膝关节本体感觉训练对偏瘫患者平衡功能的影响
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摘要
目的:探讨对脑卒中偏瘫患者施行膝关节本体感觉训练后其平衡功能恢复的影响。方法:符合要求的20例受试者依年龄、性别、功能障碍程度、偏瘫侧等条件以一一配对的方式分成观察组和对照组,对照组接受常规康复治疗,观察组在常规康复治疗的基础上加强膝关节本体感觉训练。两组患者在治疗前和治疗后分别采用角度重建法测量膝关节位置觉和使用Berg平衡量表(BBS)测量平衡功能。结果:观察组患侧膝关节位置重现的平均偏差变小(P<0.01),屈膝30°、45°的测试中,试验后膝关节位置偏差与训练前测量值对比有显著性意义(P<0.05)。试验后,观察组与对照组患侧膝关节位置重现平均偏差比较有显著性意义(P<0.01)。试验后的BBS评分值,两组对比有显著性意义(P<0.05)。结论:膝关节本体感觉训练对脑卒中患者的平衡功能恢复有积极的作用,对脑卒中偏瘫患者进行膝关节本体感觉训练很有必要的。
Objective:To explore the impact of knee joint proprioception training on the balance function recovery of stroke patients with hemiplegia.Method:Twenty subjects were divided into experimental group and control group paired with age/gender/disability. The control group received conventional rehabilitation, Experimental group received knee proprioception training on the basis of conventional rehabilitation. The two groups of patients were assessed with angle measurement of knee joint and Berg balance scale(BBS) before and after treatment.Result:After experiment, the deviation of effected knee joint position was less than that before expertment significantly(P<0.05), and the difference of deviation between the two groups was statistically significant(P<0.01).The scores of BBS between the two groups was statistically significant(P<0.05).Conclusion:Knee proprioception training have positive effect to restore the balance function of stroke patients.
Objective:To explore the impact of knee joint proprioception training on the balance function recovery of stroke patients with hemiplegia.Method:Twenty subjects were divided into experimental group and control group paired with age/gender/disability. The control group received conventional rehabilitation, Experimental group received knee proprioception training on the basis of conventional rehabilitation. The two groups of patients were assessed with angle measurement of knee joint and Berg balance scale(BBS) before and after treatment.Result:After experiment, the deviation of effected knee joint position was less than that before expertment significantly(P<0.05), and the difference of deviation between the two groups was statistically significant(P<0.01).The scores of BBS between the two groups was statistically significant(P<0.05).Conclusion:Knee proprioception training have positive effect to restore the balance function of stroke patients.
引文
[1]Mandelbaum BR,Silvers HJ,Watanabe DS,et al.Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes:2-year follow-up[J].Am J Sports Med,2005,33(7):1003—1010.
[2]Fong SM,Ng GY.The effects on sensorimotor performance and balance with Tai Chi training[J].Arch Phys Med Rehabil,2006,87:82—87.
[3]Piriyaprasarth P,Morris ME,Delany C,et al.Trials needed to assess knee proprioception following stroke[J].Physiotherapy Research International Physiother,2009,14(1):6—16.
[4]张鹏,钱风雷,封旭华,等.游泳运动员膝关节损伤康复中本体感觉训练的应用[J].中国运动医学杂志,2010,29(6):640—642.
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[10]潘毓健,徐国会,郑洁皎,等.本体感觉神经肌肉促进技术对脑卒中患者平衡功能的影响[J].中国康复理论与实践,2012,18(1):22—24.
[11]张健.早期平衡训练对脑卒中偏瘫患者步行能力的影响[J].中国康复理论与实践,2006,12(9):795—796.
[12]张丽,瓮长水,王秋华,等.前庭感觉、本体感觉及视觉功能对老年人跌倒风险影响的因素分析[J].中国康复理论与实践,2010,16(1):16—18.
[13]刘四文,刘海兵,唐丹,等.躯干控制训练改善脑卒中患者平衡功能的疗效观察[J].中华物理医学与康复杂志,2002,24(3):165—166.
[14]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.
[15]蒋拥军,李克军,王雪冰.平衡促进训练对膝关节前交叉韧带损伤重建术后患膝本体感觉的影响[J].中国康复医学杂志,2011,26(3):251—254.
