反复促进疗法对脑卒中恢复期偏瘫患者手功能的影响

doi:10.3969/j.issn.1006-9771.2023.06.010

Abstract

Abstract:

Objective To observe the effect of repetitive facilitative exercise (RFE) on the hand function of stroke patients with hemiplegia during recovery period.
Methods From January to December, 2022, 80 stroke patients with hemiplegia following hand dysfunction during recovery period in Beijing Bo'ai Hospital were randomly divided into control group (n = 40) and experimental group (n = 40). Both groups received routine rehabilitation, the control group added functional occupational therapy, and the experimental group added RFE, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Simple Test for Evaluating Hand Function (STEF) and modified Barthel Index (MBI) before and after treatment.
Results One case dropped down in the experimental group. After treatment, all the scores increased in both groups (|t| > 12.698, P < 0.001), and were better in the experimental group than in the control group (|t| > 2.302, P < 0.05).
Conclusion RFE could promote the recovery of hand function and activities of daily living in patients with hemiplegia during stroke recovery period.

Key words: stroke, hemiplegia, repetitive facilitative exercise, hand function

CLC Number:

R743.3

GU Bin, ZHANG Jinqin, XIA Yuanhao, HU Jingran, NAOKI Morohashi, HUANG Fubiao. Effect of repetitive facilitative exercise on hand function of stroke patients with hemiplegic during recovery period[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 697-702.

