膈肌锻炼联合运动训练对脑卒中后疲劳的康复效果研究
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摘要
目的探讨膈肌锻炼结合运动训练对脑卒中后疲劳(PSF)的康复效果。方法选取2015年1月至2016年3月收治的104例PSF患者为研究对象,采用随机数字表法分为观察组和对照组,每组52例,对照组仅给予常规运动康复治疗,观察组在此基础上联合膈肌锻炼,比较两组患者治疗前后的肺功能、疲劳严重程度量表评分(FSS)、改良Barthel指数(MBI)量表评分、Fugl-Meyer运动功能量表(FMA)评分及脑卒中专门化生活质量量表(SS-QOL)评分。结果观察组治疗后的第1秒用力呼气容积(FEV1)、肺活量(VC)、用力肺活量(FVC)、MBI、FMA、SS-QOL评分均显著高于对照组,FSS评分显著低于对照组,差异均有统计学意义(均P<0.05)。结论膈肌锻炼联合运动训练能显著改善PSF患者的肺功能、运动功能和日常生活活动能力,提高其生活质量,降低疲劳程度,值得推广应用。
Objective To investigate the rehabilitative effect of diaphragm muscle exercise combined with sport training on fatigue after cerebral infarction. Methods One hundred and four patients with fatigue after cerebral infarction were enrolled between January 2015 and March 2016 and randomly divided into study group and control group with 52 cases in each group. The control group was only treated with routine exercise rehabilitation, while study group received diaphragm muscle exercise combined with sport training. The pulmonary function, the scores of fatigue severity scale(FSS), modified Barthel index(MBI), Fugl-Meyer motor function assessment(FMA) and the Quality of Life Scale dedicated stroke(SS-QOL) were compared between two groups before and after treatment. Results There were no significant differences in baseline data, pulmonary function, and the scores of FSS, MBI, FMA and SS-QOL before treatment between two groups(P >0.05). The first second forced expiratory volume(FEV1), vital capacity(VC), forced vital capacity(FVC), the scores of MBI, FMA and SS-QOL in study group were significantly higher than those in control group, and FSS score was significantly lower than that in control group after treatment( P<0.05). Conclusion For patients with fatigue after cerebral infarction, diaphragm muscle exercise combined with sport training can significantly improve their lung function, motor function, the daily life and quality of life,and reduce the severity of fatigue.
Objective To investigate the rehabilitative effect of diaphragm muscle exercise combined with sport training on fatigue after cerebral infarction. Methods One hundred and four patients with fatigue after cerebral infarction were enrolled between January 2015 and March 2016 and randomly divided into study group and control group with 52 cases in each group. The control group was only treated with routine exercise rehabilitation, while study group received diaphragm muscle exercise combined with sport training. The pulmonary function, the scores of fatigue severity scale(FSS), modified Barthel index(MBI), Fugl-Meyer motor function assessment(FMA) and the Quality of Life Scale dedicated stroke(SS-QOL) were compared between two groups before and after treatment. Results There were no significant differences in baseline data, pulmonary function, and the scores of FSS, MBI, FMA and SS-QOL before treatment between two groups(P >0.05). The first second forced expiratory volume(FEV1), vital capacity(VC), forced vital capacity(FVC), the scores of MBI, FMA and SS-QOL in study group were significantly higher than those in control group, and FSS score was significantly lower than that in control group after treatment( P<0.05). Conclusion For patients with fatigue after cerebral infarction, diaphragm muscle exercise combined with sport training can significantly improve their lung function, motor function, the daily life and quality of life,and reduce the severity of fatigue.
引文
[1] Duncan F, Wu S, Mead GE.Frequency and natural history of fatigue af-ter stroke:a systematic review of longitudinal studies[J]. J PsychosomRes, 2012, 73(1):18-27. DOI:10.1016/j.jpsychores.2012.04.001.
[2]郭丽云,史长青,王潞萍,等.运动疗法对脑卒中后疲劳患者运动功能和日常生活活动能力的影响[J].中国康复医学杂志,2011,26(7):676-678.DOI:10.3969/j.issn. 1001-1242.2011.07.019.
[3] Leenen FH, Ahmad M, Marc Y, et al. Specific Inhibition of Brain An-giotensin III formation as a new strategy for prevention of heart failure af-ter myocardial infarction[J]. J Cardiovasc Pharmacol. 2018 Nov 30. DOI:10.1097/FJC.0000000000000638.
[4] Yao H, Fukuda K, Araki Y, et al. Parity As a Protective Biomarker A-gainst Silent Brain Infarction in Community-Dwelling Older Adults:The Sefuri Study[J]. J Stroke Cerebrovasc Dis, 2018, Nov 24. Epub. pii:S1052-3057(18)30643-8. DOI:10. 1016/j.jstrokecere brovasdis.2018.11.005.
[5]周锦霞,李国珍,程伟,等.大动脉粥样硬化型脑梗死与穿支动脉疾病型脑梗死的临床特点对比[J].重庆医学,2017,46(4):513-516.DOI:10.3969/j.issn.1671-8348.2017.04.028.
