电值(iEMG)比值来评估2组患者患侧肌肉的激活情况和双侧肌肉激活对称性。 结果 治疗后，2组患者的FAC分级和FMA-LE、BBS、MBI评分较组内治疗前均显著改善(P<0.05)；且机器人组治疗后的FAC分级为(1.63±0.72)级，显著优于对照组治疗后(P<0.05)。治疗后，2组患者的股直肌和胫前肌健侧与患侧的iEMG比值较组内治疗前均显著改善(P<0.05)，且机器人组胫前肌健侧与患侧的iEMG比值显著优于对照组治疗后(P<0.05)。 结论 单侧穿戴式外骨骼机器人训练可有效地改善亚急性期脑卒中患者的步行、下肢运动、平衡功能和日常生活活动能力，促进患侧下肢肌肉激活及提高双侧下肢肌肉激活对称性。 Objective To explore any differential effect of training wearing a unilateral exoskeleton on the lower-limb motor function of stroke survivors. Methods Forty stroke survivors were randomly divided into an exoskeleton group (n=20) and a control group (n=20). The control group performed conventional lower extremity exercise training while the exoskeleton group received exoskeleton-assisted lower-limb physical therapy. Each participant received eighteen 40-minute training sessions over three weeks. Before and after the intervention, the walking ability, lower-limb function, balance and ability in the activities of daily living of both groups were evaluated. Integrated electromyography (iEMG) of the rectus femoris and tibialis anterior of both legs was also recorded during sit-to-stand transitions to assess the activation of the affected muscles and the symmetry of bilateral muscle activation. Results After the three weeks, significant improvement was observed in all of the measurements in both groups, but with the exoskeleton group scoring significantly better on average in functional ambulation category grading (1.63±0.72). Both groups′ iEMGs had also improved significantly compared with before treatment, but the exoskeleton group′s average result was by that time significantly better than the control group′s average. Conclusions A wearable exoskeleton can effectively improve the rehabilitation of walking, lower limb movement, balance and skill in the activities of daily living of persons with subacute stroke. It better activates the affected lower limb muscles and improves the symmetry of bilateral lower limb muscle activation.

    外骨骼机器人脑卒中下肢运动功能康复

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    呼吸肌抗阻训练联合反馈式呼吸电刺激对脑卒中患者膈肌功能及肺功能的影响

    袁文蓉陈立娜刘洋洋王华...
    114-118页
    查看更多>>摘要：目的 观察呼吸肌抗阻训练联合反馈式呼吸电刺激疗法对脑卒中偏瘫患者双侧膈肌功能及肺功能的影响。 方法 采用随机数字表法将60例脑卒中偏瘫患者分为观察组及对照组，每组30例。2组患者均给予常规康复干预及呼吸肌抗阻训练，观察组在此基础上辅以反馈式呼吸电刺激治疗，每日治疗2次，每周治疗6 d，持续治疗3周。于治疗前、治疗3周后采用超声检测2组患者偏瘫侧及健侧吸气末膈肌厚度(IDT)、呼气末膈肌厚度(EDT)、平静呼吸及深呼吸时膈肌移动度，并计算膈肌增厚分数(DTF)，采用便携式肺功能仪检测2组患者肺功能，同时分析比较治疗前、后2组患者偏瘫侧及健侧膈肌功能障碍发生率。 结果 治疗后观察组患者偏瘫侧、健侧膈肌功能障碍发生率均较治疗前及同期对照组明显降低(P<0.05)。治疗后观察组患者偏瘫侧及健侧IDT、EDT、DTF、平静呼吸及深呼吸时膈肌移动度均较治疗前明显改善(P<0.05)，而对照组偏瘫侧及健侧上述疗效指标均较治疗前无明显改善(P>0.05)；并且治疗后观察组患者偏瘫侧及健侧IDT、DTF、深呼吸时膈肌移动度亦显著优于对照组水平(P<0.05)。治疗后2组患者各项肺功能指标均较治疗前明显改善(P<0.05)，并且观察组肺功能指标改善幅度亦显著优于对照组水平(P<0.05)。 结论 脑卒中偏瘫患者容易并发膈肌功能障碍，并以偏瘫侧膈肌功能受累为主；持续3周的呼吸肌抗阻训练联合反馈式呼吸电刺激治疗能有效增加脑卒中偏瘫患者双侧IDT、DTF及深呼吸时膈肌移动度，有助于提高患者膈肌收缩能力及肺功能，降低卒中患者膈肌功能障碍发生率。 Objective To document any effect of combining respiratory-muscle resistance training with feedback respiratory electrical stimulation in rehabilitating the diaphragm function and lung function of stroke survivors. Methods Sixty hemiplegic stroke survivors were randomly assigned to an observation group or a control group, each of 30. Both groups were given conventional rehabilitation, including respiratory-muscle resistance training. The observation group additionally received feedback respiratory electrical stimulation twice a day, six days a week for 3 weeks. Before and after the treatment, ultrasound was used to measure the end-inspiratory and end-expiratory thickness of the diaphragm. Diaphragm movement during quiet breathing and deep breathing was also observed, and the diaphragm thickening fraction was calculated. The incidence of diaphragm dysfunction on the affected and healthy sides of the two groups before and after the treatment was also analyzed and compared. Results Diaphragm dysfunction on either side had decreased significantly more in the observation group than in the control group after the treatment. The observation group also showed significantly greater average improvement in the thickening functions and in diaphragm movement on both the affected and healthy sides during quiet breathing and deep breathing. All of the pulmonary function indicators improved significantly in both groups after the treatment, but those of the observation group were, on average, significantly better than the control group′s averages. Conclusions Combining 3 weeks of respiratory muscle resistance training with electrical stimulation feedback can effectively increase the bilateral thickness of the diaphragm and diaphragm movement in deep breathing of hemiplegic stroke survivors. That reduces the incidence of diaphragm dysfunction.

