Objective: To evaluate the effectiveness of rehabilitation with movement imagery therapy under the guidance of mirror training on upper limb function and viability of hemiplegic patients after acute ischemic stroke .Methods: Seventy-six hemiplegic patients after acute ischemic stroke eligible for the case inclusion criteria were included in this study from January 1st, 2014 to June 30th, 2016. They were randomly divided into two groups: group of movement imagery therapy under the guidance of mirror training (n = 38) and the group of movement imagery therapy alone (n = 38); based on the routine rehabilitation, the patients in these two groups were received movement imagery therapy under the guidance of mirror training and the movement imagery therapy alone for 4 weeks, respectively. The National Institute of Health Stroke Scale (NIHSS) score, Barthel index, Action Research Arm Test (ARAT) score and Fugl-Meyer upper limb motor function score were evaluated before rehabilitation and after 4-week rehabilitation, and were compared between the two groups.Results: The NIHSS score, Barthel index, ARAT score and Fugl-Meyer upper limb motor function score of two groups were significantly improved after 4-week rehabilitation as compared with those before rehabilitation (all P < 0.05). After rehabilitation, these measurements were improved more obviously in the group of movement imagery therapy under the guidance of mirror training as compared with those in the group of movement imagery therapy alone (all P < 0.05).Conclusion: Rehabilitation with movement imagery therapy under the guidance of mirror training can better improve the upper limb function and daily living ability of hemiplegic patients after acute ischemic stroke.
Key words
Stroke /
Mirror therapy /
Rehabilitation /
Movement imagery /
Upper limb function
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References
[1] 吴兆苏, 姚崇华, 赵冬. 我国人群脑卒中的发病率、死亡率的流行病学研究[J]. 中国流行病学杂志, 2003, 24(3):236-239.
[2] OSTWALD S K, DAVIS S, HERSCH G, et al.Evidence-based educational guidelines for stroke survivors after discharge home[J]. J Neurosci Nurs, 2008, 40(3):173-179, 191.
[3] 中华医学会神经学分会神经康复学组, 中华医学会神经病学分会脑血管病学组, 卫生部脑卒中筛查与防治工程委员会办公室. 中国脑卒中康复治疗指南(2011版)[J]. 中国医学前沿杂志, 2012, 4(6):55-76.
[4] 中华医学会神经内科分会脑血管病学组急性缺血性脑卒中诊治指南撰写组. 中国急性缺血性脑卒中诊治指南2010[J]. 中华神经内科杂志, 2010, 43(2):1-8.
[5] SHARMA N, POMEROY V M, BARON J C.Motor imagery: a backdoor to the motor system after stroke?[J]. Stroke, 2006, 37(7):1941-1952.
[6] ISMAIL M M, GAMALELDEIN M H, HASSA K A.Closed kinetic chain exercises with or without additional hip strengthening exercises in management of patellofemoral pain syndrome: a randomized controlled trial[J]. Eur J Phys Rehabil Med, 2013, 49(5):687-698.
[7] DECETY J, JEANNEROD M, PRABLANC C.The timing of mentally represented actions[J]. Behav Brain Res, 1989, 34(1-2):35-42.
[8] PAGE S J, LEVINE P, LEONARD A C.Effects of mental practice on affected limb use and function in chronic stroke[J]. Arch Phys Med Rehabil, 2005, 86(3):399-402.
[9] 王朴, 郭毅, 张君梅, 等. 运动想象疗法对脑卒中后患者上肢运动动能康复效果的系统评价[J]. 中国循证医学杂志, 2011, 11(5):529-539.
[10] 岳雨珊, 黄杰, 谢斌, 等. 镜像疗法改善脑卒中患者上肢功能障碍的评价[J]. 中华物理医学与康复杂志, 2013, 35(2):97-105.
[11] 王维, 马跃文, 杨巍. 镜像疗法对脑卒中患者上肢功能和手功能的影响[J]. 大连医科大学学报, 2013, 35(6):600-602.
[12] RAMACHANDRAN V S, ROGERS-RAMACHANDRAN D.Synaesthesia in phantom limbs induced with mirrors[J]. Proc Biol Sci, 1996, 263(1369):377-386.
[13] SHINOURA N, SUZUKI Y, WATANABE Y, et al.Mirror therapy activates outside of cerebellum and ipsilateral M1[J]. NeuroRehabilitation, 2008, 23(3):245-252.
[14] LACROIX S, HAVTON LA, MCKAY H, et al.Bilateral corticospinal projections arise from each motor cortex in the macaque monkey: a quantitative study[J]. J Comp Neurol, 2004, 473(2):147-161.
[15] STINEAR J W, BYBLOW W D.Disinhibition in the human motor cortex is enhanced by synchronous upper limb movements[J]. J Physiol, 2002, 543(Pt 1):307-316.
[16] SALE P, FRANCESCHINI M.Action observation and mirror neuron network: a tool for motor stroke rehabilitation[J]. Eur J Phys Rehabil Med, 2012, 48(2):313-318
[17] LEE M M, CHO H Y, SONG C H.The mirror therapy program enhances upper-limb motor recovery and motor function in acute stroke patients[J]. Am J Phys Med Rehabil, 2012, 91(8):689-696
[18] ERTELT D, HEMMELMANN C, DETTMERS C, et al.Observation and execution of upper-limb movements as a tool for rehabilitation of motor deficits in paretic stroke patients: protocol of a randomized clinical trial[J]. BMC Neurol, 2012, 12:42.
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