| Part I:Effect of action observation therapy based on mirror neuron theory on neurological deficits and motor function recovery in stroke patientsObjective: To explore the effect of action observation therapy based on mirror neuron theory on neurological deficit and motor function in stroke patients.Methods:Selecting 136 stroke patients with hemiplegia were randomly divided into observation group and routine rehabilitation therapy group,Two groups of patients were given routine rehabilitation therapy.On the basis of routine rehabilitation treatment,the action observation group were given action observation therapy,the routine rehabilitation group were given the placebo therapy which similar to the action observation therapy,2 times a day,each time 30 min,once a week,for a total of 8weeks.the national institutes of health stroke scale,simplified Fugl-Meyer motor function,modified Ashwoth spasms assessment scale,Brunstrom motor function assessment were evaluated and analyzed at the immediate treatment,after 4 weeks,8weeks later and 12 weeks follow-up.Results: There was no significant difference in the general situation,NIHSS scores,FMA scores,MAS scores and Brunnstrom staging between the observation group and the routine rehabilitation group(P>0.05).After 4 weeks,8weeks of treatment,and the follow-up of 12 weeks,the NIHSS scores,FMA scores,MAS scores and Brunnstrom staging of the patients in the two groups were significantly improved compared with before treatment as the passage of time.The difference was statistically significant(P<0.05).Compared with the routine group,the scores of the observation group and the degree of improvement were significantly higher than those of the routine rehabilitation group,and there wasstatistically significant difference between the two groups(P<0.05).Conclusion:Observation of therapy based on mirror neuron theory,can reduce the degree of neurologic impairment in patients with stroke,promote the recovery of neural function,reducing muscular tension of the key muscles of stroke patients,promote the recovery of motor function in patients with stroke.Part II:Effect of action observation therapy based on mirror neuron theory on activities of daily living and prognosis of stroke patients.Objective: To explore the effect of action observation therapy based on mirror neuron theory on activities of daily living and prognosis of stroke patients.Methods:Selecting 136 stroke patients with hemiplegia were randomly divided into observation group and routine rehabilitation therapy group,Two groups of patients were given routine rehabilitation therapy,On the basis of routine rehabilitation treatment,the action observation group were given action observation therapy,the routine rehabilitation group were given the placebo therapy which similar to the action observation therapy,2 times a day,each time 30 min,once a week,for a total of 8weeks.The Modified Barthel Index,Modified Rankin Scale were evaluated and analyzed at the immediate treatment,after 4 weeks,8 weeks later and 12 weeks follow-up.Results: The MBI scores of patients in observation group before treatment were(27.88 ± 5.35),and after treatment were(75.48±4.51),and the MBI scores improved were(48.12±5.56).The MBI scores of patients in routine rehabilitation therapy group,before treatment were(27.88 ± 5.35),and after treatment were(75.48±4.51),and the MBI scores improved was(48.12±5.56).comparison within the group,the MBI scores of the two groups after treatment were significantly improved compared with before treatment,the difference between before and after treatment was significantly(P<0.05).Comparison betweenthe two groups,there was no statistical difference in MBI scores of patients before treatment(P > 0.05),the MBI scores and MBI scores improved of patients in action observation group were higher than those of routine rehabilitation treatment group,the difference between the two groups was statistically significant(P<0.05).The m RS scores of patients in observation group before treatment were(4.41±0.61),and after treatment were(2.08±0.54).The m RS scores of patients in routine rehabilitation therapy group,before treatment were(4.25±0.56),and after treatment were(2.31±0.46).There was no significant difference in m RS score between the two groups before treatment(P>0.05),the m RS scores of the patients in the observation group after treatment was significantly lower than those of the routine conventional rehabilitation group,the difference was statistically significant(P<0.05).Conclusion:Action observation therapy based on mirror neuron theory is helpful to improve the ability of ADL,reduce the disability rate and improve the prognosis of stroke patients.Part III:Effect of action observation therapy based on mirror neuron theory on real time brain functional magnetic resonance imaging in stroke patientsObjective: To explore the effect of action observation therapy based on mirror neuron theory on the real time brain functional magnetic resonance imaging in stroke patients.Methods: Selecting 36 patients with cerebral apoplexy hemiplegia were randomly divided into observation group and routine rehabilitation therapy group,Two groups of patients were given routine rehabilitation therapy,On the basis of routine rehabilitation treatment,the action observation group were given action observation therapy,the routine rehabilitation group were given the placebo therapy which similar to the action observation therapy,2 times a day,each time 30 min,once a week,for a total of 8 weeks.The real-time functional magnetic resonance imaging were evaluated and analyzed at the time before and after treatment for 8 weeks.Chose the primary motor cortex,supplementary motor area and premotor cortex as theregions of interest,and then do the corresponding data processing,observation of patients with brain function imaging and ROI brain activation volume,and statistical analysis.Results: Rtf MRI test results show that the two groups before and after treatment in the treatment of watching the video,the corresponding brain exercise in patients with cortical primary motor area?premotor cortex?supplementary motor area region of the activation volume than before treatment was significantly increased.The activation volume of motor related cortex of observation group before treatment was M1(153.94±15.93)?PMV(97.75±17.28)?SMA(90.38±18.11),and after treatment was M1(416.81±64.42)?PMV(199.50±30.06)?SMA(189.94±23.35),the activation volume of motor related cortex after treatment is significantly higher than before treatment(P<0.05).The activation volume of motor related cortex of routine rehabilitation therapy group before treatment was M1(161.53±17.66)? PMV(95.13±19.10)?SMA(92.33±19.61),and after treatment was M1(334.13±36.69)PMV(162.27±28.89)?SMA(152.20±23.21),the activation volume of motor related cortex after treatment is significantly higher than before treatment(P<0.05).Compared with the two groups,the volume of motor related cortical activation area in the motor observation group was significantly higher than those of the conventional rehabilitation treatment teams,there was statistically significan difference between the two groups(P<0.05).Conclusion:Action observation therapy through the activation of stroke patients in the M1 area,PMC area,SMA area and other sports related cortex,stroke patients with impaired motor function reorganization,thereby promoting the recovery of hemiplegic limb motor function. |
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