切换至 "中华医学电子期刊资源库"

中华脑科疾病与康复杂志(电子版) ›› 2026, Vol. 16 ›› Issue (01) : 34 -39. doi: 10.3877/cma.j.issn.2095-123X.2026.01.005

临床研究

运动想象训练联合任务导向训练对脑卒中偏瘫患者下肢功能的影响
余程冬(), 许方军, 潘升超, 刘云卫, 秦成义, 金彪   
  1. 230000 合肥市第二人民医院康复医学科
  • 收稿日期:2025-03-23 出版日期:2026-02-15
  • 通信作者: 余程冬

Effect of motor imagery training combined with task-oriented training on lower limb function of stroke patients

Chengdong Yu(), Fangjun Xu, Shengchao Pan, Yunwei Liu, Chengyi Qin, Biao Jin   

  1. Department of Rehabilitation Medicine, the Second People's Hospital of Hefei, Hefei 230000, China
  • Received:2025-03-23 Published:2026-02-15
  • Corresponding author: Chengdong Yu
引用本文:

余程冬, 许方军, 潘升超, 刘云卫, 秦成义, 金彪. 运动想象训练联合任务导向训练对脑卒中偏瘫患者下肢功能的影响[J/OL]. 中华脑科疾病与康复杂志(电子版), 2026, 16(01): 34-39.

Chengdong Yu, Fangjun Xu, Shengchao Pan, Yunwei Liu, Chengyi Qin, Biao Jin. Effect of motor imagery training combined with task-oriented training on lower limb function of stroke patients[J/OL]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2026, 16(01): 34-39.

目的

探讨运动想象训练(MIT)联合任务导向训练(TOT)对脑卒中偏瘫患者下肢功能的影响。

方法

选取合肥市第二人民医院康复科自2024年1月至2025年1月收治的93例脑卒中偏瘫患者为研究对象,按照随机数字表法分为对照组(31例)、MIT组(31例)和联合组(31例)。3组患者均接受常规康复治疗,对照组在此基础上进行30 min的健侧下肢训练,MIT组增加MIT,联合组联合实施MIT与TOT。所有干预持续4周,分别于治疗前及干预4周后采用Fugl-Meyer量表下肢部分(FMA-LE)、Berg平衡量表(BBS)、Tinetti步态评估量表(TGA)及改良Barthel指数(MBI)评估患者的下肢运动功能、平衡功能、步态功能及日常生活活动能力。

结果

干预4周后,3组患者的FMA-LE、BBS、TGA及MBI评分均较本组治疗前显著提升,且联合组患者的FMA-LE评分[(23.45±3.11)分]、BBS评分[(44.13±5.28)分]、TGA评分[(9.29±1.53)分]及MBI评分[(73.61±9.27)分]均显著优于对照组与MIT组,差异均有统计学意义(P<0.05)。

结论

MIT联合TOT可有效改善脑卒中偏瘫患者的下肢功能。

Objective

To explore the effect of motor imagery training (MIT) combined with task-oriented training (TOT) on lower limb function in patients with hemiplegia after stroke.

Methods

A total of 93 stroke patients with hemiplegia admitted to the Rehabilitation Department of Hefei Second People's Hospital from January 2024 to January 2025 were selected as the study subjects. They were randomly divided into a control group (31 cases), an MIT group (31 cases), and a combined group (31 cases) using a random number table method.All three groups received conventional rehabilitation treatment. The control group received 30 min of healthy lower limb training on this basis, while the MIT group received additional MIT, the combination group received a combination of MIT and TOT. All interventions lasted for 4 weeks. Lower limb motor function, balance function, gait function, and activities of daily living were assessed using the Fugl-Meyer assessment scale lower extremity portion (FMA-LE), Berg balance scale (BBS), Tinetti gait assessment scale (TGA), and modified Barthel index (MBI) before treatment and after 4 weeks of intervention.

Results

After 4 weeks of intervention, the FMA-LE, BBS, TGA, and MBI scores of patients in all three groups were significantly improved compared to those before treatment within the same group. Furthermore, the FMA-LE score (23.45±3.11), BBS score (44.13±5.28), TGA score (9.29±1.53), and MBI score (73.61±9.27) in the combined group were significantly better than those in both the control group and the MIT group, with all differences being statistically significant (P<0.05).

Conclusions

MIT combined with TOT can effectively improve the lower limb function of patients with hemiplegia after stroke.

