腓肠肌潜能开发训练对脑卒中偏瘫患者下肢肌张力和运动功能的影响
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摘要
目的:观察腓肠肌潜能开发训练对脑卒中偏瘫患者下肢肌张力和运动功能的影响。方法:将40例脑卒中偏瘫患者随机分为对照组和治疗组,每组20例,两组均采用常规康复治疗方法训练,治疗组每天增加30min腓肠肌潜能开发训练。所有治疗均1次/d、5d/周,共12周。在治疗前后分别采用偏瘫侧下肢综合痉挛量表(CSS)评分、下肢运动功能评分(FMA),徒手肌力测定(MMT)对患者进行综合评价,并分析其功能改善情况。结果:治疗后,两组FMA评分、MMT较治疗前显著增加(P<0.05),治疗组CSS评分较治疗前显著减少(P<0.05);与对照组比较,治疗组FMA评分显著增加(P<0.05),CSS评分显著减少(P<0.05)。结论:腓肠肌潜能开发训练可改善脑卒中偏瘫患者下肢肌张力,缓解痉挛,有效改善下肢运动功能。
Objective: To study the effects of gastrocnemius potentiality development on lower limb motor function and muscle tone of hemiplegic patients. Methods: Forty patients were randomly divided into the treatment group and the control group, 20 patients in each group. Both groups were trained using conventional rehabilitation methods. The treatment group increased 30 min of gastrocnemius potential development training every day. All treatments were once/d, 5 d/week for 12 weeks. Before and after treatment, comprehensive evaluation was performed using composite spasticity scale(CSS), fugl-meyer assessment(FMA), manual muscle test(MMT), and their functional improvement was analyzed. Results: After treatment, the scores of FMA and MMT increased than before treatment in two groups(P<0.05), CSS sores reduced in treatment group(P<0.05); compared with control group, FMA scores increased while CSS scores reduced in treatment group(P<0.05). Conclusion: The gastrocnemius potentiality development training can reduce lower limb spasticity and improve the motor function of hemiplegic patients.
Objective: To study the effects of gastrocnemius potentiality development on lower limb motor function and muscle tone of hemiplegic patients. Methods: Forty patients were randomly divided into the treatment group and the control group, 20 patients in each group. Both groups were trained using conventional rehabilitation methods. The treatment group increased 30 min of gastrocnemius potential development training every day. All treatments were once/d, 5 d/week for 12 weeks. Before and after treatment, comprehensive evaluation was performed using composite spasticity scale(CSS), fugl-meyer assessment(FMA), manual muscle test(MMT), and their functional improvement was analyzed. Results: After treatment, the scores of FMA and MMT increased than before treatment in two groups(P<0.05), CSS sores reduced in treatment group(P<0.05); compared with control group, FMA scores increased while CSS scores reduced in treatment group(P<0.05). Conclusion: The gastrocnemius potentiality development training can reduce lower limb spasticity and improve the motor function of hemiplegic patients.
引文
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[19]赵文汝.临床神经训导康复治疗学.北京:人民卫生出版社,2014:95-103
[2]鲍勇,包兴华,丁旭.气压弹道式体外冲击波对脑卒中腓肠肌痉挛的疗效观察.中国医学前沿杂志,2014,6(6):18
[3]中华医学会第四届全国脑血管病学术会议.各类脑血管疾病诊断要点.中华神经科杂志,1996,29(6):379
[4]赵文汝.临床神经训导康复治疗学.北京:人民卫生出版社,2014:244
[5]赵文汝,曹效,赵海红,等.下肢人体潜能开发训练装置的研制和临床适应证.中国康复理论与实践,2008,14(10):922-924
[6]赵文汝,赵海红,张学敏,等.六步法中医导引术治疗偏瘫足下垂的研究.中国康复医学杂志,2009,24(7):632-634
[7]燕铁斌,许云影.综合痉挛量表的信度研究.中国康复医学杂志,2002,I7(5):263-265
[8]Sullivan K J,Tilson J K,Cen S Y,et al.Fugl-Meyer assessment of sensorimotor function after stroke:standardized training procedure for clinical practice and clinical trails.Stroke,2011,42(2):427-432
[9]郭淑君,余生源,浦创.针刀联合针刺治疗脑卒中后肢体痉挛疗效观察及护理.医学信息,2016,29(24):160-161
[10]Ward A B.A literature review of the pathophysiology and on set of post-stroke spasticity.Eur J Neurol,2012,19(1):21-27
[11]Yu S H,Park S D.The effects of corestability strength exercise on muscle activity and trunk impairment scale in stroke patients.J Exerc Rehabil,2013,9(3):362-367
[12]Stevenson V L.Rehabflimfion in practice:Spasficity management.Clin Rehabil,2010,24(4):293-304
[13]李江,李如一,王琛涵,等.A型肉毒毒素与酒精局部注射治疗脑卒中后下肢肌痉挛的对比研究.中华物理医学与康复杂志.2016,38(7):504-508
[14]吴海博,秦茵.脑卒中后肢体痉挛性偏瘫康复治疗进展.按摩与康复医学,2016,7(21):8-10
[15]Page S J.Intensity versus task-specificity after stroke:how important is intensity?.Am J Phys Med Rehabil,2003,82(9):730-732
[16]Barbeau H,Fung J.The role of rehabilitation in the recovery of walking in the neurological population.Curr Opin Neurol,2001,14(6):735-740
[17]董宝强,王颖,王富龙,等.略论十二经脉气血盛衰对针灸临床的指导作用.中华中医药杂志,2006,21(3):163-165
[18]陈杰,杨娜,孔胜建,等.节律性运动训练在脑卒中偏瘫痉挛患者康复中的疗效.实用医药杂志,2016,33(4):321-322
[19]赵文汝.临床神经训导康复治疗学.北京:人民卫生出版社,2014:95-103