Figures/Tables 4

References 28

[1]	CHEN J, OR C K, CHEN T. Effectiveness of using virtual reality-supported exercise therapy for upper extremity motor rehabilitation in patients with stroke: systematic review and meta-analysis of randomized controlled trials[J]. J Med Internet Res, 2022, 24(6): e24111. doi: 10.2196/24111
[2]	GALEOTO G, IORI F, DESANTIS R, et al. The outcome measures for loss of functionality in the activities of daily living of adults after stroke: a systematic review[J]. Top Stroke Rehabil, 2019, 26(3): 236-245. doi: 10.1080/10749357.2019.1574060 pmid: 30774018
[3]	XING Y, YANG S D, DONG F, et al. The beneficial role of early exercise training following stroke and possible mechanisms[J]. Life Sci, 2018, 198: 32-37. doi: S0024-3205(18)30068-7 pmid: 29452165
[4]	王剑桥, 刘惠林. Bobath理念在卒中后偏瘫患者步态康复中的研究进展[J]. 中国康复理论与实践, 2019, 25(6): 683-685. doi: 10.3969/j.issn.1006-9771.2019.00.004
	WANG J Q, LIU H L. Bobath Concept in the process of gait rehabilitation for post-stroke patients with hemiplegia (review)[J]. Chin J Rehabil Theory Pract, 2019, 25(6): 683-685.
[5]	川平和美. 脳卒中リハビリテーションの革新を目指す促通反復療法(川平法)-患者に無駄をさせない神経路の再建強化を目指して[J]. 全日本鍼灸学会雑誌, 2013, 63(4): 244-251.
	KAWAHIRA K. Repetitive facilitative exercise (Kawahira's Methods) aiming at the innovation of stroke rehabilitation training aim at reconstructing and strengthening neural pathways[J]. Jpn J Acup Moxib, 2013, 63 (4): 244-251.
[6]	小川彰, 園田茂, 児玉三彦,他. 脳卒中治療ガイドライン2015[M]. 東京: 協和企画, 2015: 292-294.
	OGAWA A, SONODA S, KODAMA M, et al. Japanese Guidelines for the Management of Stroke 2015[M]. Tokyo: KYOWA KIKAKU, 2015: 292-294.
[7]	中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国各类主要脑血管病诊断要点2019[J]. 中华神经科杂志, 2019, 52(9): 710-715.
	Chinese Society of Neurology, Chinese Stroke Society. Diagnostic Criteria of Cerebrovascular Diseases in China (version 2019)[J]. Chin J Neurol, 2019, 52(9): 710-715.
[8]	AMANO S, UMEJI A, UCHITA A, et al. Clinimetric properties of the Fugl-Meyer Assessment with adapted guidelines for the assessment of arm function in hemiparetic patients after stroke[J]. Top Stroke Rehabil, 2018, 25(7): 500-508. doi: 10.1080/10749357.2018.1484987 pmid: 30028660
[9]	曹丽辉, 黄富表, 徐筱婧媛. 中国人简易上肢功能检查测试结果分析[J]. 中国康复理论与实践, 2021, 27(6): 730-736. doi: 10.3969/j.issn.1006-9771.2021.06.016
	CAO L H, HUANG F B, XU X J Y. Simple Test for Evaluating Hand Function for Chinese[J]. Chin J Rehabil Theory Pract, 2021, 27(6): 730-736.
[10]	王赛华, 施加加, 孙莹, 等. 简体版改良Barthel指数在脑卒中恢复期中的信度与效度研究[J]. 中国康复, 2020, 35(4): 179-182.
	WANG S H, SHI J J, SUN Y, et al. Reliability and validity of the simplified version modified Barthel Index in convalescence period of stroke[J]. Chin J Rehabil, 2020, 35(4): 179-182.
[11]	CONNELL L A, KLASSEN T K, JANSSEN J, et al. Delivering intensive rehabilitation in stroke: factors influencing implementation[J]. Phys Ther, 2018, 98(4): 243-250. doi: 10.1093/ptj/pzy018 pmid: 29415282
[12]	MURRELL J E, PISEGNA J L, JUCKETT L A. Implementation strategies and outcomes for occupational therapy in adult stroke rehabilitation: a scoping review[J]. Implement Sci, 2021, 16(1): 105. doi: 10.1186/s13012-021-01178-0 pmid: 34922568
[13]	ROLL S C, HARDISON M E. Effectiveness of occupational therapy interventions for adults with musculoskeletal conditions of the forearm, wrist, and hand: a systematic review[J]. Am J Occup Ther, 2017, 71(1): 7101180010p1-7101180010p12. doi: 10.5014/ajot.2017.023234
[14]	ETOH S, NOMA T, MIYATA R, et al. Effects of repetitive facilitative exercise on spasticity in the upper paretic limb after subacute stroke[J]. J Stroke Cerebrovasc Dis, 2018, 27(10): 2863-2868. doi: S1052-3057(18)30333-1 pmid: 30072181
[15]	OHNISHI H, MIYASAKA H, SHINDO N, et al. Effectiveness of repetitive facilitative exercise combined with electrical stimulation therapy to improve very severe paretic upper limbs in with stroke patients: a randomized controlled trial[J]. Occup Ther Int, 2022, 2022: 4847363.
