The Clinical Study Of Hand Function Recovery After Stroke By Pneumatic Hand Device Training

Objective:To explore the rehabilitation effect of pneumatic hand device training on hand motor function and activities of daily living of hemiplegic hand dysfunction patients within 2 weeks to 3 months after stroke,in order to find an effective and convenient rehabilitation measure of hand function.Methods:42 patients with hemiplegic hand motor dysfunction who were hospitalized in the Department of Rehabilitation Medicine,Department of Neurology and Interventional Stroke Ward of the first affiliated Hospital of Kunming Medical University from May 2019 to January 2020 were randomly divided into test group(21 cases,shedding 1 case)and control group(21 cases,shedding 2 cases).Patients in both groups were given basic drug therapy,routine rehabilitation therapy(physical factor therapy,exercise therapy,occupational therapy and traditional acupuncture).On the basis of this treatment,the experimental group was given mirror mode training of pneumatic hand device for 30min/days.The time and intensity of all the above treatment training are the same,once a day,6 times a week,a total of 3 weeks.Before and after treatment,the two groups were evaluated by Brunnstrom staging of hands,finger part of Fugl-Meyer motor function rating scale(Fugl-Meyer Assessment,FMA),finger part of motor function status scale(Motor Status Scale,MSS),grip strength and pinch strength test,modified barthel index(Modified Barthel Index,MBI)and closely related activities of hand function,and statistical analysis was carried out.Results:1.Before treatment,there was no significant difference in Brunnstrom hand staging,FMA hand motor function score,MSS hand function score,grip strength,pinch strength and MBI index between the two groups(P>0.05).2.After 3 weeks of treatment,the Brunnstrom hand staging,grip strength and pinch strength of the two groups were significantly improved(P<0.05),and the degree of improvement in the test group was significantly higher than that in the control group,the difference was statistically significant(P<0.05).3.After 3 weeks of treatment,the scores and total scores of seven sub items of FMA were significantly improved in two groups(P<0.05).Compared with the control group,The scores and total scores of finger joint extension,thumb pinch,columnar grip and spherical grip in the experimental group difference were statistically significant(P<0.05).There was no significant difference in the scores of finger joint flexion,hook grasping and thumb adduction between the test group and the control group(P>0.05).4.After 3 weeks of treatment,there was no significant improvement in MSS hand function except thumb to pinky tip(P>0.05),and the scores and total scores of other items in the test group were significantly improved compared with those before treatment(P<0.05).There was no significant improvement in the control group except thumb abduction,thumb to pinky base,thumb to ring finger tip,thumb to fingertip of pinky and abdomen of finger(P>0.05).The scores of other items and total scores were significantly improved compared with those before treatment(P<0.05).The scores and total scores of the test group extension,metacarpophalangeal joint flexion interphalangeal joint extension,thumb abduction,thumb to index finger,middle finger,ring finger tip and abdomen of finger,thumb to pinky abdomen,functional tasks of columnar and clamp grabs were significantly different from those in the control group(P<0.05).The scores of other items were not significantly different from those of the control group(P>0.05).5.After 3 weeks of treatment,the scores of grooming,toilet use,eating,transfer,dressing and the total scores of 6 items in two groups were significantly improved as compared with those before treatment(P<0.05).There was no significant improvement in the score of bathing items(P>0.05).The scores of metastasis items in the test group were significantly different from those in the control group(P<0.05),There was no significant difference in scores and total scores of other items compared with the control group(P>0.05).6.The motor function score of the affected hand was positively correlated with the activity of daily living score.There was a significant correlation between MBI and FMA,MBI and MSS,and the correlation coefficients were 0.74,0.69 respectively.Conclusions:1.The mirror mode training of pneumatic hand device and routine rehabilitation training can improve the hand function of stroke patients,and have a significant correlation with the ability of daily life activities(ADL).2.Mirror mode training of pneumatic hand devices combined with routine rehabilitation treatment can more effectively promote the rehabilitation of hand motor function and the improvement of self-care ability in hemiplegic patients with stroke.3.Pneumatic hand device has significant advantages in finger stretching,grasping,Pinching and thumb abduction,which can effectively promote the recovery of fine movements of the hand.