常规康复治疗联合有氧训练对老年急性脑梗死患者神经功能的影响
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摘要
目的:探讨常规康复治疗联合个体化有氧训练对老年急性脑梗死(ACI)患者运动功能及自主神经功能康复的影响。方法:将92例老年ACI患者随机分为对照组与观察组,每组46例。对照组予以常规药物治疗与康复锻炼,观察组在对照组基础上加个体化有氧训练,共训练8周。比较两组患者干预前、后Barthel指数(BI)、Fugl-Meyer量表(FMA)评分、美国国立卫生院卒中量表(NIHSS)评分、Asworth痉挛评定量表评分,并测定自主神经功能指标。结果:干预后,观察组的BI指数、FMA评分显著高于对照组,NIHSS评分和Asworth评分显著低于对照组,差异均有统计学意义(均P<0.05);干预后,观察组的R-R间期(NNI)、R-R间期标准差(SDNN)、24h相邻R-R间期差值的均方根(RMSSD)及相邻窦性R-R间期差值>50 ms比率(PNN50)均显著高于对照组(P<0.05)。结论:个体化有氧训练有助于促进老年ACI患者神经功能的康复,提高日常生活活动能力。
Objective:To investigate the effect of individualized aerobic training on rehabilitation of motor function and autonomic nerve function in elderly patients with acute cerebral infarction(ACI).Methods:A total of 92 elderly patients with ACI were randomly divided into a control group(n=46)and an observation group(n=46).Patients in the control group were given conventional drug therapy and rehabilitation exercise,while those in the observation group were treated as the control group with addition of individualized aerobic training for 8 weeks.The scores of BI,FMA,NIHSS and Asworth were evaluated and compared between the two groups.The autonomic nerve function indexes were measured.Results:After intervention,the scores of BI and FMA in the observation group were significantly higher than those in the control group,whereas the scores of NIHSS and Asworth were significantly lower(P<0.05).After intervention,the indexes of NNI,SDNN,RMSSD and PNN50 in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:Individualized aerobic training could promote the rehabilitation of neurological function in elderly patients with ACI,and improve the ability of daily living activities.
Objective:To investigate the effect of individualized aerobic training on rehabilitation of motor function and autonomic nerve function in elderly patients with acute cerebral infarction(ACI).Methods:A total of 92 elderly patients with ACI were randomly divided into a control group(n=46)and an observation group(n=46).Patients in the control group were given conventional drug therapy and rehabilitation exercise,while those in the observation group were treated as the control group with addition of individualized aerobic training for 8 weeks.The scores of BI,FMA,NIHSS and Asworth were evaluated and compared between the two groups.The autonomic nerve function indexes were measured.Results:After intervention,the scores of BI and FMA in the observation group were significantly higher than those in the control group,whereas the scores of NIHSS and Asworth were significantly lower(P<0.05).After intervention,the indexes of NNI,SDNN,RMSSD and PNN50 in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:Individualized aerobic training could promote the rehabilitation of neurological function in elderly patients with ACI,and improve the ability of daily living activities.
引文
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[2]龙耀斌.上肢康复机器人训练对脑卒中偏瘫患者上肢功能的影响[J].广西医科大学学报,2012,29(2):260-261.
[3]恽晓平.康复疗法评定学[M].北京:华夏出版社,2008:259-262.
[4]黄雪丽,李太勇,马容莉,等.早期康复训练对急性老年脑梗死患者神经功能康复及血清IMA和NSE水平的影响[J].脑与神经疾病杂志,2017,25(2):82-85.
[5]叶刚.MOTOmed运动系统治疗对促进脑梗死患者运动功能和生活能力的疗效分析[J].蚌埠医学院学报,2016,41(5):610-612.
[6]王瑞平,冯晓东,闫秀丽.强化蹬踏运动对偏瘫患者下肢功能恢复的影响[J].中国康复理论与实践,2012,18(9):810.
[7]LINDER S M,ROSENFELDT A B,RASANOW M,et al.Forced aerobic exercise enhances motor recovery after stroke:a case report[J].Am J Occup Ther,2015,69(4):1-8.
[8]XU Y H,WANG X D,ZHOU L,et al.Changes of deceleration and acceleration capacity of heart rate in patients with acute hemispheric ischemic stroke[J].Clin Interv Aging,2016,3(11):293-298.
[9]李萍,孔海霞,李洪娟.有氧运动对脑卒中后慢性偏瘫患者下肢运动功能、血趋化素及代谢危险因素的影响[J].中国动脉硬化杂志,2017,25(4):393-397.
[10]孔亚婷,朱正庭.有氧训练与抗阻训练对老年脑梗死患者自主神经功能干预效果的对比研究[J].实用心脑肺血管病杂志,2017,25(1):138-140.
[11]陈国平,亢连茹,王艳,等.有氧训练对早期脑梗死患者心血管及运动功能的影响[J].中国康复,2015,30(5):349-351.
[12]卢俏丽,姚连焕,胆迎,等.老年脑梗死患者心率变异性及其与神经功能缺损评分相关性研究[J].中华老年医学杂志,2016,35(11):1155-1159.