脑卒中偏瘫患者膝关节运动控制训练对步态的影响
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摘要
目的:通过对膝关节运动控制训练来探究脑卒中对偏瘫患者步态的影响,从而确定其临床康复治疗的对策。方法:选择深圳市第二人民医院2015年3月至2017年12月确诊为脑卒中所致步态异常的40例患者,随机分为观察组及对照组,各20例。观察组患者进行针对性的膝关节控制性训练,对照组进行常规体能训练(PT)、起立床、行走等整体训练。治疗前后采用Fugl–Meyer运动功能评价法进行康复评估。结果:两组患者治疗后Fugl–Meyer步行能力总分、平衡功能评分、左右步幅差、步速比较,Fugl-Meyer运动功能评分步行能力为治疗组为(25.35±7.52),对照组为(20.53±3.45)分;平衡能力为治疗组为(10.43±2.99)分,对照组为(8.98±3.18)分;左右步幅差(cm)为治疗组(3.45±2.70)cm,对照组为(8.71±4.35)cm;步速(m·s-1)为治疗组(0.68±0.34)分,对照组(0.44±0.29)分,评估结果差异具有统计学意义(P<0.01)。结论:通过对偏瘫患者的膝关节控制性训练,可以显著改善步态,提高患者的步行能力。
Objective To explore the influence of stroke on the gait of patients with hemiplegia by training the knee joint motion control, so as to determine the countermeasures for clinical rehabilitation. Methods Select Shenzhen Second People's Hospital from March 2015 to December 2017 was diagnosed with 40 cases of abnormal gait caused by stroke, were randomly divided into observation group and control group, 20 cases each.Targeted knee control exercises were performed in 40 patients with abnormal gait after stroke. Before and after treatment, Fugl-Meyer motor function evaluation method was used for rehabilitation evaluation. Results The walking ability of the Fugl-Meyer motor function score was(25.35 ± 7.52) in the study group and(20.53 ± 3.45) in the control group; the balance was(10.43 ± 2.99) in the study group and 8.98 ± 3.18 in the control group; the left and right step difference(cm)was The study group was(3.45 ± 2.70) and the control group was(8.71 ± 4.35).The pace(m/s)was 0.68 ± 0.34 in the study group and(0.44 ± 0.29) in the control group. After statistical analysis, there was a signifi cant difference between the two groups(P < 0.01). Conclusion By controlling the knee joints in patients with hemiplegia, the gait can be signifi cantly improved and the patient's walking ability can be improved.
Objective To explore the influence of stroke on the gait of patients with hemiplegia by training the knee joint motion control, so as to determine the countermeasures for clinical rehabilitation. Methods Select Shenzhen Second People's Hospital from March 2015 to December 2017 was diagnosed with 40 cases of abnormal gait caused by stroke, were randomly divided into observation group and control group, 20 cases each.Targeted knee control exercises were performed in 40 patients with abnormal gait after stroke. Before and after treatment, Fugl-Meyer motor function evaluation method was used for rehabilitation evaluation. Results The walking ability of the Fugl-Meyer motor function score was(25.35 ± 7.52) in the study group and(20.53 ± 3.45) in the control group; the balance was(10.43 ± 2.99) in the study group and 8.98 ± 3.18 in the control group; the left and right step difference(cm)was The study group was(3.45 ± 2.70) and the control group was(8.71 ± 4.35).The pace(m/s)was 0.68 ± 0.34 in the study group and(0.44 ± 0.29) in the control group. After statistical analysis, there was a signifi cant difference between the two groups(P < 0.01). Conclusion By controlling the knee joints in patients with hemiplegia, the gait can be signifi cantly improved and the patient's walking ability can be improved.
引文
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[2]冯丙富.MRI对脑梗死的综合诊断分析[J].中国医学创新,2014,11(3):65-66.
[3]Park EY,Choi YI.Psychometric Properties of the Lower Extremity Subscale of the Fugl-Myer Assessment for Community-dwelling Hemiplegic Stroke Patients[J].Journal of Physical Therapy Science,2014,26(11):1775-1777.
[4]Peters S,Garland S J,Miller K J,et al.Motor Planning for Loading During Gait in Subacute Stroke[J].Arch Phys Med Rehabil,2016,97(4):528-535.
[5]Gao F,Ren Y,Roth E J,et al.Effects of repeated ankle stretching on calf muscle-tendon and ankle biomechanical properties in stroke survivors[J].Clin Biomech(Bristol,Avon),2011,26(5):516-522.
[6]Patricia M著.刘钦刚译.循序渐进-成人偏瘫康复训练指南[M].2版.安徽:中国科学技术大学出版社,2017:115-117.
[7]Harris ML.Quadriceps disabicity after stroke[J].Clin Rchabil,2001,15(21):274-281.
[8]Patricia M著.刘钦刚译.偏瘫患者的全面康复治疗[M].2版.北京:华夏出版社,2017:220-221.
[9]Janet H,Carr Roberta B,Shepherd著.黄永禧,徐木华译.中风病人的运动再学习方案[M].北京:北京医科大学出版社,2002:105-106.
[10]Janet H,Carr Roberta B,Shepherd著.王宁华,黄永禧,黄真译.脑卒中康复-优化运动技巧的练习与训练指南[M].北京:北京医科大学出版社,2010:113-114.