doi:10.3969/j.issn.1674-490X.2025.03.003

Abstract

Abstract: Post-stroke hand dysfunction, as one of the common and challenging sequelae, is characterized by difficulties in treatment and slow recovery. Therefore, finding more effective and comprehensive rehabilitation strategies has become a key research focus. This review aims to summarize the current research on the pathogenesis and rehabilitation of hand dysfunction, and analyze the advantages, limitations, and clinical efficacy of different rehabilitation approaches.

Key words: stroke, hand dysfunction, central intervention, peripheral intervention, rehabilitation

CLC Number:

References

[1] 黄文柱,严文,王志军,等.基于脑重塑的手功能康复进展[J].中国医药导报, 2019, 16(26): 37-40.
[2] 张杉杉,王伟,潘永清.上八邪、合谷穴合谷刺结合后溪穴治疗中风后手功能障碍临床观察[J].中国针灸, 2019, 39(3): 271-275. DOI: 10.13703/j.0255-2930.2019.03.013.
[3] 赵金婷,李四楠,蔡楚杰,等.脑卒中后手功能康复机器人的研究进展: 从传动机构角度的探讨[J].中国康复医学杂志, 2023, 38(11): 1616-1622.
[4] LIU F W, CHEN C C, HONG W J, et al. Selectively disrupted sensorimotor circuits in chronic stroke with hand dysfunction[J]. CNS Neurosci Ther, 2022, 28(5): 677-689. DOI: 10.1111/cns.13799.
[5] 梁小凤,陈昌成,唐朝正.脑卒中后部分偏瘫手大尺度神经环路紊乱机制的静息态fMRI研究[J].中国康复医学杂志, 2024, 39(4): 515-521. DOI: 10.3969/j.issn.1001-1242.2024.04.009.
[6] WANG X, WANG H W, XIONG X, et al. Motor imagery training after stroke increases slow-5 oscillations and functional connectivity in the ipsilesional inferior parietal lobule[J]. Neurorehabil Neural Repair, 2020, 34(4): 321-332. DOI: 10.1177/1545968319899919.
[7] 李莹华.基于力反馈的手部康复机器人结合任务导向性训练对脑卒中偏瘫患者手指粗大抓握功能的影响[D].长春: 吉林大学, 2022: 38-40. DOI: 10.27162/d.cnki.gjlin.2022.006694.
[8] 陈松美,周芷晴,徐曙天,等.非受累侧半球高频经颅磁刺激改善脑卒中后中重度上肢偏瘫的作用及运动皮质重组特征分析[J].中国康复医学杂志, 2023, 38(2): 167-173. DOI: 10.3969/j.issn.1001-1242.2023.02.005.
[9] SHIM J, LEE S. Effects of high-frequency repetitive transcranial magnetic stimulation combined with motor learning on motor function and grip force of the upper limbs and activities of daily living in patients with a subacute stroke[J]. Int J Environ Res Public Health, 2023, 20(12): 6093. DOI: 10.3390/ijerph20126093.
[10] PETRUSEVICIENE L, SACK A T, KUBILIUS R, et al. High-frequency ipsilesional versus low-frequency contralesional transcranial magnetic stimulation after stroke: differential effects on ipsilesional upper extremity motor recovery[J]. Medicina(Kaunas), 2023, 59(11): 1955. DOI: 10.3390/medicina59111955.
[11] LEFAUCHEUR J P, ALEMAN A, BAEKEN C, et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation(rTMS): an update(2014-2018)[J]. Clin Neurophysiol, 2020, 131(2): 474-528. DOI: 10.1016/j.clinph.2019.11.002.
[12] 顾赛勇,邵圣茜,杨煜.康复机器人手套结合镜像疗法对脑卒中偏瘫患者上肢运动及手功能的影响[J].中外医疗, 2023, 42(9): 9-13. DOI: 10.16662/j.cnki.1674-0742.2023.09.009.
[13] GELLER D, NILSEN D M, QUINN L, et al. Home mirror therapy: a randomized controlled pilot study comparing unimanual and bimanual mirror therapy for improved arm and hand function post-stroke[J]. Disabil Rehabil, 2022, 44(22): 6766-6774. DOI: 10.1080/09638288.2021.1973121.
[14] DING L, HE J Y, YAO L, et al. Mirror visual feedback combining vibrotactile stimulation promotes embodiment perception: an electroencephalogram(EEG)pilot study[J]. Front Bioeng Biotechnol, 2020, 8: 553270. DOI: 10.3389/fbioe.2020.553270.
[15] 张明,王斌,贾凡,等.基于脑电图的脑机接口技术在脑卒中患者上肢运动功能康复中的应用[J].中国组织工程研究, 2024, 28(4): 581-586. DOI: 10.12307/2023.865.
[16] FU J H, CHEN S G, SHU X K, et al. Functional-oriented, portable brain-computer interface training for hand motor recovery after stroke: a randomized controlled study[J]. Front Neurosci, 2023, 17: 1146146. DOI: 10.3389/fnins.2023.1146146.
[17] 何聪,刘征.针刺治疗缺血性脑卒中的机制研究进展[J].环球中医药, 2023, 16(2): 343-347. DOI: 10.3969/j.issn.1674-1749.2023.02.033.
[18] 郭义.实验针灸学[M].4版.北京:中国中医药出版社, 2016: 137-139.
[19] 盛培新,戴朝富,项旭芳,等.头针配合松动上肢张力试验治疗脑卒中后手功能障碍临床研究[J].新中医, 2023, 55(13): 148-150. DOI: 10.13457/j.cnki.jncm.2023.13.028.
[20] 郑应康,王东岩,刘洋,等.功能性电刺激在脑卒中后上肢康复中的应用及研究进展[J].中国康复医学杂志, 2022, 37(8): 1121-1125.
[21] 陈佳梦,张晓雪,齐丽娜,等.川平法联合功能性电刺激对脑卒中恢复期患者手功能的影响[J].华北理工大学学报(医学版), 2022, 24(6): 475-480. DOI: 10.19539/j.cnki.2095-2694.2022.06.009.
[22] 孙秋芳,王卫丽,冯学伟.早期功能性电刺激主导下的床旁作业治疗对脑卒中患者手功能障碍的影响[J].数理医药学杂志, 2021, 34(10): 1554-1556. DOI: 10.3969/j.issn.1004-4337.2021.10.050.
[23] SINGH N, SAINI M, KUMAR N, et al. Evidence of neuroplasticity with robotic hand exoskeleton for post-stroke rehabilitation: a randomized controlled trial[J]. J Neuroeng Rehabil, 2021, 18(1): 76. DOI: 10.1186/s12984-021-00867-7.
[24] RANZANI R, LAMBERCY O, METZGER J C, et al. Neurocognitive robot-assisted rehabilitation of hand function: a randomized control trial on motor recovery in subacute stroke[J]. J Neuroeng Rehabil, 2020, 17(1): 115. DOI: 10.1186/s12984-020-00746-7.
[25] 孙之迪,钱小路.火针治疗中风后遗症的临床研究进展[J].河北中医, 2017, 39(8): 1267-1272. DOI: 10.3969/j.issn.1002-2619.2017.08.037.
[26] 何佳,项晓伟,周红娟,等.毫火针针刺手三阳经结合生物反馈疗法治疗脑卒中后手功能障碍临床研究[J].深圳中西医结合杂志, 2023, 33(14): 29-32. DOI: 10.16458/j.cnki.1007-0893.2023.14.009.
[27] 张淼,肖文迅,刘璐,等.针刺“手十四针”治疗缺血性中风恢复期偏瘫手的临床疗效观察[J].辽宁中医药大学学报, 2024, 26(11): 65-69. DOI: 10.13194/j.issn.1673-842X.2024.11.013.
[28] 蔡佳骏.中医脊柱推拿治疗缺血性脑卒中手功能障碍的临床效果[J].内蒙古中医药, 2022, 41(4): 98-99. DOI: 10.16040/j.cnki.cn15-1101.2022.04.043.
[29] 张福鑫,俞坤强,马旭,等.推拿结合肌内效贴对脑卒中患者上肢及手功能障碍的影响[J].中国现代医生, 2022, 60(9): 140-142.
[30] 何思佳,杨信才.脑卒中偏瘫患者肌肉痉挛治疗的研究进展[J].医学研究与教育, 2021, 38(2): 26-31. DOI: 10.3969/j.issn.1674-490X.2021.02.005.
[31] JIA J. Exploration on neurobiological mechanisms of the central-peripheral-central closed-loop rehabilitation[J]. Front Cell Neurosci, 2022, 16: 982881. DOI: 10.3389/fncel.2022.982881.
[32] 张亚男,郑鹏,闫雪,等.针刺八邪穴结合镜像疗法对脑卒中后偏瘫患者上肢和手功能的临床研究[J].中国康复, 2021, 36(6): 353-355. DOI: 10.3870/zgkf.2021.06.008.

