摘要
目的探讨减重步态训练联合膝关节控制训练对脑卒中后膝过伸患者下肢运动功能的康复疗效,旨在改善患者下肢运动功能,提高行走稳定性及安全性。方法选取2021年6月—2022年6月安徽医科大学第一附属医院康复医学科接诊的脑卒中患者30例,采用随机数表法分为对照组和实验组,每组15例;同时招募15名年龄、性别相匹配的健康受试者作为正常对照组,采集足底压力数据。对照组予以常规康复治疗,实验组在常规康复治疗的基础上增加减重步态训练和膝关节控制训练。治疗4周前后,比较2组患者的Berg平衡量表(BBS)、Fugl-Meyer下肢运动功能评分(FMA-LE)、10米步行试验(10MWT)、膝过伸次数测定及足底压力分析[包括双侧足底压力百分比、对称指数(SI)及身体压力中心摆动面积(COP)]。结果2组患者治疗后BBS、FMA-LE、10MWT、膝过伸次数测定均较治疗前改善(P<0.05),除10MWT外,实验组结果均优于对照组[BBS:(22.87±1.96)分vs.(20.93±2.23)分;FMA-LE:(22.07±2.64)分vs.(19.67±2.61)分;10MWT:(27.13±8.20)s vs.(30.73±10.95)s;膝过伸次数测定:(14.00±2.95)次vs.(17.40±3.91)次,均P<0.05]。2组患者SI及COP值较入院前改善,且实验组结果优于对照组(P<0.05),但与正常对照组仍存在差距(P<0.001)。结论脑卒中后膝过伸患者采用减重步态训练联合膝关节控制可有效提高患者步行及平衡能力。
Objective To explore the rehabilitation efficacy of body weight supported treadmill training(BWSTT)combined with knee joint controlling(KJC)on lower limb motor function in patients with knee hyperextension(KH)after stroke,so as to improve the motor function of lower limbs and enhance walking stability and safety.Methods Thirty stroke patients admitted to Department of Rehabilitation Medicine of the First Affiliated Hospital of Anhui Medical University from June 2021 to June 2022 were selected.They were divided into a control group and an experimental group by using the random number table method,with 15 cases in each group.In order to collect plantar pressure data,15 aging and gender-matched healthy subjects were recruited as the normal controls.The control group was treated with conventional rehabilitation therapy,while the experimental group received BWSTT and KJC on the basis therapy.The Berg balance scale(BBS),Fugl-Meyer assessment of lower extremity(FMA-LE),10-meter walking test(10MWT),KH measurements and plantar pressure analysis[bilateral plantar pressure percentage,symmetry index(SI)and center of pressure(COP)]were compared between the two groups before and after 4 weeks of treatment.Results The BBS,FMA-LE,10MWT and KH measurements improved in both groups after 4 weeks of treatment(P<0.05),and the experimental group had better results than the control group except for 10MWT[BBS score:(22.87±1.96)points vs.(20.93±2.23)points;FMA-LE:(22.07±2.64)points vs.(19.67±2.61)points;10MWT:(27.13±8.20)seconds vs.(30.73±10.95)seconds;KH measurements:(14.00±2.95)times vs.(17.40±3.91)times,all P<0.05].The SI and COP improved in both groups compared to pre-admission and were better in the experimental group than those in the control group(P<0.05),but had difference with normal subjects(P<0.001).Conclusion BWSTT combined with KJC can effectively improve walking and balance in stroke patients with KH.
作者
殷其勇
徐青亲
陈德生
汪敏
陈和木
YIN Qiyong;XU Qingqin;CHEN Desheng;WANG Min;CHEN Hemu(Department of Rehabilitation Medicine,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China;不详)
出处
《中华全科医学》
2023年第6期1034-1038,共5页
Chinese Journal of General Practice
基金
安徽省高校自然科学研究项目(KJ2020ZD18)
安徽省省级高等学校质量工程项目(2020SJJXSFK1370)。
关键词
脑卒中
膝过伸
减重步态训练
膝关节控制
足底压力分析
Stroke
Knee hyperextension
Body weight supported treadmill training
Knee joint controlling
Plantar pressure analysis
