多元化手功能锻炼在脑梗死手部功能障碍患者中的应用效果研究

Effect of multi-functional hand exercise on patients with hand dysfunction after cerebral infarction

摘要:

目的 探讨多元化手功能锻炼在脑梗死手部功能障碍患者中的应用效果。方法 采用简单随机抽样将患者分为对照组和试验组，选取2020年8月至2021年10月在院96例脑梗死伴手功能障碍患者进行对照研究。2组患者均给予脑梗死临床路径常规治疗护理及康复训练。试验组基于此予以多元化手部功能锻炼，分别干预1个月、3个月后到门诊复查，釆用美国Carroll博士研究上肢功能测试（upper extremity function test，UEFT）进行手功能评定，采用徒手肌力检查（manual muscle test，MMT）评定手部肌力康复效果，使用改良Ashworth痉挛量表（modified Ashworth scale，MAS）评估偏瘫侧手部痉挛。结果 试验组在分别干预1个月、3个月时，UEFT评分（59.830±4.133、76.830±4.450）高于对照组（56.630±5.587、65.580±4.997），手部肌力恢复明显优于对照组，差异均有统计学意义（均P<0.05）；手部MAS肌张力分级与对照组相比，干预1个月时，2组差异无统计学意义，但干预3个月后，试验组手部痉挛发生率下降明显，MAS肌张力分级明显低于对照组。结论 多元化手功能锻炼实现了脑梗死患者手部的康复从肌力M0~M5循序渐进的持续锻炼，预防挛缩，大大加快了患者手部功能的康复进程，降低了患者手部致残率，减轻了患者痛苦，可广泛应用于临床。

Abstract:

Objective To explore the application effect of multi-functional hand exercise on patients with hand dysfunction after cerebral infarction.Methods Patients were divided into control group and intervention group by simple random sampling，and 96 patients with cerebral infarction accompanied by hand dysfunction in hospital from August 2020 to October 2021 were selected for controlled trial study. Both groups were given routine treatment nursing and rehabilitation training in clinical pathway of cerebral infarction. Based on this，the intervention group were additionally given diversified hand function exercises. At the first and third month of intervention，the intervention group went to the outpatient department for re-examination，respectively. Hand function of the objects was assessed by upper extremity function test（UEFT） proposed by Dr. Carroll，America，and the effect of hand muscle strength rehabilitation was evaluated by manual muscle testing（MMT）. Hemiplegic hand spasm was assessed using the modified Ashworth scale（MAS）.Results After 1 and 3 months of intervention，the UEFT scores of the intervention group（59.830±4.133 and 76.830±4.450）were higher than those of the conventional group（56.630±5.587 and 65.580±4.997），and the hand muscle strength recovery was significantly better than that of the conventional group，with statistically significant differences（all P<0.05）. Compared with the conventional group，there was no statistically significant difference in the MAS muscle tension of the two groups after 1 month of intervention，but after 3 months of intervention，the incidence of hand spasm decreased significantly in the intervention group，and the MAS muscle tension was significantly lower than that in the conventional group.Conclusion Diversified hand function exercise can realize the hand rehabilitation of cerebral infarction from muscle strength level M0 to level M5 continuous exercise step by step，prevent contracture，greatly accelerate the rehabilitation process of patients' hand function，reduce the hand disability rate of patients，relieve the pain of patients，and can be widely used in clinical practice.