脑卒中偏瘫患者平衡功能障碍康复治疗进展
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摘要
平衡功能障碍主要表现为重心维持稳定及重心转移困难、坐位或站立姿势维持困难、行走过程中步态不稳及向偏侧倾倒等,其严重影响了患者的运动功能、日常生活以及康复的信心。该文主要从平衡功能障碍的发生机制、影响及近几年脑卒中后平衡功能障碍的康复方法展开论述,以期为脑卒中康复提供平衡功能康复的治疗参考。
Balance dysfunction is mainly manifested as the center of gravity to maintain stable and center of gravity transfer difficulties,sitting or standing posture maintenance difficulties,walking in the process of unsteady gait,and the partial side dumping,etc. It seriously affected the movement function,daily life and rehabilitation in patients with confidence. The article mainly discusses the mechanism of balance dysfunction,influence and rehabilitation methods of balance dysfunction after stroke in recent years,in order to provide a treatment reference for the rehabilitation of stroke patients with balance function.
Balance dysfunction is mainly manifested as the center of gravity to maintain stable and center of gravity transfer difficulties,sitting or standing posture maintenance difficulties,walking in the process of unsteady gait,and the partial side dumping,etc. It seriously affected the movement function,daily life and rehabilitation in patients with confidence. The article mainly discusses the mechanism of balance dysfunction,influence and rehabilitation methods of balance dysfunction after stroke in recent years,in order to provide a treatment reference for the rehabilitation of stroke patients with balance function.
引文
[1]高瑜晨,郭爱松.脑卒中后平衡功能训练和评估的进展[J].交通医学,2013,27(3):227-230.
[2]朱琪等,乔蕾,羊健中,等.康复治疗对脑卒中偏瘫患者平衡功能和日常生活活动能力的影响[J].中国康复,2008,23(1):26-27.
[3]肖振东,杨申,宁方波,等.早期平衡训练对脑卒中患者平衡功能的影响[J].社区医学杂志,2014,12(6):1-2.
[4]Panics G,Tallay A,Pavlik A,et al.The effect of proprioception training on knee joint position sense in female team handball players[J].Br J Sports Med,2008,42(6):472-476.
[5]Goldie PA,Matyas TA,Evans OM,et al.Maximum voluntary weight bearing by the affected and unaffected legs in standing following stroke[J].Clin Biomech,1996,11:333-342.
[6]Smith PS,Thompson M.Treadmill training post stroke:arethere any secondary benefits?A pilot study[J].Clin Rehabil,2008,22(10-11):997-1002.
[7]方红.平衡训练对脑卒中偏瘫患者步态及行走能力的影响[J].浙江中医药大学学报,2014,34(4):565.
[8]谭婉雯,杨冰霞.感觉功能训练对脑卒中偏瘫病人运动功能的影响[J].护理研究,2009,23(7):1905-1906.
[9]白岚月,张淑江.PNF在脑卒中康复治疗中的应用进展[J].四川医学,2013,34(11):1782.
[10]林婕,唐占英,金晟,等.Bobath康复疗法的研究进展[J].神经损伤与功能重建,2014,9(6):515-518.
[11]郭京伟,谢欲晓,黄学英,等.强化髋外展肌群对脑卒中偏瘫患者平衡功能和步行安全性的影响[J].中国康复医学杂志,2008,23(6):510-512,517.
[12]刘文权,徐武华,吴婉霞,等.强化膝关节控制训练对脑卒中偏瘫患者平衡功能和步行能力的影响[J].实用医学杂志,2012,28(21):3536-3538.
[13]郭昆义,唐智生,徐晓兰.本体感觉训练对脊髓型颈椎病术后患者平衡功能的影响[J].现代中西医结合杂志,2014,23(34):3802-3804.
[14]Protas EJ,Tissier S.Strength and speed training for elders with mobility disability[J].Journal of Agingand Physical Activity,2009,17(3):257-271.
[15]Goodman PJ.Connecting the Core[J].NACA’s Performance Training Journal,2004,3(6):10-14.
[16]Willson JD,Dougherty CP,Ireland ML,et al.Core stabilityand its relationship to lower extremity function andinjury[J].J Am Acad Orthop Surg,2005,13:316-325.
[17]Akuthota V,Nadler SF.Core strengthening[J].Archives of Physical Medicine and Rehabilitation,2004,85:86-92.
[18]寄婧,王宁霞.Bobath球训练对脑卒中偏瘫患者运动功能的影响[J].临床荟萃,2016,31(1):81-84.
[19]顾昭华,龚晨,伊文超,等.多点多轴悬吊训练系统对脑卒中偏瘫患者平衡和步行能力的影响[J].中国康复医学杂志,2013,28(5):452-454.
[20]王永正.强化躯干训练对脑卒中偏瘫患者平衡功能和运动功能的影响研究[J].中外医学研究,2015,13(12):136-137.
