Rehabilitation effect of isokinetic trainer combined with mirror image therapy on spastic hemiplegia after cerebral infarction

doi:10.3877/cma.j.issn.2095-123X.2022.02.008

Abstract

Abstract:

Objective

To explore the rehabilitation effect of isokinetic trainer combined with mirror image therapy on spastic hemiplegia after cerebral infarction.

Methods

One hundred and forty-eight patients with spastic hemiplegia after cerebral infarction who were treated in our hospital from February 2017 to December 2019 were selected and randomly divided into control group (routine rehabilitation treatment, 37 cases), upper limb group (routine rehabilitation + mirror therapy treatment, 37 cases), lower limb group (routine rehabilitation + isokinetic trainer treatment, 37 cases) and combination group (routine rehabilitation+mirror therapy+isokinetic trainer treatment, 37 cases). The muscle strength scores of upper limbs and lower limbs, motor functions of upper limbs and lower limbs and the muscle tension of upper and lower limbs before and after treatment, rehabilitation effects, quality of life scores before and 3 months after treatment were compared among the four groups.

Results

After treatment, the scores of muscle strength scores of biceps brachii of upper extremity and quadriceps femoris of the lower extremity and the motor function scores and total scores of the upper limbs and lower limbs of the four groups were increased (P<0.05), and the scores of biceps brachii of upper extremity muscle strength and motor function of upper limb in upper limb group after treatment and combined group were higher than those in control group and lower limb group (P<0.05), and the scores of quadriceps femoris of the lower extremity muscle strength and motor function of lower limbs in lower limb group and combined group after treatment were higher than those in control group and upper limb group (P<0.05). The total scores of upper limb and lower limb motor function in the combined group, upper limb group and lower limb group after treatment were higher than those in the control group (P<0.05), and the total scores of upper limb and lower limb motor function in the combined group after treatment were higher than those in the upper limb group and lower limb group (P<0.05). After treatment, the modified Ashworth spasm scale scores of upper and lower limbs in four groups were lower than those before treatment (P<0.05), and there was no significant difference in the modified Ashworth spasm scale scores of upper and lower limbs among the four groups after treatment (P>0.05). The total effective rate of the combined group was significantly higher than that of the control group (P<0.01). At 3 months after treatment, the scores of qauality life of the four groups were significantly higher than those before treatment (P<0.05), of which the combination group were higher than the other three groups (P<0.05), and those of upper limb group and lower limb group were higher than the control group (P<0.05).

Conclusion

The isokinetic trainer combined with mirror image therapy can improve the muscle strength and motor function of upper limbs and lower limbs of patients with spastic hemiplegia after cerebral infarction, enhance the rehabilitation effect and improve the quality of life.

Key words: Cerebral infarction, Spastic hemiplegia, Isokinetic trainer, Mirror therapy

Dandan Chen, Jing Gao. Rehabilitation effect of isokinetic trainer combined with mirror image therapy on spastic hemiplegia after cerebral infarction[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2022, 12(02): 103-109.

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Figures/Tables 6

References 18

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项目		对照组（n=37）	上肢组（n=37）	下肢组（n=37）	联合组（n=37）	F/χ²值	P值
年龄（岁，Mean±SD）		50.12±7.25	51.15±6.29	50.22±7.13	51.06±6.25	0.239	0.869
脑梗死病程（d，Mean±SD）		38.55±7.36	38.22±7.35	37.46±7.22	38.15±7.21	0.146	0.932
性别[男/女,例（%）]		20（54.05）/17（45.95）	19（51.35）/18（48.65）	21（56.76）/16（43.24）	19（51.35）/18（48.65）	1.351	0.245
发病部位[例（%）]
	大脑前动脉	7（18.92）	5（13.51）	7（18.92）	6（16.22）	0.398	0.528
	大脑中动脉	26（70.27）	28（75.68）	24（72.97）	27（72.97）	1.035	0.309
	大脑后动脉	4（10.81）	4（10.81）	6（16.22）	4（10.81）	0.463	0.496
患侧[例（%）]
	左侧偏瘫	16（43.24）	17（45.95）	18（48.65）	18（48.65）	0.218	0.641
	右侧偏瘫	21（56.76）	20（54.05）	19（51.35）	19（51.35）	0.218	0.641
上肢肱二头肌肌力[例（%）]
	0级	4（10.81）	6（16.22）	5（13.51）	5（13.51）	0.961	0.327
	1级	22（59.46）	19（51.35）	21（56.76）	20（54.05）	0.492	0.483
	2级	11（29.73）	12（32.43）	11（29.73）	12（32.43）	0.247	0.619
下肢股四头肌肌力[例（%）]
	0级	2（5.41）	1（2.70）	2（5.41）	1（2.70）	0.257	0.782
	1级	13（35.14）	15（40.54）	14（37.84）	14（37.84）	0.338	0.613
	2级	22（59.46）	21（56.76）	21（56.76）	22（59.46）	0.315	0.648
伴感觉异常		30（81.08）	33（89.19）	29（78.38）	32（86.49）	0.379	0.542