    脑卒中电刺激膈肌厚度膈肌移动度肺功能

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    电针夹廉泉穴治疗脑卒中后口咽期吞咽障碍的临床研究

    康星宇郭壮丽高呈飞吴艺玲...
    119-124页
    查看更多>>摘要：目的 观察电针夹廉泉穴对脑卒中后口咽期吞咽障碍(PSOD)的影响。 方法 选取符合标准的PSOD患者45例，按随机数字表法分为电针组、神经肌肉电刺激(NMES)组和对照组，每组患者15例。对照组患者给予常规吞咽康复训练，电针组在此基础上增加电针夹廉泉穴治疗，NMES组在常规吞咽康复训练的基础上增加双侧颏下肌群NMES。电针和NMES均每日1次，每次30 min，每周治疗5 d，连续治疗3周。于治疗前和治疗3周后(治疗后)对3组患者进行吞咽造影检查(VFSS)，采用功能性经口进食量表(FOIS)、标准吞咽功能评价量表(SSA)、渗漏-误吸量表(PAS)和改良式钡剂吞咽障碍量表(MBSImp)评估其吞咽功能，另采用表面肌电图(sEMG)检测患者空吞咽和吞咽5 ml温水时颏下肌群的肌肉功能[包括波幅峰值、波幅均值和平均吞咽时程]。 结果 治疗后，3组患者的SSA、FOIS、MBSImp、PAS评分以及空吞和吞咽5 ml温水时sEMG的波幅峰值、波幅均值、平均吞咽时程较组内治疗前均显著改善(P<0.05)，且电针组和NMES组上述指标均显著优于对照组治疗后(P<0.05)。电针组的SSA评分[(22.40±3.40)分]、FOIS分级[(6.13±0.92)级]、MBSImp评分[(7.8±1.82)分]、PAS评分[(1.73±0.70)分]、空吞唾液时sEMG的波幅峰值[(92.53±18.28)μV]、空吞唾液时sEMG的波幅均值[(23.45±2.93)μV]、空吞唾液时sEMG的平均吞咽时程[(1.50±0.15)s]、吞咽5 ml温水时sEMG的波幅峰值[(96.79±19.99)μV]、吞咽5 ml温水时sEMG的波幅均值[(23.83±3.01)μV]、吞咽5 ml温水时sEMG的平均吞咽时程[(1.52±0.14)s]均显著优于NMES组和对照组治疗后，差异均有统计学意义(P<0.05)。 结论 电针夹廉泉穴可显著改善脑卒中后口咽期吞咽障碍患者的吞咽功能，且电针组的治疗效果优于神经肌肉电刺激组。 Objective To observe any effect of electroacupuncture applied to the Jialianquan points in treating post-stroke oropharyngeal dysphagia. Methods Forty-five stroke survivors with oropharyngeal dysphagia were randomly divided into an electroacupuncture group (n=15), a neuromuscular electrical stimulation group (n=15) and a control group (n=15). All groups received 30 minutes of routine swallowing function training 5 times a week for 3 weeks. The electroacupuncture group was additionally provided with 30 minutes of electroacupuncture applied to the Jialianquan (CV23) points, and the neuromuscular electrical stimulation group instead received 30 minutes of neuromuscular electrical stimulation over the bilateral submental muscles. Videofluoroscopic swallowing studies were performed before and after the 3 weeks of treatment. Standardized swallowing assessment was conducted producing functional oral intake scale ratings, modified barium swallow impairment profiles and the penetration-aspiration scale scores. Surface electromyography was also employed to evaluate submental muscle functioning through measuring the swallowing time, average EMG (AEMG) value and peak amplitude. Results After the treatment, significant improvement was observed in all of the evaluations with both groups, but the average scores were significantly better in the electroacupuncture and neuromuscular electrical stimulation groups compared with the control group and significantly better in the electroacupuncture group than in the neuromuscular electrical stimulation group. Conclusion Electroacupuncture at the Jialianquan point can significantly improve the swallowing of stroke survivors with oropharyngeal dysphagia. It is more effective than neuromuscular electric stimulation.

