斜坡下减重步行训练对脑卒中后患者步态的疗效
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摘要
目的探讨在斜坡上进行减重步行训练对脑卒中后患者步行的影响。方法 2015年3月至2017年6月,46例脑卒中患者随机分为对照组和实验组各23例。两组均予常规康复,实验组加用斜坡下减重步行训练,对照组加用平地下减重步行训练。治疗前和治疗3周后,使用Fugl-Meyer评定量表下肢部分(FMA-LE)、Berg平衡量表(BBS)、Tinetti步态评估量表(TGA)进行评估。结果治疗后,两组FMA-LE、BBS和TGA评分提高(t>2.491,P<0.05),实验组高于对照组(t>2.195,P<0.05)。结论减重步行训练能有效改善脑卒中后患者的步态,斜坡下减重步行训练效果更显著。
Objective To apply the body weight support treadmill training(BWSTT) on slope for gait training in patients after stroke.Methods From March, 2015 to June, 2017, 46 patients after stroke were randomly divided into control group(n=23) and experimental group(n=23). Both groups accepted routine rehabilitation, and the experimental group accepted BWSTT on slope, while the control group accepted BWSTT on flat. They were assessed with Fugl-Meyer Assessment-Lower Extremities(FMA-LE), Berg Balance Scale(BBS) and Tinetti Gait Analysis(TGA) before and after treatment.Results The scores of FMA-LE, BBS and TGA improved after treatment(t>2.491, P<0.05), and were more in the experimental group than in the control group(t>2.195, P<0.05).Conclusion BWSTT is effective on gait in hemiplegic patients, and is more effective on slope.
Objective To apply the body weight support treadmill training(BWSTT) on slope for gait training in patients after stroke.Methods From March, 2015 to June, 2017, 46 patients after stroke were randomly divided into control group(n=23) and experimental group(n=23). Both groups accepted routine rehabilitation, and the experimental group accepted BWSTT on slope, while the control group accepted BWSTT on flat. They were assessed with Fugl-Meyer Assessment-Lower Extremities(FMA-LE), Berg Balance Scale(BBS) and Tinetti Gait Analysis(TGA) before and after treatment.Results The scores of FMA-LE, BBS and TGA improved after treatment(t>2.491, P<0.05), and were more in the experimental group than in the control group(t>2.195, P<0.05).Conclusion BWSTT is effective on gait in hemiplegic patients, and is more effective on slope.
引文
[1]王桂茂,严隽陶,刘玉超,等.脑卒中偏瘫步态的时空参数与骨盆运动学分析[J].中国康复医学杂志,2010,25(12):1148-1151.
[2]陈源,张继荣.脑卒中患者步行功能障碍的康复现状[J].中国康复,2017,32(1):70-73.
[3]Mazzoleni S,Focacci A,Franceschini M,et al.Robot-assisted end-effector-based gait training in chronic stroke patients:a multicentric uncontrolled observational retrospective clinical study[J].Neuro Rehabilitation,2017,40(4):483-492.
[4]Ma C,Chen N,Mao Y,et al.Alterations of muscle activation pattern in stroke survivors during obstacle crossing[J].Front Neurol,2017,8:70.
[5]Norman KE,Pepin A,Ladouceur M,et al.A treadmill apparatus and harness support for evaluation and rehabilitation of gait[J].Arch Phys Med Rehabil,1995,76(8):772-778.
[6]束一铭,钱竞光,戎科,等.偏瘫患者步态特征的动力学仿真分析[J].医用生物力学,2017,32(6):535-540.
[7]赵胜挺,李顺萍,叶斌.脑梗偏瘫患者下肢康复机器人康复治疗分析[J].现代医学与健康研究电子杂志,2017,1(8):150-151.
[8]Gama GL,de Lucena Trigueiro LC,Sim?o CR,et al.Effects of treadmill inclination on hemiparetic gait:controlled and randomized clinical trial[J].Am J Phys Med Rehabil,2015,94(9):718-727.
[9]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[10]梁亚利,张静.健康儿童在不同坡度上行走时的步态分析[J].保健医学研究与实践,2017,14(5):50-53.
[11]沙蕉,顾茜,刘芳,等.早期减重步态训练对前交叉韧带重建术后下肢步行功能的影响[J].中国康复医学杂志,2015,30(2):138-142.
[12]江容安.减重步行训练对卒中后遗症期偏瘫患者的康复疗效[J].中外医疗,2015,34(10):55-56.
[13]李芳,郑洁皎.表面肌电图在脑卒中患者异常步态分析中的研究进展[J].中国康复理论与实践,2016,22(10):1159-1162.
[14]熊振宇,郑玉惠,叶柄照,等.脑卒中偏瘫患者步行能力康复的研究进展[J].按摩与康复医学,2018,9(3):5-8.
[15]杨璐瑶.康复医学中减重步行训练的应用研究[J].科技展望,2016,26(35):277.
[16]卢建亮,陈卓铭,吴浩,等.下肢康复机器人训练对脑卒中偏瘫患者下肢运动功能的康复作用[J].中国现代神经疾病杂志,2017,17(5):334-339.
[17]Mohammadi R,Phadke CP.Effects of treadmill incline and speed on peroneus longus muscle activity in persons with chronic stroke and healthy subjects[J].Gait Posture,2017,54:221-228.
