姿势控制训练结合核心肌群训练对脑卒中患者运动功能的影响
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摘要
目的:探讨姿势控制结合核心肌群训练对脑卒中患者下肢运动功能、平衡功能及步行能力的影响。方法:选择2015年12月到2017年12月我院收治的94例脑卒中偏瘫恢复期患者。患者被随机均分为常规康复组和联合训练组(在常规康复组基础上接受姿势控制和核心肌群训练),两组均治疗4周。观察比较两组治疗前后Fugl-Meyer运动功能量表(FMA)评分、Berg平衡量表(BBS)评分以及Holden步行功能分级(FAC)。结果:与治疗前比较,两组治疗4周后下肢FMA评分、BBS评分及FAC分级均显著升高,P均=0.001。与常规康复组比较,治疗4周后,联合训练组下肢FMA评分[(22.61±1.84)分比(25.84±1.67)分]、BBS评分[(23.28±1.92)分比(28.82±1.36)分]以及FAC分级[(2.96±0.71)级比(4.02±0.46)级]升高更显著,P均=0.001。结论:姿势控制训练结合核心肌群训练可明显促进脑卒中偏瘫患者下肢运动功能的恢复,改善平衡,提高步行能力,值得临床推广。
Objective:To explore influence of posture control combined core muscle group training on motor function of lower limb,balance function and walking ability in patients with stroke.Methods:A total of 94 patients with hemiplegia after stroke during rehabilitation period,who were treated in our hospital from Dec 2015 to Dec 2017,were selected.Patients were randomly and equally divided into routine rehabilitation group and combined training group(received posture control and core muscle group training based on routine rehabilitation group),both groups were treated for four weeks.Scores of Fugal-Meyer motor assessment(FMA)scale,Berg balance scale(BBS)and Holden functional ambulation classification(FAC)were observed and compared between two groups before and after treatment.Results:Compared with before treatment,there were significant rise in scores of lower limb FMA,BBS and FAC class in two groups after four-week treatment,P=0.001 all.Compared with routine rehabilitation group after four-week treatment,there were significant rise in lower limb FMA score[(22.61±1.84)scores vs.(25.84±1.67)scores],BBS score[(23.28±1.92)scores vs.(28.82±1.36)scores]and FAC class[(2.96±0.71)classes vs.(4.02±0.46)classes]in combined training group,P=0.001 all.Conclusion:Posture control training combined core muscle group training can significantly promote rehabilitation of lower limb motor function,improve balance and walking ability in patients with hemiplegia after stroke,which is worth extending.
Objective:To explore influence of posture control combined core muscle group training on motor function of lower limb,balance function and walking ability in patients with stroke.Methods:A total of 94 patients with hemiplegia after stroke during rehabilitation period,who were treated in our hospital from Dec 2015 to Dec 2017,were selected.Patients were randomly and equally divided into routine rehabilitation group and combined training group(received posture control and core muscle group training based on routine rehabilitation group),both groups were treated for four weeks.Scores of Fugal-Meyer motor assessment(FMA)scale,Berg balance scale(BBS)and Holden functional ambulation classification(FAC)were observed and compared between two groups before and after treatment.Results:Compared with before treatment,there were significant rise in scores of lower limb FMA,BBS and FAC class in two groups after four-week treatment,P=0.001 all.Compared with routine rehabilitation group after four-week treatment,there were significant rise in lower limb FMA score[(22.61±1.84)scores vs.(25.84±1.67)scores],BBS score[(23.28±1.92)scores vs.(28.82±1.36)scores]and FAC class[(2.96±0.71)classes vs.(4.02±0.46)classes]in combined training group,P=0.001 all.Conclusion:Posture control training combined core muscle group training can significantly promote rehabilitation of lower limb motor function,improve balance and walking ability in patients with hemiplegia after stroke,which is worth extending.
