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上肢力量训练对脑卒中患者上肢及手指功能恢复和卒中后抑郁的影响

Effect of strengthen training of upper-limb on the rehabilitation of upper-limb and fingers function and post stroke depression in stroke patients

  • 摘要: 目的:观察脑卒中患者上肢力量训练对上肢及手指功能恢复的影响,并评价其对脑卒中后抑郁缓解的效果。方法:选取2017年1月至2017年5月于同济大学医学院附属第十人民医院收治的首次发病脑卒中合并偏瘫患者100例作为研究对象。患者随机分为2组(n=50):对照组给予常规康复治疗,卒中后抑郁患者加用盐酸帕罗西汀治疗;训练组在常规康复治疗的基础上,给予力量训练,卒中后抑郁患者加用盐酸帕罗西汀治疗。所有患者在治疗前、治疗后6个月均采用Fugl-Meyer量表(FMA)、Barthel指数(BI)和美国国立卫生研究院脑卒中量表(NIHSS)进行评定;卒中后抑郁患者采用汉密顿抑郁量表(HAMD)进行抑郁程度评价。结果:治疗6个月后,训练组患者FMA、FMA(上肢)、FMA(手指)和NIHSS评分均高于对照组,差异有统计学意义(P<0.05);两组间Barthel指数差异无统计学意义。两组卒中后抑郁患者治疗6个月后,训练组患者HAMD评分优于对照组(P<0.05)。结论:脑卒中患者上肢力量训练能改善上肢及手指功能,有效提高患者生活质量,且有助于缓解卒中后抑郁。

     

    Abstract: Objective:To observe the influence of strengthen training of upper-limb on the rehabilitation of upper-limb and fingers function in stroke patients and evaluate the effect of this training on post stroke depression. Methods:One hundred patients at the first onset of stoke and hemiplegia in our hospital from January 2017 to May 2017 were recruited. They were randomly divided into the train group (n=50) and control group (n=50). The control group were treated with conventional rehabilitation therapy only. The train group were treated with conventional therapy and strengthen training. They were assessed with Fugl-Meyer Assessment (FMA), Barthel Index (BI), and NIHSS before and after treatment. Patients with post stroke depression in both groups received paroxetine hydrochloride treatment. In addition, the train group received strengthen training. They were evaluated with HAMD before and after treatment. Results:Six months after the treatment, the scores of FMA, FMA of upper-limb, FMA of fingers, and NIHSS were higher in the train group than those in the control group, and the differences were statistically significant (P<0.05).There was no significant difference in the scores of BI between the two groups. Six months after the treatment, the HAMD scores of both groups decreased significantly, and the train group scored better than the control group with significant difference (P<0.05). Conclusions:For patients with stoke and hemiplegia, strengthen training of upper-limb can improve the function of the upper-limb and the fingers, which is important to improve patients’ quality of life. It can also relieve patients’ degree of depression.

     

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