《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (6): 703-707.doi: 10.3969/j.issn.1006-9771.2023.06.011
收稿日期:
2023-02-03
修回日期:
2023-05-31
出版日期:
2023-06-25
发布日期:
2023-07-14
通讯作者:
孙新亭,E-mail: 作者简介:
张倩(1985-),女,汉族,北京市人,硕士,主管治疗师,主要研究方向:神经康复。
ZHANG Qian1,2, SUN Xinting1,2()
Received:
2023-02-03
Revised:
2023-05-31
Published:
2023-06-25
Online:
2023-07-14
Contact:
E-mail: 摘要:
目的 观察视频镜像训练对脑卒中恢复期患者下肢运动功能、步行能力和平衡的效果。
方法 2022年1月至10月,北京博爱医院43例脑卒中恢复期患者随机分为对照组(n = 22)和镜像组(n = 21)。两组均接受常规康复训练,镜像组另外增加视频镜像训练,共4周。治疗前后采用Fugl-Meyer评定量表下肢部分(FMA-LE)、功能性步行分级(FAC)和Berg平衡量表(BBS)进行评定。
结果 治疗后,两组FMA-LE、FAC和BBS评分均显著改善(|t| > 6.205, P < 0.001),且镜像组FMA-LE和BBS评分优于对照组(|t| > 2.164, P < 0.05)。
结论 结合视频镜像训练更有利于改善脑卒中恢复期患者下肢运动功能和平衡能力。
中图分类号:
张倩, 孙新亭. 视频镜像训练对脑卒中恢复期患者下肢功能的效果[J]. 《中国康复理论与实践》, 2023, 29(6): 703-707.
ZHANG Qian, SUN Xinting. Effect of video-based mirror therapy on lower limb motor function of stroke patients at recovery stage[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 703-707.
[1] |
GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet Neurol, 2021, 20(10): 795-820.
doi: 10.1016/S1474-4422(21)00252-0 pmid: 34487721 |
[2] |
GBD 2016 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016[J]. Lancet, 2017, 390(10100): 1260-1344.
doi: S0140-6736(17)32130-X pmid: 28919118 |
[3] |
GRAU-PELLICER M, CHAMARRO-LUSAR A, MEDINA-CASANOVAS J, et al. Walking speed as a predictor of community mobility and quality of life after stroke[J]. Top Stroke Rehabil, 2019, 26(5): 349-358.
doi: 10.1080/10749357.2019.1605751 |
[4] |
MINET L R, PETERSON E, VON KOCH L, et al. Occurrence and predictors of falls in people with stroke: six-year prospective study[J]. Stroke, 2015, 46(9): 2688-2690.
doi: 10.1161/STROKEAHA.115.010496 pmid: 26243230 |
[5] |
SELVES C, STOQUART G, LEJEUNE T. Gait rehabilitation after stroke: review of the evidence of predictors, clinical outcomes and timing for interventions[J]. Acta Neurol Belg, 2020, 120(4): 783-790.
doi: 10.1007/s13760-020-01320-7 pmid: 32166723 |
[6] |
DI PELLEGRINO G, FADIGA L, FOGASSI L, et al. Understanding motor events: a neurophysiological study[J]. Exp Brain Res, 1992, 91(1): 176-180.
doi: 10.1007/BF00230027 pmid: 1301372 |
[7] |
RAMACHANDRAN V S, ROGERS-RAMACHANDRAN D, COBB S. Touching the phantom limb[J]. Nature, 1995, 377(6549): 489-490.
doi: 10.1038/377489a0 |
[8] | RYAN D, FULLEN B, RIO E, et al. Effect of action observation therapy in the rehabilitation of neurologic and musculoskeletal conditions: a systematic review[J]. Arch Rehabil Res Clin Transl, 2021, 3(1): 100106. |
[9] |
凌晴, 胡世红, 王田尧, 等. 镜像疗法促进脑卒中上肢功能恢复和皮质脊髓束重塑的弥散张量成像研究[J]. 中国康复理论与实践, 2021, 27(1): 31-36.