引文
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[10]Haruyama K,Kawakami M,Otsuka T.Effect of Core Stability Training on Trunk Function,Standing Balance,and Mobility in Stroke Patients[J].Neurorehabil Neural Repair,2017,31(3):240-249.
[11]尹群辉,张皓.脑卒中偏瘫患者预期性姿势调节的研究进展[J].中国康复理论与实践,2017,23(11):1250-1253.
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[13]Liu M,Chen J,Fan W,et al.Effects of modified sit-to-stand training on balance control in hemiplegic stroke patients:a randomized controlled trial[J].Clin Rehabil,2016,30(7):627-636.
[14]Yang YR,Chen YH,Chang HC,et al.Effects of interactive visual feedback training on post-stroke pusher syndrome:apilot randomized controlled study[J].Clin Rehabil,2015,29(10):987-993.
[15]邵印麟,周立晨,欧阳迎,等.姿势控制训练对脑卒中偏瘫患者近端肢体关节肌肉能力的影响[J].中国康复医学杂志,2017,32(9):1059-1062.
[2]邹淑怡,温红梅.执行功能对脑卒中后运动恢复的影响及其机制研究进展[J].中国康复理论与实践,2016,22(9):1024-1027.
[3]Dogru Huzmeli E,Yildirim SA,Kilinc M.Effect of sensory training of the posterior thigh on trunk control and upper extremity functions in stroke patients[J].Neurol Sci,2017,38(4):651-657.
[4]覃林,韦霞,刘琳,等.太极运动对脑卒中患者运动、情绪及生活质量影响的系统评价和Meta分析[J].中国组织工程研究,2016,20(2):297-303.
[5]荣积峰,王卫宁,吴毅,等.悬吊核心稳定训练对脑卒中恢复期患者平衡功能和步行能力的影响[J].中国康复,2017,32(2):109-112.
[6]Gabel CP,Rando N,Melloh M.Slacklining and stroke:A rehabilitation case study considering balance and lower limb weakness[J].World J Orthop,2016,7(8):513-518.
[7]祝飞虹,吴赞杨,马振宇,等.核心稳定性训练结合肌电生物反馈对恢复脑卒中偏瘫患者上肢功能及日常生活活动能力的临床研究[J].中国现代医学杂志,2016,26(4):76-79.
[8]孙良文,胡锦荣,黎飞,等.基于日常生活活动能力的功能性移动训练在脑卒中后偏瘫患者中的应用[J].中华物理医学与康复杂志,2017,39(6):446-449.
[9]梁亚利,余超,廖瑞松,等.动态扰动结合双跑带运动平板训练对脑卒中偏瘫患者步行能力的影响[J].中国康复医学杂志,2017,32(12):1412-1414.
[10]Haruyama K,Kawakami M,Otsuka T.Effect of Core Stability Training on Trunk Function,Standing Balance,and Mobility in Stroke Patients[J].Neurorehabil Neural Repair,2017,31(3):240-249.
[11]尹群辉,张皓.脑卒中偏瘫患者预期性姿势调节的研究进展[J].中国康复理论与实践,2017,23(11):1250-1253.
[12]Rossano C,Terrier P.Visually-guided gait training in paretic patients during the first rehabilitation phase:study protocol for a randomized controlled trial[J].Trials,2016,17(1):523.
[13]Liu M,Chen J,Fan W,et al.Effects of modified sit-to-stand training on balance control in hemiplegic stroke patients:a randomized controlled trial[J].Clin Rehabil,2016,30(7):627-636.
[14]Yang YR,Chen YH,Chang HC,et al.Effects of interactive visual feedback training on post-stroke pusher syndrome:apilot randomized controlled study[J].Clin Rehabil,2015,29(10):987-993.
[15]邵印麟,周立晨,欧阳迎,等.姿势控制训练对脑卒中偏瘫患者近端肢体关节肌肉能力的影响[J].中国康复医学杂志,2017,32(9):1059-1062.