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MOTOmed智能运动反馈训练联合精细化康复训练对脑梗死后偏瘫患者的影响OA北大核心CSTPCD

Clinical Effect of MOTOmed Intelligent Motion Feedback Training Combined with Refined Rehabilitation Training on Patients with Hemiplegia after Cerebral Infarction

中文摘要英文摘要

目的 观察MOTOmed智能运动反馈训练联合精细化康复训练对脑梗死后偏瘫患者神经功能、平衡功能、肢体运动功能和生活质量的影响.方法 选择2022年1-10月在南通市第三人民医院康复中心住院治疗的148例脑梗死后偏瘫患者,采用随机数字表法分为对照组和观察组,每组74例.对照组在常规治疗基础上接受精细化康复训练.根据脑梗死患者(卧床患者、可坐立患者、借助辅具可站立患者和无辅具可挺直站立患者)肢体运动功能障碍程度给予相应的运动康复训练(如肢体关节训练、身体转移训练、平衡训练和步行训练等),5 d/周,持续治疗12周.观察组在对照组基础上联合MOTOmed智能运动反馈训练(被动运动模式、有助力运动模式和主动训练模式的上肢/下肢运动康复训练),1次/d,45 min/次,5 d/周,持续治疗12周.分别于治疗前后采用美国国立卫生研究院脑卒中量表(NIHSS)评分评估患者神经功能缺损情况;采用Berg平衡量表(BBS)评分评估患者平衡功能;采用Fugl-Meyer运动功能评定量表(FMA)评分评估患者肢体运动功能;采用改良Barthel指数量表(MBI)评分评估患者日常生活活动能力;采用世界卫生组织生活质量测定量表简表(WHOQOL-BREF)评分评估患者生活质量;比较患者大脑中动脉(MCA)、大脑前动脉(ACA)血流速度变化和血清神经生长因子(NGF)、脑源性神经营养因子(BDNF)水平.结果 与治疗前比较,2组治疗后NIHSS评分均明显降低,上肢/下肢FMA评分、BBS评分、MBI评分、WHOQOL-BREF评分、MAC和ACA血流速度、血清NGF和BDNF水平均明显升高,差异均具有统计学意义(P<0.05).与对照组比较,观察组治疗后NIHSS评分明显降低,上肢/下肢FMA评分、BBS评分、MBI评分、WHOQOL-BREF评分、MAC和ACA血流速度、血清NGF和BDNF水平均明显升高,差异均具有统计学意义(P<0.05).结论 MOTOmed智能运动反馈训练联合精细化康复训练可改善脑梗死后偏瘫患者神经功能、平衡功能、肢体运动功能和生活质量,值得临床推广.

Objective To observe the clinical effect of MOTOmed intelligent motion feedback training combined with refined rehabilitation training on neurological function,balance function,limb motor function and quality of life of patients with hemiplegia after cerebral infarction.Methods A total of 148 patients with hemiplegia after cerebral infarction in the rehabilitation center of Nantong Third People's Hospital from January to October 2022 were randomly divided into control group and observation group,with 74 cases in each group.The control group received refined rehabilitation training in addition to the routine treatment.According to the degree of limb motor dysfunction(bedridden,sit upright,stand upright with assistive devices,and stand upright without assis-tive devices),the patients with hemiplegia after cerebral infarction were provided with corresponding exercise rehabilitation training(such as limb joint training,body transfer training,balance training and walking training)five days a week for 12 weeks.The obser-vation group received MOTOmed intelligent motion feedback training in addition to the training of the control group(upper/lower limb motor rehabilitation training with passive movement,assistive movement and active training modes),once a day,45 minutes a time,five days a week for 12 weeks.Before and after treatment,the National Institutes of Health stroke scale(NIHSS)score was used to evaluate the neurological deficits.Berg balance scale(BBS)was used to evaluate balance function.Fugl-Meyer assessment(FMA)scale was used to evaluate limb motor function;modified Barthel index(MBI)was used to evaluate activities of daily living.The world health organization quality of life-BREF(WHOQOL-BREF)scale was used to evaluate quality of life.Blood flow velocity changes of the middle cerebral artery(MCA)and anterior cerebral artery(ACA),levels of serum nerve growth factor(NGF)and brain-derived neurotrophic factor(BDNF)were compared.Results Compared with that before treatment,NIHSS score of the con-trol group and the observation group after treatment decreased significantly,while FMA score of the upper or lower limbs,BBS score,MBI score,WHOQOL-BREF score,MAC and ACA blood flow velocity and serum NGF and BDNF level increased signifi-cantly,and the differences were statistically significant(P<0.05).Compared with the control group,NIHSS score of the observation group after treatment was lower,while FMA score of the upper or lower limbs,BBS score,MBI score,WHOQOL-BREF score,MAC and ACA blood flow velocity and serum NGF and BDNF level were higher,and the differences were statistically significant(P<0.05).Conclusion MOTOmed intelligent motion feedback training combined with refined rehabilitation training can improve neurological function,balance function,limb motor function and quality of life of patients with hemiplegia after cerebral infarction,which is recommended for clinical application.

王斌;高松年;刘巧云;董新春

南通市第三人民医院,江苏 南通 226000江苏医药职业学院,江苏 盐城 224005

脑梗死偏瘫MOTOmed智能运动反馈训练精细化康复训练神经功能运动功能平衡功能生活质量

cerebral infarctionhemiplegiaMOTOmed intelligent motion feedback trainingrefined rehabilitation trainingneurological functionmotor functionbalance functionquality of life

《康复学报》 2024 (002)

117-123 / 7

江苏省基层卫生发展与全科医学教育研究中心项目(2022B02);南通市科技局指导性项目(MSZ20197)

10.3724/SP.J.1329.2024.02004

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