[18]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.
[19]张春波,闫焱,李灵玲.减重步行训练对脑卒中恢复中期偏瘫患者下肢运动功能的影响[J].中国冶金工业医学杂志,2017,34(3):328-329.
[20]高永义,董国钦,罗新,等.智能运动康复训练联合减重步态训练对脑卒中偏瘫患者下肢运动功能的影响[J].中医研究,2017,30(12):32-34.
[21]许耀文.坡度与地板滑溜度对人员物料搬运时步态之影响[J].技术与创新管理,2017,38(2):122-126.
[22]Lay AN,Hass CJ,Gregor RJ.The effects of sloped surfaces on locomotion:a kinematic and kinetic analysis[J].J Biomech,2006,39(9):1621-1628.
[23]徐光青,毛玉2),苏义基,等.脑卒中患者步行时下肢运动的三维运动学研究[J].中华医学杂志,2007,87(41):2889-2892.
[24]杜玲玲,夏清.脑卒中偏瘫患者膝过伸步态运动学特点分析[J].中国康复,2018,33(1):7-10.
[25]蔡金铃,高晓平,陈和木,等.步态训练矫正仪对脑卒中足下垂患者步态改善的效果分析[J].安徽医学,2015,36(8):931-934.
[2]陈源,张继荣.脑卒中患者步行功能障碍的康复现状[J].中国康复,2017,32(1):70-73.
[3]Mazzoleni S,Focacci A,Franceschini M,et al.Robot-assisted end-effector-based gait training in chronic stroke patients:a multicentric uncontrolled observational retrospective clinical study[J].Neuro Rehabilitation,2017,40(4):483-492.
[4]Ma C,Chen N,Mao Y,et al.Alterations of muscle activation pattern in stroke survivors during obstacle crossing[J].Front Neurol,2017,8:70.
[5]Norman KE,Pepin A,Ladouceur M,et al.A treadmill apparatus and harness support for evaluation and rehabilitation of gait[J].Arch Phys Med Rehabil,1995,76(8):772-778.
[6]束一铭,钱竞光,戎科,等.偏瘫患者步态特征的动力学仿真分析[J].医用生物力学,2017,32(6):535-540.
[7]赵胜挺,李顺萍,叶斌.脑梗偏瘫患者下肢康复机器人康复治疗分析[J].现代医学与健康研究电子杂志,2017,1(8):150-151.
[8]Gama GL,de Lucena Trigueiro LC,Sim?o CR,et al.Effects of treadmill inclination on hemiparetic gait:controlled and randomized clinical trial[J].Am J Phys Med Rehabil,2015,94(9):718-727.
[9]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[10]梁亚利,张静.健康儿童在不同坡度上行走时的步态分析[J].保健医学研究与实践,2017,14(5):50-53.
[11]沙蕉,顾茜,刘芳,等.早期减重步态训练对前交叉韧带重建术后下肢步行功能的影响[J].中国康复医学杂志,2015,30(2):138-142.
[12]江容安.减重步行训练对卒中后遗症期偏瘫患者的康复疗效[J].中外医疗,2015,34(10):55-56.
[13]李芳,郑洁皎.表面肌电图在脑卒中患者异常步态分析中的研究进展[J].中国康复理论与实践,2016,22(10):1159-1162.
[14]熊振宇,郑玉惠,叶柄照,等.脑卒中偏瘫患者步行能力康复的研究进展[J].按摩与康复医学,2018,9(3):5-8.
[15]杨璐瑶.康复医学中减重步行训练的应用研究[J].科技展望,2016,26(35):277.
[16]卢建亮,陈卓铭,吴浩,等.下肢康复机器人训练对脑卒中偏瘫患者下肢运动功能的康复作用[J].中国现代神经疾病杂志,2017,17(5):334-339.
[17]Mohammadi R,Phadke CP.Effects of treadmill incline and speed on peroneus longus muscle activity in persons with chronic stroke and healthy subjects[J].Gait Posture,2017,54:221-228.
[18]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.
[19]张春波,闫焱,李灵玲.减重步行训练对脑卒中恢复中期偏瘫患者下肢运动功能的影响[J].中国冶金工业医学杂志,2017,34(3):328-329.
[20]高永义,董国钦,罗新,等.智能运动康复训练联合减重步态训练对脑卒中偏瘫患者下肢运动功能的影响[J].中医研究,2017,30(12):32-34.
[21]许耀文.坡度与地板滑溜度对人员物料搬运时步态之影响[J].技术与创新管理,2017,38(2):122-126.
[22]Lay AN,Hass CJ,Gregor RJ.The effects of sloped surfaces on locomotion:a kinematic and kinetic analysis[J].J Biomech,2006,39(9):1621-1628.
[23]徐光青,毛玉2),苏义基,等.脑卒中患者步行时下肢运动的三维运动学研究[J].中华医学杂志,2007,87(41):2889-2892.
[24]杜玲玲,夏清.脑卒中偏瘫患者膝过伸步态运动学特点分析[J].中国康复,2018,33(1):7-10.
[25]蔡金铃,高晓平,陈和木,等.步态训练矫正仪对脑卒中足下垂患者步态改善的效果分析[J].安徽医学,2015,36(8):931-934.