摘要
目的:比较结构性速度依赖性平板训练和常规步行训练对脑卒中偏瘫患者下肢运动功能、平衡功能、ADL能力、步行能力和速度的影响。方法:解放军总医院康复医学科2002-09/2004-08收治脑卒中偏瘫患者50例,所有患者均可独立或在监视下步行16m以上,且步行速度1min超过10m,排除存在限制活动的并发症者。将50例脑卒中偏瘫患者分层随机为速度依赖性组(25例)和常规步行训练组(25例)。速度依赖性组进行结构速度依赖性平板步行训练治疗,常规步行训练治疗以神经易化技术为主。20min/次,1次/d,5次/周,连续4周治疗。两组患者仍进行除步行训练以外的其他训练内容。在治疗前、后对两组患者进行下肢Fugl-Meyer运动功能评价、Berg平衡量表、步行功能性分级、功能独立性测量和步行速度的评定。结果:45例患者完成研究,5例脱落。速度依赖性组(23例)和常规步行训练组(22例)经过4周治疗后,两组患者的平衡功能、步行功能、功能独立性和步行速度变化较治疗前均明显改善(P<0.001),但在平衡功能、步行功能、功能独立性和步行速度方面的改善效果上结构性速度依赖性平板训练比常规步行训练更为有效(ES=0.69～0.89),但在下肢运动功能改善效果方面两者比较差异无显著性意义(ES=0.35)。所有参与研究的患者(包括脱落的5例)在训练期间没有出?
AIM:To compare the effects of structured speed dependent treadmill training (STT) with conventional gait training(CGT) on the restoration of motor function of the lower limbs, balance, activities of daily life (ADL),walking ability and gait speed in hemiplegic patients after stroke. METHODS:Fifty hemiplegic patients after stroke hospitalized in the Department of Rehabilitation Medicine,General Hospital of Chinese PLA during September 2002 to August 2004,were randomly divided into STT group(n=25) and CGT group(n=25).All the patients could walk over 16 m independently or under monitoring,and their walking speed was over 10 m per minute;while those had complications that restricted the activity were excluded.The patients in the STT group were treated with STT,while those in the CGT group were treated mainly with neural facilitation,20 minutes per time,once a day,5 times per week for successive 4 weeks. ll the patients also received other trainings.The motor function of the lower limbs was assessed with Fungl Meyer assessment(FMA),and both groups were evaluated with the Berg balance scale, and functional ambulation category(FAC) and ambulation item of functional independence measurement(FIM) before and after treatment respectively. RESULTS:Forty five patients had completed the study and 5 were lost. After the 4 week training,the balance,walking function,functional independence and walking speed were all obviously ameliorated as compared with before treatment in both group(P < 0.001), while those in the STT group(n=23) were ameliorated more significantly than those in the CGT group(n=22)(effect sizes,ES=0.69 to 0.89),but there was no significant difference in the improvement of the motor function of lower limbs between the two groups(ES =0.35).No heart symptoms and other side effects were observed in all the patients(including the 5 lost ones) of both group involved in the study. CONCLUSION:Structured STT in poststroke ambulatory patients is more effective, and it is a new,reliable and feasible intervention for the training of dysfunction in hemiplegic patients after stroke.
出处
《中国临床康复》
CSCD
2004年第34期7617-7619,共3页
Chinese Journal of Clinical Rehabilitation
基金
国家十五攻关项目资助课题(2001BA703B22)~~