[21]廖亮华,罗伟良,陈树丹,等.躯干控制能力训练对偏瘫患者平衡和下肢功能的影响[J].中国康复医学杂志,2006,21(7):608-609,616.
[22]Bagnato S,Boccagni C,Boniforti F,et al.Motor dysfunction of the“non-28affected”lower limb:a kinematic comparative study between hemiparetic stroke andtotal knee prosthesized patients[J].Neurological Sciences,2009,30(2):107-113.
[23]黄小静,窦祖林,丘卫红,等.动态姿态平衡仪训练对脑卒中偏瘫患者平衡功能的影响[J].中国康复医学杂志,2011,26(11):1029-1034,1038.
[24]Smith PS,Hembree JA,Thompson ME.Berg Balance Scale and Functional Reach:determining the best clinical tool forindividuals post acute stroke[J].Clinical Rehabilitation,2004,18(7):811-818.
[25]燕铁斌.起立-行走计时测试简介[J].中国康复理论与实践,2000,6(3):115.
[26]李中元,王雅青,马启寿,等.静动态站立平衡仪治疗脑卒中偏瘫22例疗效观察[J].福建中医药大学学报,2013,23(1):62-63.
[27]刘景隆,周连元,张红.脑卒中后本体感觉障碍对日常生活能力的影响[J].中国康复理论与实践,2006,12(6):496-497.
[28]赵宁.本体感觉训练对脑卒中偏瘫患者平衡功能及躯干控制能力的影响[J].社区医学杂志,2016,14(4):61-62.
[29]刘勇.PNF技术对脑卒中患者的疗效观察[C]//浙江省物理医学与康复学学术年会暨第八届浙江省康复医学发展论坛论文集,宁波:浙江省科学技术协会,2013,146-147.
[30]张保国,李琳,林乐乐,等.本体感觉神经肌肉促进技术结合静态平衡训练对脑卒中偏瘫患者躯干控制及平衡能力的影响[J].中国康复医学杂志,2011,26(11):1068-1070.
[31]谢凌峰,黄晓琳,黄杰,等.本体感觉训练对脑卒中偏瘫患者运动功能及日常生活活动能力的影响[J].中华物理医学与康复杂志,2012,34(8):592-595.
[32]张勃,丁玎,吕立.本体感觉训练结合核心稳定性训练对脑卒中偏瘫患者下肢功能及平衡的影响[J].中国康复理论与实践,2014,20(12):1109-1112.
[33]王艳,唐强,李晓艳,等.头穴丛刺结合康复技术对脑瘫患儿运动功能及智力的影响[J].中医药学报,2011,39(4):85-86.
[34]王涛,李佩芳,浦芳,等.针刺督脉结合康复训练对脑卒中患者平衡功能的临床观察[J].云南中医中药杂志,2014,35(3):16-19.
[35]曾沛金,黎高林.头针结合康复训练对脑卒中患者平衡功能障碍的临床研究[J].中国医药导刊,2012,14(12):2034-2035.
[36]Ladwig KH,Marten Mittag B,Erazo N,et al.Identifying somatizationdisorder in a population based health examination survey:Psychosocial burden and gender differences[J].Psychosomatics,2001,42(6):511.
[2]朱琪等,乔蕾,羊健中,等.康复治疗对脑卒中偏瘫患者平衡功能和日常生活活动能力的影响[J].中国康复,2008,23(1):26-27.
[3]肖振东,杨申,宁方波,等.早期平衡训练对脑卒中患者平衡功能的影响[J].社区医学杂志,2014,12(6):1-2.
[4]Panics G,Tallay A,Pavlik A,et al.The effect of proprioception training on knee joint position sense in female team handball players[J].Br J Sports Med,2008,42(6):472-476.
[5]Goldie PA,Matyas TA,Evans OM,et al.Maximum voluntary weight bearing by the affected and unaffected legs in standing following stroke[J].Clin Biomech,1996,11:333-342.
[6]Smith PS,Thompson M.Treadmill training post stroke:arethere any secondary benefits?A pilot study[J].Clin Rehabil,2008,22(10-11):997-1002.
[7]方红.平衡训练对脑卒中偏瘫患者步态及行走能力的影响[J].浙江中医药大学学报,2014,34(4):565.
[8]谭婉雯,杨冰霞.感觉功能训练对脑卒中偏瘫病人运动功能的影响[J].护理研究,2009,23(7):1905-1906.
[9]白岚月,张淑江.PNF在脑卒中康复治疗中的应用进展[J].四川医学,2013,34(11):1782.
[10]林婕,唐占英,金晟,等.Bobath康复疗法的研究进展[J].神经损伤与功能重建,2014,9(6):515-518.
[11]郭京伟,谢欲晓,黄学英,等.强化髋外展肌群对脑卒中偏瘫患者平衡功能和步行安全性的影响[J].中国康复医学杂志,2008,23(6):510-512,517.