[6]邓伟华,杨勇,潘小平,等.心源性脑梗死与非心源性脑梗死静脉溶栓的对比研究[J].实用医学杂志,2015,(11):1781-1783.DOI:10.3969/j.issn.1006-5725.2015.11.017.
[7]马婕,曾令丹,张艳,等.综合康复干预防治脑梗死后肩手综合征的疗效观察[J].中华物理医学与康复杂志,2015,37(5):373-375.DOI:10.3760/cma.j.issn. 0254-1424.2015.05.014.
[8]李军涛,王伊龙,于进洪,等.脑卒中专门化生存质量量表(SS-QOL)中译本在冀南地区效度的研究[J].脑与神经疾病杂志,2007,15(3):177-179.DOI:10.3969/j.issn. 1006-351X. 2007.03.007.
[9] Radman N, Staub F, Aboulafia-Brakha T, et al. Poststroke fatigue follow-ing minor infarcts:a prospective study[J]. Neurology, 2012, 79(14):1422-1427. DOI:10.1212/WNL.0b013e31826d5f3a.
[10] Tang WK, Chen YK, Mok V, et al. Acute basal ganglia infarcts in post-stroke fatigue:an MRI study[J]. J Neurol, 2010, 257(2):178-182. DOI:10.1007/s00415-009-5284-2.
[11]钟水生,胡琼力,李志刚,等.合并阻塞性睡眠呼吸暂停综合征的脑梗死患者血清皮质醇水平的测定[J].中华神经医学杂志,2018,17(8):796-801.DOI:10.3760/cma.j.issn. 1671-8925. 2018.08.007.
[12] Wang BL, Jin H, Han XQ, et al. Involvement of brain-derived neu-rotrophic factor in exercise?induced cardioprotection of post-myocar-dial infarction rats[J]. Int J Mol Med. 2018, 42(5):2867-2880. DOI:10.3892/ijmm.2018.3841.
[2]郭丽云,史长青,王潞萍,等.运动疗法对脑卒中后疲劳患者运动功能和日常生活活动能力的影响[J].中国康复医学杂志,2011,26(7):676-678.DOI:10.3969/j.issn. 1001-1242.2011.07.019.
[3] Leenen FH, Ahmad M, Marc Y, et al. Specific Inhibition of Brain An-giotensin III formation as a new strategy for prevention of heart failure af-ter myocardial infarction[J]. J Cardiovasc Pharmacol. 2018 Nov 30. DOI:10.1097/FJC.0000000000000638.
[4] Yao H, Fukuda K, Araki Y, et al. Parity As a Protective Biomarker A-gainst Silent Brain Infarction in Community-Dwelling Older Adults:The Sefuri Study[J]. J Stroke Cerebrovasc Dis, 2018, Nov 24. Epub. pii:S1052-3057(18)30643-8. DOI:10. 1016/j.jstrokecere brovasdis.2018.11.005.
[5]周锦霞,李国珍,程伟,等.大动脉粥样硬化型脑梗死与穿支动脉疾病型脑梗死的临床特点对比[J].重庆医学,2017,46(4):513-516.DOI:10.3969/j.issn.1671-8348.2017.04.028.
[6]邓伟华,杨勇,潘小平,等.心源性脑梗死与非心源性脑梗死静脉溶栓的对比研究[J].实用医学杂志,2015,(11):1781-1783.DOI:10.3969/j.issn.1006-5725.2015.11.017.
[7]马婕,曾令丹,张艳,等.综合康复干预防治脑梗死后肩手综合征的疗效观察[J].中华物理医学与康复杂志,2015,37(5):373-375.DOI:10.3760/cma.j.issn. 0254-1424.2015.05.014.
[8]李军涛,王伊龙,于进洪,等.脑卒中专门化生存质量量表(SS-QOL)中译本在冀南地区效度的研究[J].脑与神经疾病杂志,2007,15(3):177-179.DOI:10.3969/j.issn. 1006-351X. 2007.03.007.
[9] Radman N, Staub F, Aboulafia-Brakha T, et al. Poststroke fatigue follow-ing minor infarcts:a prospective study[J]. Neurology, 2012, 79(14):1422-1427. DOI:10.1212/WNL.0b013e31826d5f3a.
[10] Tang WK, Chen YK, Mok V, et al. Acute basal ganglia infarcts in post-stroke fatigue:an MRI study[J]. J Neurol, 2010, 257(2):178-182. DOI:10.1007/s00415-009-5284-2.
[11]钟水生,胡琼力,李志刚,等.合并阻塞性睡眠呼吸暂停综合征的脑梗死患者血清皮质醇水平的测定[J].中华神经医学杂志,2018,17(8):796-801.DOI:10.3760/cma.j.issn. 1671-8925. 2018.08.007.
[12] Wang BL, Jin H, Han XQ, et al. Involvement of brain-derived neu-rotrophic factor in exercise?induced cardioprotection of post-myocar-dial infarction rats[J]. Int J Mol Med. 2018, 42(5):2867-2880. DOI:10.3892/ijmm.2018.3841.