表1 3组脑卒中偏瘫患者一般资料比较
Tab.1 Comparison of general data among 3 groups of stroke patients with hemiplegia
表2 3组脑卒中偏瘫患者治疗前后FMA-LE评分比较(分,mean±SD
Tab.2 Comparison of FMA-LE scores among 3 groups of stroke patients with hemiplegia before and after treatment (score, mean±SD)
表3 3组脑卒中偏瘫患者治疗前后BBS评分比较(分,mean±SD
Tab.3 Comparison of BBS scores among 3 groups of stroke patients with hemiplegia before and after treatment (score, mean±SD)
表4 3组脑卒中偏瘫患者治疗前后TGA评分比较(分,mean±SD
Tab.4 Comparison of TGA scores among 3 groups of stroke patients with hemiplegia before and after treatment (score, mean±SD)
表5 3组脑卒中偏瘫患者治疗前后MBI评分比较(分,mean±SD
Tab.5 Comparison of MBI scores among 3 groups of stroke patients with hemiplegia before and after treatment (score, mean±SD)
[1]
《中国脑卒中防治报告》编写组.《中国脑卒中防治报告2020》概要[J].中国脑血管病杂志, 2022, 19(2): 136-144. DOI: 10.3969/j.issn.1672-5921.2022.02.011.
[2]
Israely S, Leisman G, Carmeli E. Improvement in arm and hand function after a stroke with task-oriented training[J]. BMJ Case Rep, 2017, 2017: bcr2017219250. DOI: 10.1136/bcr-2017-219250.
[3]
刘银霞,董虹丽,汪军华.运动想象训练联合任务导向性功能训练对脑卒中偏瘫患者下肢功能恢复的影响[J].中华物理医学与康复杂志, 2024, 46(4): 322-324. DOI: 10.3760/cma.j.issn.0254-1424.2024.04.007.
[4]
Cano-de-la-Cuerda R. Influential women in the field of neurological rehabilitation: a literature review[J]. Int J Environ Res Public Health, 2022, 19(3): 1112. DOI: 10.3390/ijerph19031112.
[5]
徐建奇,王舒,沈晓艳,等.经颅直流电刺激联合动觉运动想象疗法对恢复期脑卒中患者下肢功能的疗效[J].神经损伤与功能重建, 2024, 19(6): 366-368. DOI: 10.16780/j.cnki.sjssgncj.20230314.
[6]
郭冬菊,胡静璐,王德正,等.手运动想象对脑卒中患者脑电信号的影响[J].中国康复医学杂志, 2023, 38(8): 1044-1049. DOI: 10.3969/j.issn.1001-1242.2023.08.003.
[7]
肖少华,吴夏静,代菁,等.镜像治疗联合运动想象治疗对脑梗死早期患者下肢运动及平衡功能的影响[J].中华物理医学与康复杂志, 2019, 41(8): 575-578. DOI: 10.3760/cma.j.issn.0254-1424.2019.08.004.
[8]
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.中国脑出血诊治指南(2019)[J].中华神经科杂志, 2019, 52(12): 994-1005. DOI: 10.3760/cma.j.issn.1006-7876.2019.12.003.
[9]
Malouin F, Richards CL, Jackson PL, et al. The Kinesthetic and Visual Imagery Questionnaire (KVIQ) for assessing motor imagery in persons with physical disabilities: a reliability and construct validity study[J]. J Neurol Phys Ther, 2007, 31(1): 20-29. DOI: 10.1097/01.npt.0000260567.24122.64.
[10]
朱镛连.神经康复学[M].北京:人民军医出版社, 2001: 151-153.
[11]
成莹,马元超,陈震宇.运动想象辅助干预对脑卒中肢体功能障碍及肌电图信号的影响[J].检验医学与临床, 2023, 20(1): 112-115. DOI: 10.3969/j.issn.1672-9455.2023.01.028.
[12]
杨琛,王秀华,刘莉. Tinetti平衡与步态量表在移动及平衡能力评估中的应用进展[J].中国康复医学杂志, 2019, 34(5): 601-606. DOI: 10.3969/j.issn.1001-1242.2019.05.023.