[12]刘文权,徐武华,吴婉霞,等.强化膝关节控制训练对脑卒中偏瘫患者平衡功能和步行能力的影响[J].实用医学杂志,2012,28(21):3536-3538.
[13]郭昆义,唐智生,徐晓兰.本体感觉训练对脊髓型颈椎病术后患者平衡功能的影响[J].现代中西医结合杂志,2014,23(34):3802-3804.
[14]Protas EJ,Tissier S.Strength and speed training for elders with mobility disability[J].Journal of Agingand Physical Activity,2009,17(3):257-271.
[15]Goodman PJ.Connecting the Core[J].NACA’s Performance Training Journal,2004,3(6):10-14.
[16]Willson JD,Dougherty CP,Ireland ML,et al.Core stabilityand its relationship to lower extremity function andinjury[J].J Am Acad Orthop Surg,2005,13:316-325.
[17]Akuthota V,Nadler SF.Core strengthening[J].Archives of Physical Medicine and Rehabilitation,2004,85:86-92.
[18]寄婧,王宁霞.Bobath球训练对脑卒中偏瘫患者运动功能的影响[J].临床荟萃,2016,31(1):81-84.
[19]顾昭华,龚晨,伊文超,等.多点多轴悬吊训练系统对脑卒中偏瘫患者平衡和步行能力的影响[J].中国康复医学杂志,2013,28(5):452-454.
[20]王永正.强化躯干训练对脑卒中偏瘫患者平衡功能和运动功能的影响研究[J].中外医学研究,2015,13(12):136-137.
[21]廖亮华,罗伟良,陈树丹,等.躯干控制能力训练对偏瘫患者平衡和下肢功能的影响[J].中国康复医学杂志,2006,21(7):608-609,616.
[22]Bagnato S,Boccagni C,Boniforti F,et al.Motor dysfunction of the“non-28affected”lower limb:a kinematic comparative study between hemiparetic stroke andtotal knee prosthesized patients[J].Neurological Sciences,2009,30(2):107-113.
[23]黄小静,窦祖林,丘卫红,等.动态姿态平衡仪训练对脑卒中偏瘫患者平衡功能的影响[J].中国康复医学杂志,2011,26(11):1029-1034,1038.
[24]Smith PS,Hembree JA,Thompson ME.Berg Balance Scale and Functional Reach:determining the best clinical tool forindividuals post acute stroke[J].Clinical Rehabilitation,2004,18(7):811-818.
[25]燕铁斌.起立-行走计时测试简介[J].中国康复理论与实践,2000,6(3):115.
[26]李中元,王雅青,马启寿,等.静动态站立平衡仪治疗脑卒中偏瘫22例疗效观察[J].福建中医药大学学报,2013,23(1):62-63.
[27]刘景隆,周连元,张红.脑卒中后本体感觉障碍对日常生活能力的影响[J].中国康复理论与实践,2006,12(6):496-497.
[28]赵宁.本体感觉训练对脑卒中偏瘫患者平衡功能及躯干控制能力的影响[J].社区医学杂志,2016,14(4):61-62.
[29]刘勇.PNF技术对脑卒中患者的疗效观察[C]//浙江省物理医学与康复学学术年会暨第八届浙江省康复医学发展论坛论文集,宁波:浙江省科学技术协会,2013,146-147.
[30]张保国,李琳,林乐乐,等.本体感觉神经肌肉促进技术结合静态平衡训练对脑卒中偏瘫患者躯干控制及平衡能力的影响[J].中国康复医学杂志,2011,26(11):1068-1070.
[31]谢凌峰,黄晓琳,黄杰,等.本体感觉训练对脑卒中偏瘫患者运动功能及日常生活活动能力的影响[J].中华物理医学与康复杂志,2012,34(8):592-595.
[32]张勃,丁玎,吕立.本体感觉训练结合核心稳定性训练对脑卒中偏瘫患者下肢功能及平衡的影响[J].中国康复理论与实践,2014,20(12):1109-1112.
[33]王艳,唐强,李晓艳,等.头穴丛刺结合康复技术对脑瘫患儿运动功能及智力的影响[J].中医药学报,2011,39(4):85-86.
[34]王涛,李佩芳,浦芳,等.针刺督脉结合康复训练对脑卒中患者平衡功能的临床观察[J].云南中医中药杂志,2014,35(3):16-19.
[35]曾沛金,黎高林.头针结合康复训练对脑卒中患者平衡功能障碍的临床研究[J].中国医药导刊,2012,14(12):2034-2035.
[36]Ladwig KH,Marten Mittag B,Erazo N,et al.Identifying somatizationdisorder in a population based health examination survey:Psychosocial burden and gender differences[J].Psychosomatics,2001,42(6):511.