doi: 10.3969/j.issn.1006-9771.2021.01.004 |
LING Q, HU S H, WANG T Y, et al. Effects of mirror therapy on upper limb motor function and corticospinal tract remodeling after stroke: a diffusion tensor imaging study[J]. Chin J Rehabil Theory Pract, 2021, 27(1): 31-36. | |
[10] | THIEME H, MORKISCH N, MEHRHOLZ J, et al. Mirror therapy for improving motor function after stroke[J]. Cochrane Database Syst Rev, 2018, 7: D8449. |
[11] |
BRODERICK P, HORGAN F, BLAKE C, et al. Mirror therapy for improving lower limb motor function and mobility after stroke: a systematic review and meta-analysis[J]. Gait Posture, 2018, 63: 208-220.
doi: S0966-6362(18)30555-1 pmid: 29775908 |
[12] |
SUTBEYAZ S, YAVUZER G, SEZER N, et al. Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial[J]. Arch Phys Med Rehabil, 2007, 88(5): 555-559.
doi: 10.1016/j.apmr.2007.02.034 |
[13] |
JO S, KIM H, SONG C. A novel approach to increase attention during mirror therapy among stroke patients: a video-based behavioral analysis[J]. Brain Sci, 2022, 12(3): 297.
doi: 10.3390/brainsci12030297 |
[14] | 中华神经外科学会, 中华神经科学会. 各类脑血管病诊断要点[J]. 中华神经科杂志, 1996, 29(6): 379-380. |
[15] |
PANDIAN S, ARYA K N, KUMAR D. Minimal clinically important difference of the lower-extremity Fugl-Meyer Assessment in chronic-stroke[J]. Top Stroke Rehabil, 2016, 23(4): 233-239.
doi: 10.1179/1945511915Y.0000000003 pmid: 27086865 |
[16] |
MEHRHOLZ J, WAGNER K, RUTTE K, et al. Predictive validity and responsiveness of the Functional Ambulation Category in hemiparetic patients after stroke[J]. Arch Phys Med Rehabil, 2007, 88(10): 1314-1319.
doi: 10.1016/j.apmr.2007.06.764 |
[17] | MIYATA K, TAMURA S, KOBAYASHI S, et al. Berg Balance Scale is a valid measure for plan interventions and for assessing changes in postural balance in patients with stroke[J]. J Rehabil Med, 2022, 54: m359. |
[18] |
FINK G R. Functional MR imaging: from the BOLD effect to higher motor cognition[J]. Suppl Clin Neurophysiol, 2004, 57: 458-468.
pmid: 16106646 |
[19] | KANDEL E R, KOESTER J D, MACK S H, et al. Principles of neural science[M]. New York: McGraw Hill, 2021. |
[20] |
GUGGISBERG A G, KOCH P J, HUMMEL F C, et al. Brain networks and their relevance for stroke rehabilitation[J]. Clin Neurophysiol, 2019, 130(7): 1098-1124.
doi: S1388-2457(19)30127-0 pmid: 31082786 |
[21] |
RIZZOLATTI G, CATTANEO L, FABBRI-DESTRO M, et al. Cortical mechanisms underlying the organization of goal-directed actions and mirror neuron-based action understanding[J]. Physiol Rev, 2014, 94(2): 655-706.
doi: 10.1152/physrev.00009.2013 pmid: 24692357 |
[22] |
NUMATA K, MURAYAMA T, TAKASUGI J, et al. Mirror observation of finger action enhances activity in anterior intraparietal sulcus: a functional magnetic resonance imaging study[J]. J Jpn Phys Ther Assoc, 2013, 16(1): 1-6.
doi: 10.1298/jjpta.Vol16_001 |
[23] |
GEIGER A, BENTE G, LAMMERS S, et al. Distinct functional roles of the mirror neuron system and the mentalizing system[J]. Neuroimage, 2019, 202: 116102.
doi: 10.1016/j.neuroimage.2019.116102 |
[24] |
CASPERS S, ZILLES K, LAIRD A R, et al. ALE meta-analysis of action observation and imitation in the human brain[J]. Neuroimage, 2010, 50(3): 1148-1167.
doi: 10.1016/j.neuroimage.2009.12.112 pmid: 20056149 |
[25] |
COOK R, BIRD G, CATMUR C, et al. Mirror neurons: from origin to function[J]. Behav Brain Sci, 2014, 37(2): 177-192.
