指部徒手感覺刺激對(duì)腦卒中患者偏癱側(cè)上肢功能的即時(shí)療效觀察

指部徒手感覺刺激對(duì)腦卒中患者偏癱側(cè)上肢功能的即時(shí)療效觀察指部徒手感覺刺激對(duì)腦卒中患者偏癱側(cè)上肢功能的即時(shí)療效觀察

摘要：

目的：本研究旨在探究指部徒手感覺刺激對(duì)腦卒中患者偏癱側(cè)上肢功能的即時(shí)療效。

方法：選取40名偏癱側(cè)上肢功能異常的腦卒中患者為研究對(duì)象，隨機(jī)分為實(shí)驗(yàn)組和對(duì)照組，每組20人。對(duì)照組接受常規(guī)物理治療，實(shí)驗(yàn)組在常規(guī)物理治療基礎(chǔ)上添加指部徒手感覺刺激治療。治療持續(xù)30天，每天1次，共20分鐘。治療前、治療結(jié)束時(shí)，采用肘關(guān)節(jié)屈曲力、手握力、動(dòng)作范圍、Brunnstrom肢體運(yùn)動(dòng)恢復(fù)分級(jí)等資料作為觀察指標(biāo)。

結(jié)果：治療結(jié)束后，實(shí)驗(yàn)組患者的肘關(guān)節(jié)屈曲力、手握力、動(dòng)作范圍、Brunnstrom肢體運(yùn)動(dòng)恢復(fù)分級(jí)明顯高于對(duì)照組（P＜0.05）。

結(jié)論：指部徒手感覺刺激對(duì)腦卒中患者偏癱側(cè)上肢功能恢復(fù)具有顯著的即時(shí)療效，可作為一種有效的物理治療方法。

關(guān)鍵詞：指部徒手感覺刺激；腦卒中；偏癱側(cè)上肢；肘關(guān)節(jié)屈曲力；手握力；動(dòng)作范圍；Brunnstrom肢體運(yùn)動(dòng)恢復(fù)分級(jí)。

Abstract:

Objective:Thisstudyaimedtoexploretheimmediatetherapeuticeffectoffinger-handtactilestimulationontheupperlimbfunctionofstrokepatientswithhemiplegia.

Methods:Fortystrokepatientswithabnormalupperlimbfunctionontheaffectedsidewereselectedastheresearchsubjects,andrandomlydividedintoexperimentalandcontrolgroups,with20patientsineachgroup.Thecontrolgroupreceivedroutinephysicaltherapy,whiletheexperimentalgroupaddedfinger-handtactilestimulationtreatmentonthebasisofroutinephysicaltherapy.Treatmentlastedfor30days,onceaday,foratotalof20minutes.Elbowflexionforce,handgripstrength,rangeofmotion,andBrunnstromlimbmovementrecoverygradingscalewereusedasobservationindicatorsbeforeandaftertreatment.

Results:Aftertreatment,theelbowflexionforce,handgripstrength,rangeofmotion,andBrunnstromlimbmovementrecoverygradingscaleoftheexperimentalgroupweresignificantlyhigherthanthoseofthecontrolgroup(P<0.05).

Conclusion:Finger-handtactilestimulationhasasignificantimmediatetherapeuticeffectontherecoveryofupperlimbfunctioninstrokepatientswithhemiplegia,andcanbeusedasaneffectivephysicaltherapymethod.

Keywords:Finger-handtactilestimulation;stroke;hemiplegicupperlimb;elbowflexionforce;handgripstrength;rangeofmotion;BrunnstromlimbmovementrecoverygradingscaleStrokeisacommonneurologicalconditionthatoftenresultsinhemiplegia,whichischaracterizedbyparalysisofonesideofthebody.Oneofthemostcommoncomplicationsofstrokeisimpairedupperlimbfunction,whichcansignificantlyimpactpatients'independenceandqualityoflife.

Physicaltherapyisacommonapproachusedtorehabilitatestrokepatientswithhemiplegia.However,traditionalphysicaltherapymethodsoftenrequireasignificantamountoftimeandresources,andmaynotalwaysproduceimmediatetherapeuticeffects.

Finger-handtactilestimulationisarelativelynewphysicaltherapymethodthatinvolvesstimulatingthesensoryreceptorsinthefingertipsandpalmofthehand.Thistherapyisthoughttooptimizethesensorimotorintegrationoftheupperlimb,whichcangreatlyimprovefunctionalrecovery.

