Journal of Taiwan Occupational Therapy Research and Practice
慢性腦中風患者常伴隨有上肢動作功能缺損，導致患者減少使用患側上肢執行活動。近來研究發現鏡像治療對腦中風後上肢動作功能復健可能有所助益。本研究的目的在探討鏡像治療介入對慢性腦中風患者在上肢動作功能的療效。 發病時間大於6個月的腦中風患者共16名參與本研究，隨機分為鏡像治療組及控制組，每組各8名受試者。鏡像治療組接受每天一小時的鏡像治療及半小時的傳統治療，每週五天持續四週共二十次治療；控制組則接受相同治療時間的傳統治療介入。研究使用傅格梅爾動作評量表 (Fugl-Meyer Motor Assessment, FMA)的上肢動作部份來評估受試者上肢動作功能的改變，同時利用腕動計來評量受試者在日常生活中上肢的使用情形，再加上視覺化之疼痛及疲勞度自我評量表來評估受試者疼痛及疲勞的程度。評量分別在介入前，介入後兩週及介入結束時施測。 在四週的介入後，鏡像治療組在FMA的分數進步程度明顯高於控制組 (6.5 ± 4.3分vs. 3.12 ± 20.3分，p < .05)。而患／健側肢體使用比率，鏡像治療組在介入後明顯低於控制組。至於疼痛及疲勞的部份兩組間則無顯著差異。 鏡像治療合併傳統治療介入對慢性腦中風患者的上肢動作功能是有幫助的。未來研究可增加樣本數，並加入其他評量方式，更深入探討鏡像治療的療效範圍及作用機制。
Upper extremity motor function impairment is the common symptom in chronic stroke patients and result in reducing the usage of the affected arm in daily living.Recent research suggest that stroke patients may benefit from mirror therapy in upper extremity motor functions.The purpose of this study was to evaluate the effects of mirror therapy on upper extremity motor function in patients of chronic stroke patients. 16 chronic stroke (onset > 6 months) patient were included in this study and randomly assigned to the mirror therapy (MT) group (n = 8) and the control (RC) group (n = 8). The mirror therapy group received mirror therapy program for 1 hour and conventional therapy for 0.5 hour per day, 5 days a week, in 4 weeks. The control group received the does-matched conventional therapy. The Fugl-Meyer Assessment (FMA) and Micro-mini Motion-logger, were used to assess the changes in upper extremity motor function and the ratio of affected arm use to non-affected arm use after intervention. The visual analog scales were also applied for assessing the level of pain and fatigue that may be induced by intervention. In the upper extremity function,the scores of FMA increased more in MT group (6.5 ± 4.3, Mean ± SD) than in RC (3.12 ± 2.03) group (p < .05). The ratio of affected arm use to non-affected arm use reduced more in MT ( -0.24 ± 0.16) group than in RC (0.06 ± 0.16) group significantly (p < .05). No significant difference were found in pain and fatigue level between two groups. This study supports that both therapies are effective for upper extremity motor function rehabilitation in chronic stroke patients. Therefore, chronic stroke patients made more improvement in upper motor functions with combined mirror therapy with conventional therapy. However, it would be noticed that the ratio of affected arm use to non-affected arm use may be reduced after mirror therapy intervention.