指部徒手感覺刺激對腦卒中患者偏癱側上肢功能的即時療效觀察

指部徒手感覺刺激對腦卒中患者偏癱側上肢功能的即時療效觀察指部徒手感覺刺激對腦卒中患者偏癱側上肢功能的即時療效觀察

摘要：

目的：本研究旨在探究指部徒手感覺刺激對腦卒中患者偏癱側上肢功能的即時療效。

方法：選取40名偏癱側上肢功能異常的腦卒中患者為研究對象，隨機分為實驗組和對照組，每組20人。對照組接受常規(guī)物理治療，實驗組在常規(guī)物理治療基礎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、治療結束時，采用肘關節(jié)屈曲力、手握力、動作范圍、Brunnstrom肢體運動恢復分級等資料作為觀察指標。

結果：治療結束后，實驗組患者的肘關節(jié)屈曲力、手握力、動作范圍、Brunnstrom肢體運動恢復分級明顯高于對照組（P＜0.05）。

結論：指部徒手感覺刺激對腦卒中患者偏癱側上肢功能恢復具有顯著的即時療效，可作為一種有效的物理治療方法。

關鍵詞：指部徒手感覺刺激；腦卒中；偏癱側上肢；肘關節(jié)屈曲力；手握力；動作范圍；Brunnstrom肢體運動恢復分級。

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