综合康复疗法治疗脑卒中后偏瘫患者膝反张的疗效观察
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摘要
目的1.探讨综合康复疗法对脑卒中后偏瘫患者膝反张的治疗效果；2.分析脑卒中后膝反张形成的机制。为临床上寻求一种更有效、综合的康复干预措施提供依据。
方法选择符合入选标准的脑卒中后膝反张的患者41例,随机分成对照组20例和治疗组21例。两组患者均给予常规的药物治疗和康复训练,治疗组在此基础上给予综合康复疗法,即改善股四头肌胭绳肌小腿三头肌的肌力肌张力、促进伸屈肌的协调性训练、本体感觉恢复等。分别于治疗前、治疗4周后对膝反张的角度,踝关节被动背伸的角度,患侧股四头肌、胭绳肌肌力,股四头肌、腓肠肌肌张力,Barthel指数,下肢Fugl-Meyer运动功能进行评定。所有数据采用SPSS16.0统计软件包进行统计分析。
结果1.两组患者膝反张的角度均有明显改善,但治疗组与对照组比较差异有显著性(p<0.05)；两组患者膝反张的纠正率均有明显改善,但治疗组与对照组比较差异有显著性(p<0.05)；2.两组患者踝关节被动背伸的角度均有明显改善,但治疗组与对照组比较差异有显著性(p<0.05)；3.两组患者股四头肌、胭绳肌肌力,股四头肌、腓肠肌肌张力均有明显改善,但治疗组与对照组比较差异有显著性(p<0.05)；4.两组患者ADL能力均有明显改善,但治疗组与对照组比较差异有显著性(p<0.05)；5.两组患者下肢运动功能均较治疗前明显改善,但治疗组较对照组改善更为明显(p<0.05)。
结论1.综合康复疗法对脑卒中后膝反张的患者ADL能力、下肢运动功能的提高有明显改善作用,疗效确切；2.膝反张形成是多因素共同作用所致。
Objectives 1.To discuss the influence of integrative rehabilitation therapy on the recovery of stroke with genu recurvatum; 2.Analysis formation mechanism of the patients with genu recurvatum. To sum up, seeking a more effective method to improve knee function after stroke.
Methods 41 patients with stroke were randomly divided into 2 groups (control group and treatment group). There were 20 patients in control group. There were 21 patients in treatment group. Two groups of patients were by given conventional treatment and rehabilitation of drugs. On this basis, the treatment group was given comprehensive rehabilitation therapy. Concluding improve the muscle power and muscle tone of the quadriceps, hamstring, triceps. Promoting extensor flexor strength and coordination training and restoring proprioception. Before the treatment and after 4 weeks treatment evaluate the angle of the genu recurvatum, the muscle tone of the quadriceps and triceps, Barthel index, Fugl-Meyer lower extremity motor function. All data were processed by SPSS16.0 package.
Results 1.Two groups of patients with genu recurvatum showed significant improvement, but the treatment group compared with the control group there was significant difference(p<0.05); The correct rate of showed big improvement, but the treatment group compared with the control group there was significant difference(p<0.05); 2.Two groups of patients showed significant improvement with passive ankle dorsiflexion angle, but the treatment group compared with the control group there was significant difference(p<0.05); 3.The muscle power of quadriceps, hamstring and the muscle tone of quadriceps triceps have significantly improved, but the treatment group compared the control group there was significant difference (p<0.05); 4.Two groups of patients have big improvement with ADL capacity, but the treatment group compared the control group there was significant difference(p<0.05); 5.The lower extremity motor function have significantly improved compared with before treatments, but the treatment group improved more significantly than the control group(p<0.05).
Conclusions 1.Integrated rehabilitation therapy has great improvement with ADL capacity and lower extremity motor function of the patients of genu recurvatum; 2.The formation of genu recurvatum is caused by multiple factors.
方法选择符合入选标准的脑卒中后膝反张的患者41例,随机分成对照组20例和治疗组21例。两组患者均给予常规的药物治疗和康复训练,治疗组在此基础上给予综合康复疗法,即改善股四头肌胭绳肌小腿三头肌的肌力肌张力、促进伸屈肌的协调性训练、本体感觉恢复等。分别于治疗前、治疗4周后对膝反张的角度,踝关节被动背伸的角度,患侧股四头肌、胭绳肌肌力,股四头肌、腓肠肌肌张力,Barthel指数,下肢Fugl-Meyer运动功能进行评定。所有数据采用SPSS16.0统计软件包进行统计分析。
结果1.两组患者膝反张的角度均有明显改善,但治疗组与对照组比较差异有显著性(p<0.05)；两组患者膝反张的纠正率均有明显改善,但治疗组与对照组比较差异有显著性(p<0.05)；2.两组患者踝关节被动背伸的角度均有明显改善,但治疗组与对照组比较差异有显著性(p<0.05)；3.两组患者股四头肌、胭绳肌肌力,股四头肌、腓肠肌肌张力均有明显改善,但治疗组与对照组比较差异有显著性(p<0.05)；4.两组患者ADL能力均有明显改善,但治疗组与对照组比较差异有显著性(p<0.05)；5.两组患者下肢运动功能均较治疗前明显改善,但治疗组较对照组改善更为明显(p<0.05)。
结论1.综合康复疗法对脑卒中后膝反张的患者ADL能力、下肢运动功能的提高有明显改善作用,疗效确切；2.膝反张形成是多因素共同作用所致。
Objectives 1.To discuss the influence of integrative rehabilitation therapy on the recovery of stroke with genu recurvatum; 2.Analysis formation mechanism of the patients with genu recurvatum. To sum up, seeking a more effective method to improve knee function after stroke.
Methods 41 patients with stroke were randomly divided into 2 groups (control group and treatment group). There were 20 patients in control group. There were 21 patients in treatment group. Two groups of patients were by given conventional treatment and rehabilitation of drugs. On this basis, the treatment group was given comprehensive rehabilitation therapy. Concluding improve the muscle power and muscle tone of the quadriceps, hamstring, triceps. Promoting extensor flexor strength and coordination training and restoring proprioception. Before the treatment and after 4 weeks treatment evaluate the angle of the genu recurvatum, the muscle tone of the quadriceps and triceps, Barthel index, Fugl-Meyer lower extremity motor function. All data were processed by SPSS16.0 package.
Results 1.Two groups of patients with genu recurvatum showed significant improvement, but the treatment group compared with the control group there was significant difference(p<0.05); The correct rate of showed big improvement, but the treatment group compared with the control group there was significant difference(p<0.05); 2.Two groups of patients showed significant improvement with passive ankle dorsiflexion angle, but the treatment group compared with the control group there was significant difference(p<0.05); 3.The muscle power of quadriceps, hamstring and the muscle tone of quadriceps triceps have significantly improved, but the treatment group compared the control group there was significant difference (p<0.05); 4.Two groups of patients have big improvement with ADL capacity, but the treatment group compared the control group there was significant difference(p<0.05); 5.The lower extremity motor function have significantly improved compared with before treatments, but the treatment group improved more significantly than the control group(p<0.05).
Conclusions 1.Integrated rehabilitation therapy has great improvement with ADL capacity and lower extremity motor function of the patients of genu recurvatum; 2.The formation of genu recurvatum is caused by multiple factors.
引文
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