doi: 10.1017/S0140525X13000903 pmid: 24775147 |
[26] | BORGES L R, FERNANDES A B, OLIVEIRA D P J, et al. Action observation for upper limb rehabilitation after stroke[J]. Cochrane Database Syst Rev, 2022, 8(8): D11887. |
[27] |
MACINTYRE T E, MADAN C R, MORAN A P, et al. Motor imagery, performance and motor rehabilitation[J]. Prog Brain Res, 2018, 240: 141-159.
doi: S0079-6123(18)30116-X pmid: 30390828 |
[28] |
DECONINCK F J, SMORENBURG A R, BENHAM A, et al. Reflections on mirror therapy: a systematic review of the effect of mirror visual feedback on the brain[J]. Neurorehabil Neural Repair, 2015, 29(4): 349-361.
doi: 10.1177/1545968314546134 pmid: 25160567 |
[29] |
LEE H J, KIM Y M, LEE D K. The effects of action observation training and mirror therapy on gait and balance in stroke patients[J]. J Phys Ther Sci, 2017, 29(3): 523-526.
doi: 10.1589/jpts.29.523 pmid: 28356646 |
[30] | IKIZLER M H, OZDOLAP S, MENGI A, et al. The effect of mirror therapy on lower extremity motor function and ambulation in post-stroke patients: a prospective, randomized-controlled study[J]. Turk J Phys Med Rehabil, 2020, 66(2): 154-160. |
[31] |
GANDHI D B, STERBA A, KHATTER H, et al. Mirror therapy in stroke rehabilitation: current perspectives[J]. Ther Clin Risk Manag, 2020, 16: 75-85.
doi: 10.2147/TCRM |
[32] |
庄金阳, 贾杰. 镜像疗法在脑卒中后下肢运动功能康复中的应用进展[J]. 中国康复理论与实践, 2018, 24(9): 1048-1051.
doi: 10.3969/j.issn.1006-9771.2018.09.011 |
ZHUANG J Y, JIA J. Application of mirror therapy in rehabilitation for lower extremities motor function after stroke (review)[J]. Chin J Rehabil Theory Pract, 2018, 24(9): 1048-1051. | |
[33] |
HARMSEN W J, BUSSMANN J B, SELLES R W, et al. A mirror therapy-based action observation protocol to improve motor learning after stroke[J]. Neurorehabil Neural Repair, 2015, 29(6): 509-516.
doi: 10.1177/1545968314558598 pmid: 25416737 |
[34] |
IN T, LEE K, SONG C. Virtual reality reflection therapy improves balance and gait in patients with chronic stroke: randomized controlled trials[J]. Med Sci Monit, 2016, 22: 4046-4053.
doi: 10.12659/MSM.898157 |
[35] |
KEMMERER D. What modulates the Mirror Neuron System during action observation?: Multiple factors involving the action, the actor, the observer, the relationship between actor and observer, and the context[J]. Prog Neurobiol, 2021, 205: 102128.
doi: 10.1016/j.pneurobio.2021.102128 |
[36] |
HIYAMIZU M, MAEOKA H, MATSUO A, et al. Effects of self-action observation on standing balance learning: a change of brain activity detected using functional near-infrared spectroscopy[J]. NeuroRehabilitation, 2014, 35(3): 579-585.
doi: 10.3233/NRE-141153 pmid: 25248448 |
[37] |
吴静华, 吴菊芬, 匡丹, 等. 镜像疗法对脑卒中患者下肢运动、平衡功能和步行能力效果的Meta分析[J]. 中国康复理论与实践, 2020, 26(9): 1015-1023.
doi: 10.3969/j.issn.1006-9771.2020.09.004 |
WU J H, WU J F, KUANG D, et al. Effects of mirror therapy on lower-limb motor, balance and walking after stroke: a meta-analysis[J]. Chin J Rehabil Theory Pract, 2020, 26(9): 1015-1023. | |
[38] | CROSBY L D, MARROCCO S, BROWN J, et al. A novel bilateral lower extremity mirror therapy intervention for individuals with stroke[J]. Heliyon, 2016, 2(12): e208. |
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