项目		对照组（n=37）	上肢组（n=37）	下肢组（n=37）	联合组（n=37）	F/χ²值	P值
年龄（岁，Mean±SD）		50.12±7.25	51.15±6.29	50.22±7.13	51.06±6.25	0.239	0.869
脑梗死病程（d，Mean±SD）		38.55±7.36	38.22±7.35	37.46±7.22	38.15±7.21	0.146	0.932
性别[男/女,例（%）]		20（54.05）/17（45.95）	19（51.35）/18（48.65）	21（56.76）/16（43.24）	19（51.35）/18（48.65）	1.351	0.245
发病部位[例（%）]
	大脑前动脉	7（18.92）	5（13.51）	7（18.92）	6（16.22）	0.398	0.528
	大脑中动脉	26（70.27）	28（75.68）	24（72.97）	27（72.97）	1.035	0.309
	大脑后动脉	4（10.81）	4（10.81）	6（16.22）	4（10.81）	0.463	0.496
患侧[例（%）]
	左侧偏瘫	16（43.24）	17（45.95）	18（48.65）	18（48.65）	0.218	0.641
	右侧偏瘫	21（56.76）	20（54.05）	19（51.35）	19（51.35）	0.218	0.641
上肢肱二头肌肌力[例（%）]
	0级	4（10.81）	6（16.22）	5（13.51）	5（13.51）	0.961	0.327
	1级	22（59.46）	19（51.35）	21（56.76）	20（54.05）	0.492	0.483
	2级	11（29.73）	12（32.43）	11（29.73）	12（32.43）	0.247	0.619
下肢股四头肌肌力[例（%）]
	0级	2（5.41）	1（2.70）	2（5.41）	1（2.70）	0.257	0.782
	1级	13（35.14）	15（40.54）	14（37.84）	14（37.84）	0.338	0.613
	2级	22（59.46）	21（56.76）	21（56.76）	22（59.46）	0.315	0.648
伴感觉异常		30（81.08）	33（89.19）	29（78.38）	32（86.49）	0.379	0.542

组别	例数	上肢肱二头肌肌力				下肢股四头肌肌力
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
对照组	37	8.92±1.63	20.16±3.17	19.181	<0.001	13.59±2.08	27.84±4.26	18.284	<0.001
上肢组	37	9.05±1.72	23.06±3.46^a	22.207	<0.001	13.17±2.13	27.53±4.35	18.034	<0.001
下肢组	37	8.78±1.59	21.12±3.57^b	19.796	<0.001	12.94±2.05	33.89±5.16^ab	22.952	<0.001
联合组	37	9.19±1.75	24.57±4.39^ac	18.284	<0.001	13.36±2.11	35.62±5.21^ab	25.171	<0.001
F值		0.407	10.665			0.646	27.985
P值		0.748	<0.001			0.587	<0.001

组别	例数	上肢肱二头肌肌力				下肢股四头肌肌力
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
对照组	37	8.92±1.63	20.16±3.17	19.181	<0.001	13.59±2.08	27.84±4.26	18.284	<0.001
上肢组	37	9.05±1.72	23.06±3.46^a	22.207	<0.001	13.17±2.13	27.53±4.35	18.034	<0.001
下肢组	37	8.78±1.59	21.12±3.57^b	19.796	<0.001	12.94±2.05	33.89±5.16^ab	22.952	<0.001
联合组	37	9.19±1.75	24.57±4.39^ac	18.284	<0.001	13.36±2.11	35.62±5.21^ab	25.171	<0.001
F值		0.407	10.665			0.646	27.985
P值		0.748	<0.001			0.587	<0.001

评分		对照组（n=37）	上肢组（n=37）	下肢组（n=37）	联合组（n=37）	F值	P值
上肢运动功能	治疗前	19.87±4.16	18.22±3.96	18.55±4.07	20.15±3.82	2.103	0.102
	治疗后	40.17±6.71	46.25±6.97^a	41.26±6.82^b	47.58±7.02^ac	10.398	<0.001
	t值	15.640	21.269	17.393	20.877
	P值	<0.001	<0.001	<0.001	<0.001
下肢运动功能	治疗前	11.22±1.67	12.05±1.96	11.84±1.73	11.41±1.55	1.793	0.151
	治疗后	20.87±5.26	22.01±5.62	27.84±5.83^ab	28.96±5.47^ab	19.915	<0.001
	t值	10.636	10.261	16.004	18.777
	P值	<0.001	<0.001	<0.001	<0.001
总分	治疗前	31.09±5.52	30.27±5.26	30.39±5.31	31.56±5.84	0.454	0.715
	治疗后	61.04±9.27	69.26±9.78^a	69.10±9.85^a	76.54±10.23^abc	18.260	<0.001
	t值	16.886	21.357	21.042	23.227
	P值	<0.001	<0.001	<0.001	<0.001

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