内科

目的探讨等速肌力训练联合双侧上肢强制性运动训练对缺血性脑卒中伴上肢本体感觉功能障碍患者的上肢本体感觉功能、运动功能、日常生活能力的影响。方法选取2019年7月至2020年6月在本院就诊的缺血性脑卒中伴上肢本体感觉功能障碍患者96例作为研究对象，采用随机数字法分为观察组及对照组，每组48例。对照组患者给予脑卒中后常规药物治疗及等速肌力训练，观察组患者在对照组治疗和训练的基础上，给予双侧上肢强制性运动训练，1周训练5 d，持续训练4周。比较两组患者干预前后的本体感觉功能、FM量表上肢运动及感觉功能评分、Carroll上肢功能测试（UEFT）评分及改良Barthel（MBI）指数评分。结果干预前，两组患者的平均轨迹误差（ ATE）、测试执行时间（Time）比较，差异无统计学意义（P＞0.05）；干预4周后，两组患者的ATE、Time均显著降低，观察组患者的水平显著低于对照组，差异有统计学意义（P＜0.05）。干预前，两组患者的FM量表运动、感觉功能评分比较，差异无统计学意义（P＞0.05）；干预4周后，两组患者的FM量表运动、感觉功能评分均显著增高，观察组患者的评分显著高于对照组，差异有统计学意义（P＜0.05）。干预前，两组患者的 UEFT、MBI评分比较，差异无统计学意义（P＞0.05）；干预4周后，两组患者的UEFT、MBI评分均显著增高，观察组患者的评分显著高于对照组，差异有统计学意义（P＜0.05）。结论等速肌力训练结合双侧上肢强制性运动训练有助于缺血性脑卒中伴上肢本体感觉功能障碍患者改善其上肢本体感觉功能，促进运动功能恢复，提高日常生活能力。

ObjectiveTo explore the effects of isokinetic muscle strength training combined with bilateral upper limb constraint-induced movement on upper limb proprioceptive function, motor function and activity of daily living in patients with ischemic stroke complicated with upper limb proprioceptive dysfunction. MethodsNinety-six patients with ischemic stroke complicated with upper limb proprioceptive dysfunction treated in our hospital from July 2019 to June 2020 were enrolled as the research objects, and they were randomly divided into observation group and control group, with 48 cases in each group. The patients in the control group were given routine drug for treatment and isokinetic muscle strength training after stroke, based on which the patients in the observation group received bilateral upper limb constraint-induced movement, for 5 days in one week and a 4-week continuous training. The proprioception, FM scale upper limb motor and sensory function scores, Carroll upper extremity function test (UEFT) scores and modified Barthel index (MBI) scores were compared between the two groups before and after intervention. ResultsBefore intervention, there were no statistically significant differences in the average trajectory error (ATE) and test execution time (Time) between the two groups (P＞0.05). After 4 weeks of intervention, ATE and Time of the two groups decreased significantly, and the levels of the observation group were significantly lower than those of the control group, with statistically significant differences (P＜0.05). Before intervention, there were no statistically significant differences in the scores of motor function and sensory function of FM scale between the two groups (P＞0.05). After 4 weeks of intervention, the scores of motor function and sensory function of FM scale significantly increased in both groups, and the scores of the observation group were significantly higher than those of the control group, with statistically significant differences (P＜0.05). Before intervention, there were no statistically significant differences in UEFT and MBI scores between the two groups (P＞0.05). After 4 weeks of intervention, the UEFT and MBI scores of the two groups significantly increased, and the scores of the observation group were significantly higher than those of the control group, with statistically significant differences (P＜0.05). ConclusionIsokinetic muscle strength training combined with bilateral upper limb constraint-induced movement is helpful to improve upper limb proprioceptive function in patients with ischemic stroke complicated with upper limb proprioceptive dysfunction, promote recovery of motor function, and improve ability of daily living activity.