    电针吞咽障碍神经肌肉电刺激视频透视吞咽检查表面肌电图

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    针刺同步手功能康复训练对脑卒中患者上肢感觉及运动功能的影响

    刘西花于子夫马赛刘姣姣...
    125-127页
    查看更多>>摘要：目的 观察针刺同步手功能康复训练对脑卒中患者上肢运动及感觉功能的影响。 方法 采用随机数字表法将64例脑卒中患者分为针刺同步康复组(简称同步组)和针刺联合康复组(简称对照组)，每组32例。2组患者均给予常规手功能康复训练和针刺治疗，其中同步组患者上述疗法同步实施，对照组患者上述疗法非同步实施，2组患者均连续治疗4周。于治疗前、治疗4周后分别采用Fugl-Meyer运动功能量表上肢部分(FMA-UE)、功能独立性量表(FIM)、改良Barthel指数量表(MBI)、改良Ashworth痉挛评级(MAS)、改良版诺丁汉感觉功能量表(reNSA)及Fugl-Meyer感觉功能量表(FMA-S)对2组患者进行疗效评定。 结果 在感觉功能方面，治疗后同步组reNSA深、浅感觉评分及FMA-S评分均显著高于对照组(P<0.05)，2组患者reNSA复合感觉评分组间差异无统计学意义(P>0.05)；在运动功能方面，治疗后同步组FMA-UE及MBI评分均显著高于对照组(P<0.05)，2组患者屈肘肌MAS评级及FIM评分组间差异仍无统计学意义(P>0.05)。 结论 针刺同步手功能康复训练能进一步改善脑卒中患者上肢感觉及运动功能，促进患者日常生活活动能力提高，该联合疗法值得临床推广、应用。

    针刺同步治疗手功能训练脑卒中运动功能感觉功能

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    运动想象训练联合强制性运动疗法对脑卒中偏瘫患者上肢运动功能的影响

    梁思颖李灵晓易浩
    128-130页
    查看更多>>摘要：目的 观察运动想象训练联合强制性运动疗法(CIMT)对脑卒中偏瘫患者上肢运动功能的影响。 方法 采用随机数字表法将95例脑卒中后偏瘫患者分为运动想象组(32例)、CIMT组(31例)及联合组(32例)。所有患者均接受常规药物治疗及康复训练(包括良肢位摆放、体位转换训练、关节主被动训练及牵拉训练等)，待常规康复训练结束后运动想象组患者辅以运动想象疗法，CIMT组患者辅以CIMT训练，联合组患者则辅以运动想象疗法及CIMT训练，3组患者均连续治疗4周。于治疗前、治疗4周后分别采用简易Fugl-Meyer上肢运动功能量表(FMA-UE)、Carroll上肢功能测试量表(UEFT)及改良Barthel指数(MBI)量表对3组患者进行疗效评定。 结果 治疗后3组患者FMA-UE、UEFT及MBI评分均较治疗前明显提高(P<0.05)，并且联合组治疗后其FMA-UE评分[(43.50±6.22)分]、UEFT评分[(35.79±6.15)分]及MBI评分[(71.74±5.92)分]均显著优于运动想象组及CIMT组水平(P<0.05)。 结论 运动想象疗法联合CIMT训练能进一步改善脑卒中偏瘫患者上肢运动功能及日常生活活动能力，该联合疗法值得临床推广、应用。

    运动想象疗法强制性运动疗法脑卒中上肢运动功能

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    运动想象疗法对后遗症期脑卒中患者下肢运动功能的影响

