| Objective:To establish a rehabilitation mode of mirror therapy combined with remote rehabilitation,and to discuss the application effect of this rehabilitation mode in upper limb function rehabilitation exercise for stroke patients with hemiplegia,so as to provide theoretical and practical basis for remote upper limb function rehabilitation exercise for stroke patients with hemiplegia after discharge with mirror therapy.Methods:Patients with cerebral apoplexy hemiplegia discharged from a class iii a general hospital in nanchang,jiangxi province from May 2017 to October 2017 and from May 2018 to October 2018 who met the inclusion and exclusion criteria in the department of rehabilitation medicine were selected as the research objects.May 2017 to October 2017,during the discharge stroke hemiplegia patients as control group,in May 2018 to October 2018 during the discharge stroke hemiplegia patients as observation group,control group patients after discharge in patients with normal discharge rehabilitation exercise guidance,observation group on the basis of this mirror therapy in combination with remote rehabilitation rehabilitation mode is adopted to improve the rehabilitation at home.Two groups of patients were 24 h prior to discharge,discharge follow-up 4 weeks and 12 weeks back to the hospital discharge,the use of upper limb simplified Fugl Meyer motor function assessment scale(Fugl-Meyer assessment,FMA)evaluation of patients with upper limb movement function,upper limb motion study scale(Action Research Arm Test,ARAT)to evaluate patients’ hand movements of flexibility and completion and Barthel Index rating scale(Barthel Index,BI)to evaluate patients’ daily life activities ability.Results:1.The deadline at the end of this study,the control group included in 38 cases of cerebral apoplexy hemiplegia patients in this study,39 patients into the observationgroup was originally included in this study,along with the progress in the research process observation group 2 patients due to failure to complete this research according to the requirements in the midway exits are eliminated and,eventually have to observe group of 37 cases,control group 38 cases of complete and collect the data of this research:(1)observation group male 21 cases,16 cases of women;The control group included 20 males and 18 females.(2)the average age of the patients in the observation group was(55.00±5.15)years.The mean age of patients in the control group was(55.97±6.17)years.(3)stroke type observation group ischemic patients 22 cases,15 cases of hemorrhagic patients;In the control group,there were 26 patients with ischemic blood group and 12 patients with ischemic blood group.After statistical analysis,there was no statistically significant difference in general data between the two groups(P>0.05).2.There were no statistically significant differences in baseline data between the two groups 24 h before discharge(P>0.05),upper limb FMA score(t=0.535,P=0.594),ARAT score(t=-0.586,P=0.559),BI scale score(t=-0.270,P=0.788).3.Comparison of FMA upper limb score between the two groups before and after intervention: time effect difference of FMA upper limb score between the two groups was statistically significant(F=74.611,P<0.001);There were significant differences between the two groups in FMA upper limb scores,and the scores of the observation group were higher than those of the control group during the study period,with statistically significant differences(F=24.225,P<0.001).There was an interaction effect between the intervention factor and the time factor of the upper limb score of FMA(F=5.417,P=0.007).The FMA upper limb score at 4 weeks and 12 weeks after discharge was significantly higher than that at 24 h before discharge,and the score at12 weeks after discharge was higher than that at 4 weeks after discharge,with statistically significant differences(t=-9.069,P<0.001;t=-13.305,P<0.001;t=-3.220,P=0.003);In the control group,FMA upper limb score at 4 weeks and 12 weeks after discharge was significantly higher than that 24 hours before discharge,and the score at 12 weeks after discharge was higher than that at 4 weeks after discharge,the differences were statistically significant(t=-3.048,P=0.004;t=-7.303,P<0.001;t=-2.566,P=0.014).At 24 h before discharge,there was no significant difference inFMA scores between the two groups(F=0.229,P=0.635).At 4 and 12 weeks after discharge,FMA scores of the two groups were compared,and the differences were statistically significant(F=17.993,P<0.001;F=7.025,P=0.012).4.Comparison of ARAT scale scores between the two groups before and after the intervention: the time effect difference of ARAT scores between the two groups was statistically significant(F=102.749,P<0.001).There were significant differences in ARAT scores between the two groups.The ARAT scale score of the observation group was higher than that of the control group during the study period,and the difference was statistically significant(F=5.708,P=0.019).There was an interaction effect between the intervention factor and time factor of ARAT score(F=3.651,P=0.035).The ARAT scale score at 4 weeks and 12 weeks after discharge in the observation group was significantly higher than that at 24 h before discharge,and the score at 12 weeks after discharge was higher than that at 4 weeks after discharge,with statistically significant differences(t=-8.807,P<0.001;t=-11.735,P<0.001;t=-2.759,P=0.009);(2)the ARAT scale score of patients in the control group at 4 weeks and 12 weeks after discharge was significantly higher than that at 24 h before discharge,and the score at 12 weeks after discharge was higher than that at 4 weeks after discharge,with statistically significant differences(t=-8.237,P<0.001;t=-8.095,P<0.001;t=-2.497,P=0.017).The ARAT scores of patients in the two groups showed no significant difference(F=0.211,P=0.649).At 4 and 12 weeks after discharge,ARAT scores of patients in the two groups were compared,and the differences were statistically significant(F=4.927,P=0.033;F=8.058,P=0.007).5.Comparison of BI scale scores between the two groups before and after the intervention: time effect differences of BI scale scores between the two groups were statistically significant(F=47.089,P<0.001);There were significant differences in BI scale scores between the two groups,and the effect of the observation group was better than that of the control group,with statistically significant differences(F=9.492,P=0.003).There was an interaction effect between intervention factors and time factors in BI index scale score(F=3.174,P=0.045).The comparison between the two groups of patients in the BI scale evaluation group showed that:(1)the BI index scale score of patients in the observation group at 4 weeks and 12 weeks after dischargewas significantly higher than that at 24 h before discharge,and the score at 12 weeks after discharge was higher than that at 4 weeks after discharge,the differences were statistically significant(t=-5.301,P<0.001;t=-8.923,P<0.001;t=-2.763,P=0.009);The BI index scale score of patients in the control group at 4 weeks and 12 weeks after discharge was significantly higher than that at 24 h before discharge,and the score at 12 weeks after discharge was higher than that at 4 weeks after discharge,with statistically significant differences(t=-2.557,P=0.015;t=-5.321,P<0.001;t=-2.674,P=0.011).Finally,inter-group comparison of BI scales between the two groups showed that:(1)24h before discharge,there was no significant difference in BI scores between the two groups(F=0.131,P=0.719).At 4 and 12 weeks after discharge,BI scores of patients in the two groups were compared,and the differences were statistically significant(F=6.144,P=0.018;F=8.395,P=0.006).Conclusion:The whole research process cycle,with the passage of time,the index observation group were superior to control group,that the mirror therapy in combination with remote rehabilitation model of recovery effectively under the condition of remote use mirror therapy improve upper limb motor function in patients with cerebral apoplexy hemiplegia,hand all kinds of fine motor and improve the ability of patients daily life activities.Therefore,the rehabilitation mode of mirror therapy combined with remote rehabilitation can realize patients’ self-rehabilitation exercise at home,promote patients’ rehabilitation,and save public health and medical resources to a certain extent. |
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