[16]Lephart SM,Giraldo JL,Borsa PA,et al.Knee joint proprioception:a comparison between female intercollegiate gymnasts and controls[J].Knee Surg,Sports Traumatol,Arthroscopy,1996,4:121—124.
[17]Gilman S.Joint position sense and vibration sense:anatomical organisation and assessment[J].Neurol Neurosurg Psychiatry,2002,73:473—477.
[18]张弛,王惠芳.膝关节本体感觉康复研究的进展[J].中华物理医学与康复杂志,2000,22(6):373—375.
[19]Wei M,Lin N,Newlands SD.Does orbital proprioception contribute to gaze stability uring translation?[J].Exp Brain Res,2011,215:77—87.
[20]Hewett TE,Paterno MV,Myer GD.Strategies for enhancing proprioception and neuromuscular control of the knee[J].Clin Orthop Relat Res,2002,402:76—94.
[2]Fong SM,Ng GY.The effects on sensorimotor performance and balance with Tai Chi training[J].Arch Phys Med Rehabil,2006,87:82—87.
[3]Piriyaprasarth P,Morris ME,Delany C,et al.Trials needed to assess knee proprioception following stroke[J].Physiotherapy Research International Physiother,2009,14(1):6—16.
[4]张鹏,钱风雷,封旭华,等.游泳运动员膝关节损伤康复中本体感觉训练的应用[J].中国运动医学杂志,2010,29(6):640—642.
[5]Lin DH,Lin YF,Chai HM,et al.Comparison of proprioceptive functions between computerized proprioception facilitation exercise and closed kinetic chain exercise in patients with knee osteoarthritis[J].Clin Rheumatol,2007,26:520—528.
[6]Birmingham TB,Kramer JF,Inglis JT,et al.Effect of a neoprene sleeve on knee joint position sense during sitting open kinetic chain and supine closed kinetic chain tests[J].Am J Sports Med,1998,26:562—566.
[7]Panics G,Tallay A,Pavlik A,et al.Effect of proprioception training on knee joint position sense in female team handball players[J].Br J Sports Med,2008,42(6):472—474.
[8]Roberts D,Ageberg E,Andersson G,et al.Effects of shortterm cycling on knee joint proprioception in ACL-deficient patients[J].Knee Surg Sports Traumatol Arthrosc,2004,12:357—363.
[9]Collins AT,Blackburn JT,Olcott CW,et al.The effects of stochastic resonance electrical stimulation and neoprene sleeve on knee proprioception[J].Journal of Orthopaedic Surgery and Research,2009,4:3 doi:10.1186/1749-799X-4-3.
[10]潘毓健,徐国会,郑洁皎,等.本体感觉神经肌肉促进技术对脑卒中患者平衡功能的影响[J].中国康复理论与实践,2012,18(1):22—24.
[11]张健.早期平衡训练对脑卒中偏瘫患者步行能力的影响[J].中国康复理论与实践,2006,12(9):795—796.
[12]张丽,瓮长水,王秋华,等.前庭感觉、本体感觉及视觉功能对老年人跌倒风险影响的因素分析[J].中国康复理论与实践,2010,16(1):16—18.
[13]刘四文,刘海兵,唐丹,等.躯干控制训练改善脑卒中患者平衡功能的疗效观察[J].中华物理医学与康复杂志,2002,24(3):165—166.
[14]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.
[15]蒋拥军,李克军,王雪冰.平衡促进训练对膝关节前交叉韧带损伤重建术后患膝本体感觉的影响[J].中国康复医学杂志,2011,26(3):251—254.
[16]Lephart SM,Giraldo JL,Borsa PA,et al.Knee joint proprioception:a comparison between female intercollegiate gymnasts and controls[J].Knee Surg,Sports Traumatol,Arthroscopy,1996,4:121—124.
[17]Gilman S.Joint position sense and vibration sense:anatomical organisation and assessment[J].Neurol Neurosurg Psychiatry,2002,73:473—477.
[18]张弛,王惠芳.膝关节本体感觉康复研究的进展[J].中华物理医学与康复杂志,2000,22(6):373—375.
[19]Wei M,Lin N,Newlands SD.Does orbital proprioception contribute to gaze stability uring translation?[J].Exp Brain Res,2011,215:77—87.
[20]Hewett TE,Paterno MV,Myer GD.Strategies for enhancing proprioception and neuromuscular control of the knee[J].Clin Orthop Relat Res,2002,402:76—94.