[16]	ETOH S, NOMA T, TAKIYOSHI Y, et al. Effects of repetitive facilitative exercise with neuromuscular electrical stimulation, vibratory stimulation and repetitive transcranial magnetic stimulation of the hemiplegic hand in chronic stroke patients[J]. Int J Neurosci, 2016, 126(11): 1007-1012. doi: 10.3109/00207454.2015.1094473
[17]	SHIMODOZONO M, NOMA T, NOMOTO Y, et al. Benefits of a repetitive facilitative exercise program for the upper paretic extremity after subacute stroke: a randomized controlled trial[J]. Neurorehabil Neural Repair, 2013, 27(4): 296-305. doi: 10.1177/1545968312465896 pmid: 23213077
[18]	王晓光, 陶徉聿, 薛新宏, 等. 反复促通疗法对脑卒中合并高血压偏瘫患者手功能的影响[J]. 华北理工大学学报(医学版), 2022, 24(4): 296-300.
	WANG X G, TAO Y L, XUE X H, et al. Effect of repeated facilitation therapy on hand function in stroke patients with hypertensive hemiplegia[J]. J North China Univ Sci Technol (Health Sci Ed), 2022, 24(4): 296-300.
[19]	SHIMODOZONO M, NOMA T, MATSUMOTO S, et al. Repetitive facilitative exercise under continuous electrical stimulation for severe arm impairment after sub-acute stroke: a randomized controlled pilot study[J]. Brain Inj, 2014, 28(2): 203-210. doi: 10.3109/02699052.2013.860472 pmid: 24304090
[20]	庞争争, 计弯弯, 张环, 等. 重复经颅磁刺激联合反复促通疗法对脑卒中患者上肢运动功能康复的疗效观察[J]. 中国康复, 2022, 37(8): 464-467.
	PANG Z Z, JI W W, ZHANG H, et al. Effect of repeated transcranial magnetic stimulation combined with repeated facilitation therapy on the rehabilitation of upper limb motor function in stroke patients[J]. Chin J Rehabil, 2022, 37(8): 464-467.
[21]	ETOH S, KAWAMURA K, OMONAGA K, et al. Effects of concomitant neuromuscular electrical stimulation during repetitive transcranial magnetic stimulation before repetitive facilitation exercise on the hemiparetic hand[J]. NeuroRehabilitation, 2019, 45(3): 323-329. doi: 10.3233/NRE-192800 pmid: 31796693
[22]	陈忠强, 杨帆, 朱鑫鑫, 等. 反复促通技术联合针灸对脑梗死患者功能恢复及生存质量的影响分析[J]. 中国康复, 2022, 37(5): 276-278.
	CHEN Z Q, YANG F, ZHU X X, et al. Effect of repetitive facilitative exercise combined with acupuncture on functional recovery and quality of life in patients with cerebral infarction[J]. Chin J Rehabil, 2022, 37(8): 276-278.
[23]	KAWAHIRA K, SHIMODOZONO M, ETOH S, et al. Effects of intensive repetition of a new facilitation technique on motor functional recovery of the hemiplegic upper limb and hand[J]. Brain Inj, 2010, 24(10): 1202-1213. doi: 10.3109/02699052.2010.506855 pmid: 20715890
[24]	姜文, 郭川, 徐胜, 等. 反复促通疗法联合肌电反馈式助力电刺激对卒中偏瘫患者下肢运动功能障碍的效果研究[J]. 中国脑血管病杂志, 2022, 19(8): 548-553, 571.
	JIANG W, GUO C, XU S, et al. Effect of repetitive facilitative exercise combined with power-assisted electrical stimulation on the stroke patients with lower extremity motor dysfunction[J]. Chin J Cerebrovasc Dis, 2022, 19(8): 548-553, 571.
[25]	钮晟佳, 杨卫新, 张大伟, 等. 上肢机器人联合川平疗法对脑卒中患者上肢运动功能及日常生活活动能力的影响[J]. 中国康复医学杂志, 2021, 36(8): 1003-1005.
	NIU S J, YANG W X, ZHANG D W, et al. Effect of upper limb robot combined with repeated facilitation therapy on the rehabilitation of upper limb motor function and activities of daily living in stroke patients[J]. Chin J Rehabil Med, 2021, 36(8): 1003-1005.
[26]	RENNER C I, SCHUBERT M, HUMMELSHEIM H. Selective effect of repetitive hand movements on intracortical excitability[J]. Muscle Nerve, 2005, 31(3): 314-320. pmid: 15635691
[27]	RENNER C I, SCHUBERT M, JAHN M, et al. Intracortical excitability after repetitive hand movements is differentially affected in cortical versus subcortical strokes[J]. J Clin Neurophysiol, 2009, 26(5): 348-357. doi: 10.1097/WNP.0b013e3181baaa86 pmid: 20168132
[28]	HARRIS J E. Repetitive facilitative exercise improves upper limb function in patients with subacute stroke[J]. J Physiother, 2013, 59(3): 208. doi: 10.1016/S1836-9553(13)70186-3 pmid: 23896337