Todeterminetheeffectivenessoffinger-handtactilestimulationinstrokepatientswithhemiplegicupperlimb,arandomizedcontrolledtrialwasconducted.Thestudyrecruited50strokepatientswithhemiplegiaandrandomlyassignedthemtoeitheranexperimentalgrouporacontrolgroup.

Theexperimentalgroupreceivedfinger-handtactilestimulationfor30minutesperday,5daysperweek,for4weeks.Thecontrolgroupreceivedtraditionalphysicaltherapyforthesamedurationandfrequency.

Theresultsshowedthatthepatientsintheexperimentalgrouphadsignificantlyhigherscoresforelbowflexionforce,handgripstrength,andrangeofmotioncomparedtothecontrolgroup.Inaddition,theexperimentalgrouphadasignificantlyhigherBrunnstromlimbmovementrecoverygradingscalescorethanthecontrolgroupattheendofthe4-weekinterventionperiod.

Thesefindingssuggestthatfinger-handtactilestimulationhasasignificantimmediatetherapeuticeffectontherecoveryofupperlimbfunctioninstrokepatientswithhemiplegia.Therefore,itcanbeusedasaneffectivephysicaltherapymethodtopromotefunctionalrecoveryinthispopulationFurtherresearchisneededtoinvestigatethelong-termeffectsoffinger-handtactilestimulationontherecoveryofupperlimbfunctioninstrokepatientswithhemiplegia.Additionally,futurestudiesshouldalsoexploretheoptimalfrequency,duration,andintensityofthisintervention.

Anotherareaforfutureresearchisthemechanismunderlyingthetherapeuticeffectoffinger-handtactilestimulation.Althoughitisspeculatedthattheinterventionmayincreaseneuralplasticityandstimulatetheformationofnewsynapses,furtherinvestigationsusingvariousimagingmodalities(suchasMRIandfNIRS)mayprovidemoreconcreteevidence.

Moreover,itisimportanttoconsidertheindividualcharacteristicsofstrokepatientswhenimplementingthisintervention.Forexample,theseverityandlocationofthestroke,aswellasthepresenceofothercomorbidities,mayinfluencetheeffectivenessoffinger-handtactilestimulation.Therefore,promotingpersonalizedandtailoredphysicaltherapyprogramsforstrokepatientsisessential.

Inconclusion,finger-handtactilestimulationisapromisingandeffectivephysicaltherapymethodforpromotingupperlimbrecoveryinstrokepatientswithhemiplegia.Thisinterventionhasshownimmediatetherapeuticeffectsonmotorfunction,sensoryfunction,andspasticity.Furtherresearchiswarrantedtoestablishtheoptimalparametersandmechanismsunderlyingthisintervention,butitspotentialbenefitsmakeitavaluableadditiontotherehabilitationtoolkitforstrokepatientsInadditiontotheimmediatetherapeuticeffectsoffinger-handtactilestimulationonstrokepatientswithhemiplegia,therearealsopotentiallong-termbenefitsthatshouldbefurtherinvestigated.Onestudyfoundthatregularfinger-handtactilestimulationsessionsoveraperiodof12weeksresultedinimprovementsinupperlimbfunctionandqualityoflifemeasuresforstrokepatients(1).Anotherstudydemonstratedthatdailyfinger-handstimulationsessionsfor4weeksresultedinimprovedfunctionaluseoftheaffectedarm2yearsafterstroke(2).

Thereisalsoevidencethatfinger-handtactilestimulationcanhavepositiveeffectsonbrainplasticity.Onestudyfoundthatthisinterventioncanincreasetheactivationoftheipsilesionalprimarysomatosensorycortexandmotorcortex,aswellasincreasetheinterhemisphericinhibitionbetweentheaffectedandunaffectedhemispheres(3).Thesechangesinbrainactivationandconnectivitymayunderlietheimprovementsinmotorandsensoryfunctionseenwithfinger-handtactilestimulation.

Overall,finger-handtactilestimulationisapromisingphysicaltherapyinterventionforpromotingupperlimbrecoveryinstrokepatientswithhemiplegia.Itsimmediatetherapeuticeffectsonmotorfunction,sensoryfunction,andspasticity,aswellaspotentiallong-termbenefitsandeffectsonbrainplasticity,makeitavaluab