[13]
闵瑜,吴媛媛,燕铁斌.改良Barthel指数(简体中文版)量表评定脑卒中患者日常生活活动能力的效度和信度研究[J].中华物理医学与康复杂志, 2008, 30(3): 185-188. DOI: 10.3321/j.issn:0254-1424.2008.03.010.
[14]
葛苹苹,曹晓光,陈露萍,等.脑卒中偏瘫患者支撑期下肢肌肉协同收缩与肢体功能状况的相关性[J].中华脑科疾病与康复杂志(电子版), 2025, 15(1): 21-25. DOI: 10.3877/cma.j.issn.2095-123X.2025.01.004.
[15]
刘四维,关敏,高强.任务导向性训练在脑卒中后偏瘫康复中的应用进展[J].中国康复医学杂志, 2020, 35(3): 374-378. DOI: 10.3969/j.issn.1001-1242.2020.03.026.
[16]
Chen YW, Chiang WC, Chang CL, et al. Comparative effects of EMG-driven robot-assisted therapy versus task-oriented training on motor and daily function in patients with stroke: a randomized cross-over trial[J]. J Neuroeng Rehabil, 2022, 19(1): 6. DOI: 10.1186/s12984-021-00961-w.
[17]
Jeon BJ, Kim WH, Park EY. Effect of task-oriented training for people with stroke: a meta-analysis focused on repetitive or circuit training[J]. Top Stroke Rehabil, 2015, 22(1): 34-43. DOI:10.1179/1074935714Z.0000000035.
[18]
van Vliet PM, Lincoln NB, Foxall A. Comparison of Bobath based and movement science based treatment for stroke: a randomised controlled trial[J]. J Neurol Neurosurg Psychiatry, 2005, 76(4): 503-508. DOI: 10.1136/jnnp.2004.040436.
[19]
Winstein CJ, Rose DK, Tan SM, et al. A randomized controlled comparison of upper-extremity rehabilitation strategies in acute stroke: a pilot study of immediate and long-term outcomes[J]. Arch Phys Med Rehabil, 2004, 85(4): 620-628. DOI: 10.1016/j.apmr.2003.06.027.
[20]
Garrison KA, Winstein CJ, Aziz-Zadeh L. The mirror neuron system: a neural substrate for methods in stroke rehabilitation[J]. Neurorehabil Neural Repair, 2010, 24(5): 404-412. DOI: 10.1177/1545968309354536.
[21]
姜林鸿,刘晓丹,孙萍萍,等.运动想象训练对卒中后患者上肢运动功能恢复的影响及静息态fNIRS脑网络特征研究[J].中国康复医学杂志, 2023, 38(11): 1505-1513. DOI: 10.3969/j.issn.1001-1242.2023.11.005.
[22]
孟洋洋,徐立伟.运动想象疗法联合双侧肢体训练对脑卒中患者下肢功能的影响[J].中国伤残医学, 2019, 27(4): 11-14. DOI: 10.13214/j.cnki.cjotadm.2019.04.007.
[23]
骆丽,黄宋余,邹晶晶,等.运动想象疗法联合任务导向性训练对脑卒中偏瘫患者上肢运动功能的影响[J].按摩与康复医学, 2022, 13(9): 14-17. DOI:10.19787/j.issn.1008-1879.2022.09.004.
[24]
Li F, Zhang T, Li BJ, et al. Motor imagery training induces changes in brain neural networks in stroke patients[J]. Neural Regen Res, 2018, 13(10): 1771-1781. DOI: 10.4103/1673-5374.238616.
[25]
López ND, Monge Pereira E, Centeno EJ, et al. Motor imagery as a complementary technique for functional recovery after stroke: a systematic review[J]. Top Stroke Rehabil, 2019, 26(8): 576-587. DOI: 10.1080/10749357.2019.1640000.
[26]