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	. [J]. Journal of Hebei Medical College for Continuing Education, 2024, 41(6): 42-50.
[2]	. [J]. Journal of Hebei Medical College for Continuing Education, 2024, 41(5): 55-67.
[3]	. [J]. Journal of Hebei Medical College for Continuing Education, 2024, 41(4): 21-29.
[4]	. [J]. Journal of Hebei Medical College for Continuing Education, 2024, 41(4): 60-73.
[5]	. [J]. Journal of Hebei Medical College for Continuing Education, 2024, 41(3): 8-17.
[6]	. [J]. Journal of Hebei Medical College for Continuing Education, 2024, 41(2): 63-70.
[7]	. [J]. Journal of Hebei Medical College for Continuing Education, 2024, 41(1): 9-17.
[8]	. [J]. Journal of Hebei Medical College for Continuing Education, 2024, 41(1): 62-70.
[9]	. [J]. Journal of Hebei Medical College for Continuing Education, 2023, 40(5): 53-59.
[10]	. [J]. Journal of Hebei Medical College for Continuing Education, 2023, 40(4): 11-18.
[11]	. [J]. Journal of Hebei Medical College for Continuing Education, 2023, 40(4): 19-24.
[12]	. [J]. Journal of Hebei Medical College for Continuing Education, 2023, 40(3): 46-54.
[13]	. [J]. Journal of Hebei Medical College for Continuing Education, 2023, 40(2): 18-24.
[14]	. [J]. Journal of Hebei Medical College for Continuing Education, 2023, 40(2): 66-73.
[15]	. [J]. Journal of Hebei Medical College for Continuing Education, 2023, 40(1): 29-32.