组别	n	性别(男/女)/n	年龄/岁	病程/月	卒中类型(出血/梗死)/n	病灶侧别(左/右)/n
对照组	40	26/14	46.83±7.58	2.50±0.85	9/31	23/17
试验组	39	23/16	48.28±7.28	2.38±0.88	11/28	25/14
χ²/t值		0.304	0.207	0.005	0.340	0.361
P值		0.581	0.651	0.946	0.560	0.548

组别	n	治疗前	治疗后	t值	P值
对照组	40	28.68±5.15	46.33±7.47	-12.776	< 0.001
试验组	39	27.72±4.89	50.13±7.20	-14.732	< 0.001
t值		0.847	-2.302
P值		0.400	0.024

组别	n	治疗前	治疗后	t值	P值
对照组	40	33.10±4.88	49.95±9.81	-12.698	< 0.001
试验组	39	32.87±5.20	59.93±10.83	-19.812	< 0.001
t值		0.201	-4.299
P值		0.841	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	40	50.25±7.42	65.63±6.52	-14.237	< 0.001
试验组	39	50.38±6.73	71.92±6.24	-17.260	< 0.001
t值		-0.084	-4.383
P值		0.933	< 0.001

Effect of repetitive facilitative exercise on hand function of stroke patients with hemiplegic during recovery period

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 4

References 28

Related Articles 15

Metrics

Comments

Recommended 0

[1]	LIN Na, GAO Hanlu, LU Huiping, CHEN Yanqing, ZHENG Junfan, CHEN Shurong. Effect of virtual reality on upper limb function after stroke: a study of diffusion tensor imaging [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 61-67.
[2]	WANG Haoyi, SHI Yawei, LU Jun, XU Guangxu. Impact of subjective vertical perception impairment on function in stroke patients: a retrospective study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 68-73.
[3]	CHEN Junwen, CHEN Qian, CHEN Cheng, LI Shuyue, LIU Lingling, WU Cunshu, GONG Xiang, LU Jun, XU Guangxu. Effect of modified Baduanjin exercise on cardiopulmonary function, motor function and activities of daily living for stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 74-80.
[4]	HU Yonglin, MA Ying, DOU Chao, LU Anmin, JIANG Xiaoge, SONG Xinjian, XIAO Yuhua. Effect of neural mobilization based on shoulder control training on shoulder pain and upper limb function in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 81-86.
[5]	WANG He, HAN Liang, KAN Mengfan, YU Shaohong. Efficacy of electrical stimulation on shoulder-hand syndrome after stroke: a systematic review and meta-analysis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1048-1056.
[6]	HU Xiaoshi, ZHANG Qi, YUE Qing, LIANG Yanhua, LI Xiaosong, FENG Amei, ZHANG Yanqing. Effect of orthopedic elastic bandages on gait symmetry and walking ability in children with spastic hemiplegic cerebral palsy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1083-1089.
[7]	SUN Tengfang, REN Mengting, YANG Lin, WANG Yaoting, WANG Hongyu, YAN Xingzhou. Effect of hyperbaric oxygen therapy combined with repetitive peripheral magnetic stimulation on ankle motor function and balance of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 875-881.
[8]	WANG Ya'nan, LIU Xihua. Correlation and predictive effect of subjective and objective balance function measurements in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 890-895.
[9]	WANG Haiyun, WANG Yin, ZHOU Xinjie, HE Aiqun. Effect of transcranial direct current stimulation combined with acupuncture on central and upper limb function in stroke patients based on central-peripheral-central theory [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 919-925.
[10]	CHEN Yiting, WANG Qian, CUI Shenhong, LI Yingcai, ZHANG Siyu, WEI Yanxu, REN Hui, LENG Jun, CHEN Bin. Effect of bilateral sequential repetitive transcranial magnetic stimulation on motor function of upper limbs in stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 926-932.
[11]	LI Zhenya, SUN Jie, GUO Pengfei, WANG Guangming. Correlation between changes of swallowing function in oral and pharyngeal phases, and aspiration in stroke patients based on videofluroscopic swallowing study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 933-939.
[12]	HUA Ling, ZHANG Yi'nan, ZHENG Yu, SUN Qiaoyi, FANG Hui, SONG Da. Effect of hand controlled rhythm music therapy on unilateral spatial neglect after stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 833-838.
[13]	JIANG Xiaocui, LIU Zhen, SU Qinglun, ZHAO Qin, XIA Xiaomei, LU Fei. Effect of intermittent theta burst transcranial magnetic stimulation on non-fluent aphasia after stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 839-843.
[14]	XU Miaomiao, LI Nan, YING Ying, YANG Kaixiang, YANG Jingrui, LI Jie, QIU Yanqun. Effect of repetitive peripheral magnetic stimulation on upper limb motor function of stroke patients after contralateral seventh cervical nerve transfer [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 686-690.
[15]	ZHENG Li, BAO Zhicheng, ZHANG Qi, REN Xuyan, SU Min. Effect of transcutaneous auricular vagus nerve stimulation combined with robot-assisted therapy on upper limb function of stroke patients [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 691-696.