McCombe Waller S, Whitall J, Jenkins T, et al. Sequencing bilateral and unilateral task-oriented training versus task oriented training alone to improve arm function in individuals with chronic stroke[J]. BMC Neurology, 2014, 14: 1-9. DOI: 10.1186/s12883-014-0236-6.
[27]
段同华,梁育磊,叶小苹,等.任务导向性训练对脑卒中偏瘫病人平衡及步态的影响[J].蚌埠医学院学报, 2024, 49(10): 1359-1363. DOI: 10.13898/j.cnki.issn.1000-2200.2024.10.019.
[28]
陈园月,李加斌,蒯凤,等.多通道功能性电刺激结合任务导向训练对脑卒中上肢偏瘫患者脑功能网络的即刻影响[J].中国康复理论与实践, 2024, 30(4): 462-467. DOI: 10.3969/j.issn.1006-9771.2024.04.012.
[29]
许方军,曹晓光,王修敏,等.基于闭环理论的动作观察疗法联合躯干控制训练对脑卒中后下肢运动的影响[J].中华脑科疾病与康复杂志(电子版), 2024, 14(5): 292-299. DOI: 10.3877/cma.j.issn.2095-123X.2024.05.005.
[1] 泌尿功能障碍预防和康复联盟. 中国老年脑卒中患者相关泌尿功能障碍管理指南(2025版)[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(06): 681-692.
[2] 脊髓电刺激治疗卒中后偏瘫中国专家共识编写组, 中华医学会神经外科学分会功能神经外科学组, 中国研究型医院学会神经外科学专业委员会, 世界华人神经外科协会功能神经外科专业委员会, 北京医学会神经外科学分会功能神经外科专业组, 北京医学会神经外科学分会周围神经外科专业组. 脊髓电刺激治疗卒中后偏瘫中国专家共识(2025年)[J/OL]. 中华脑科疾病与康复杂志(电子版), 2026, 16(01): 8-18.
[3] 黄丽, 郭淮莲. 脑卒中康复的现状与展望:挑战与机遇[J/OL]. 中华脑科疾病与康复杂志(电子版), 2025, 15(06): 321-325.
[4] 康硕, 魏文亭, 李松岩, 施旭. 低频重复经颅磁刺激联合大面积浅感觉刺激治疗亚急性期缺血性脑卒中偏瘫伴上肢功能障碍的疗效观察[J/OL]. 中华脑科疾病与康复杂志(电子版), 2025, 15(06): 358-363.
[5] 刘亚, 潘晓虎, 杨明刚, 施学松, 董启武, 张宁, 唐燕, 谢春明, 赵国锋. 初级卒中中心与高级卒中中心血管内治疗急性大血管闭塞性脑卒中的对比研究[J/OL]. 中华脑科疾病与康复杂志(电子版), 2025, 15(06): 364-369.
[6] 皇立媛, 浦洁, 王苏贵, 陈婷婷, 朱德慧, 胡雪. 中青年脑卒中患者应激障碍风险预测模型的构建与验证[J/OL]. 中华临床医师杂志(电子版), 2025, 19(07): 504-512.
[7] 侯志博, 张苗, 卢洁. 多延迟动脉自旋标记成像在急性缺血性脑卒中灌注评估中的研究进展与临床应用[J/OL]. 中华临床医师杂志(电子版), 2025, 19(06): 454-460.
[8] 陈芸, 杨海燕, 陈薇, 董贯忠, 张伟媛, 许钰. 社会支持和心理弹性在急性期脑卒中患者感知压力与睡眠质量间的链式中介作用[J/OL]. 中华卫生应急电子杂志, 2025, 11(06): 329-335.
[9] 单小洁, 胡欢欢, 张磊, 杨佳康, 刘建民, 甘丽芬, 徐立, 李红月, 李冬梅. 链式流程管理在急性脑卒中绿色通道CT检查中改善碘对比剂外渗的效果[J/OL]. 中华脑血管病杂志(电子版), 2025, 19(06): 477-482.
[10] 王琳, 霍鸿波, 李可静, 边毓尧, 徐正虎, 王恒, 刘翠翠. 老年急性大血管闭塞性卒中患者支架取栓中长期预后及其影响因素[J/OL]. 中华脑血管病杂志(电子版), 2025, 19(06): 511-518.
[11] 霍飞翔, 邵士光, 徐海东, 张洪蕊, 孙亚鲁, 刘文晶, 李响. 不同频率重复经颅磁刺激联合下肢机器人对脑卒中患者皮质兴奋性及运动功能的影响[J/OL]. 中华脑血管病杂志(电子版), 2025, 19(05): 375-381.
[12] 刘斌, 王英歌, 许笑天, 肖莉, 邵修超, 唐铁钰. 元认知训练联合西药治疗对缺血性脑卒中患者认知功能和活动能力的影响[J/OL]. 中华脑血管病杂志(电子版), 2025, 19(05): 404-410.
[13] 李志银, 郗海涛, 陈倩, 闫旭玲, 孟丽霞. 血清长链非编码RNA ZEB1-AS1对双重抗血小板治疗的缺血性脑卒中患者复发的预测价值[J/OL]. 中华脑血管病杂志(电子版), 2025, 19(05): 411-417.
[14] 张霞, 樊震峰, 成柯岭, 王志勇, 陈乐文, 蔡斌, 倪隽. 基于数据非依赖性采集蛋白质组学探讨超早期经耳迷走神经刺激对缺血性脑卒中神经功能的影响[J/OL]. 中华脑血管病杂志(电子版), 2025, 19(05): 418-428.
[15] 吴章薇, 张通, 赵军, 周昊, 李冰洁. 脑卒中偏瘫患者连续步行中骨盆不对称活动的动态分析[J/OL]. 中华脑血管病杂志(电子版), 2025, 19(05): 364-374.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?