    伦亿禧王强毛勇李林海...
    131-133页
    查看更多>>摘要：目的 观察运动想象疗法对后遗症期脑卒中患者下肢运动功能的影响。 方法 将后遗症期脑卒中患者30例按随机数字表法分为观察组和对照组，每组患者15例。2组患者均接受常规药物治疗和常规康复训练，观察组患者在此基础上增加运动想象训练。常规康复训练和运动想象疗法均每日1次，每周训练5 d，连续训练8周。于治疗前和治疗8周后(治疗后)分别采用Fugl-Meyer运动功能评定(FMA)下肢部分、Holden步行能力分级(FAC)、"起立-行走"计时测试(TUGT)和10 m步行速度测试(10MWT)评估2组患者的下肢运动能力、步行能力、转移能力和最大步行速度。 结果 治疗后，2组患者的FMA评分、TUGT和10MWT与组内治疗前比较，差异均有统计学意义(P<0.05)。观察组治疗后的FMA评分、TUGT和10MWT分别为(27.70±4.50)分、(21.05±11.03)s、(0.77±0.42)m/s，均显著优于对照组治疗后，差异均有统计学意义(P<0.05)。 结论 运动想象疗法结合常规康复训练可显著提高后遗症期脑卒中患者的步行效率，改善其下肢运动功能。

    运动想象疗法后遗症期脑卒中下肢运动功能

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    基于虚拟现实的肩前屈特定角度训练对脑卒中偏瘫患者上肢功能恢复的影响

    李辉劳方金顾旭东傅建明...
    134-136页
    查看更多>>摘要：目的 观察基于虚拟现实的肩前屈特定角度训练对脑卒中偏瘫患者上肢功能恢复的影响。 方法 采用随机数字表法将60例脑卒中偏瘫患者分为治疗组和对照组，每组30例。2组患者均给予常规药物和综合康复治疗，在此基础上，治疗组在虚拟现实环境中佩戴角度传感器，做肩关节特定屈曲角度(30°、60°、90°)训练，每周5 d，共6周。治疗前和治疗6周后(治疗后)，比较2组患者完成不同肩关节屈曲角度虚拟任务时的实际肩前屈角度，采用上肢Fugl-Meyer评分法(FMA-UE)和改良Ashworth量表(MAS)对2组患者的上肢运动功能、肱二头肌痉挛情况进行评定。 结果 治疗前，2组患者完成不同肩前屈角度任务下的实际肩前屈角度、FMA-UE评分、MAS评分比较，差异均无统计学意义(P>0.05)。与组内治疗前比较，治疗组治疗后完成30°、60°、90°肩前屈角度任务下的实际肩前屈角度均接近于任务角度(P<0.05)。与对照组治疗后比较，治疗组60°、90°肩前屈角度任务下的实际肩前屈角度更接近于任务角度(P<0.05)。与对照组治疗后比较，治疗组FMA-UE评分[(38.26±12.66)分]较高、MAS评分[(0.76±0.71)分]较低(P<0.05)。 结论 基于虚拟现实的肩前屈特定角度训练，可提高脑卒中偏瘫患者肩关节屈曲60°、90°时的肩部控制能力，改善上肢运动功能，抑制肱二头肌肌张力。

    脑卒中偏瘫虚拟现实上肢功能

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    肌内效贴骨盆干预对脑卒中后骨盆前倾患者的步行和平衡能力的影响

    吴燕婷祁奇姚加佳袁雅欣...
    137-140页
    查看更多>>摘要：目的 探讨肌内效贴骨盆干预对脑卒中后骨盆前倾患者的骨盆倾斜角度、步行能力和平衡的影响。 方法 将脑卒中后骨盆前倾患者26例按随机数字表法分为观察组(n＝13)和对照组(n＝13)，2组患者均接受常规康复治疗，观察组在此基础上增加骨盆处肌内效贴干预，对照组则进行骨盆处肌内效贴安慰治疗。2组受试者均在贴扎前(干预前)和贴扎后即刻(干预后)接受骨盆倾斜角度、10 m步行时间、步态分析(干预前、后步态时空参数的差值)和平衡能力(干预前、后稳定极限的差值)的评估。于贴扎前(干预前)和贴扎后即刻(干预后)对2组患者进行骨盆倾斜角度评定、10 m步行时间测试、步态分析和平衡能力的评估。 结果 干预后，2组双侧骨盆倾斜角度与组内干预前比较，差异均有统计学意义(P<0.05)，且观察组干预后双侧骨盆倾斜角度与对照组干预同侧比较，差异均有统计学意义(P<0.05)。干预后，观察组10 m步行时间为(19.55±6.51)s，与组内干预前和对照组干预后比较，差异均有统计学意义(P<0.05)。观察组步态参数中的步速、步频、步长、步幅干预前、后的差值与对照组比较，差异均有统计学意义(P<0.05)。观察组稳定极限参数中的方向控制和稳定极限总分干预前、后的差值与对照组比较，差异均有统计学意义(P<0.05)。 结论 肌内效贴骨盆干预可即时显著地纠正脑卒中后骨盆前倾患者的骨盆角度，增加其步行速度，改善其步行和平衡功能。

    脑卒中肌内效贴骨盆前倾步态平衡

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