倒退步行平板训练对脑卒中患者下肢功能的影响

Effectiveness of backward walking treadmill training in lower extremity function after stroke

目的探讨倒退步行平板训练对脑卒中偏瘫患者下肢运动功能、平衡功能和步行速度的影响。方法下肢 Brunnstrom 分级为3或4级、在不使用拐杖和矫形器情况下可独立步行10 m 以上的26例脑卒中偏瘫患者,随机分为试验组(13例)和对照组(13例)。对照组的患者接受常规步行训练治疗60 min,试验组的患者在接受常规步行训练治疗30 min 基础上附加倒退步行平板训练治疗30 min,每周5次,连续3周。两组患者在治疗前和3周治疗后进行下肢运动功能评价(Fugl-Meyer法)、平衡功能评估(Berg 平衡量表)、步行速度评定(10 m 最大步行速度测量)。结果经过3周治疗后,在下肢运动功能、平衡功能和步行速度改善上,试验组明显优于对照组,P 值分别为0.033、0.001和0.034。结论倒退步行平板训练可以改善脑卒中偏瘫患者下肢运动功能、平衡功能和步行速度。

Objective To examine the effectiveness of backward walking treadmill training for restoration of motor function, balance and walking speed in patients with stroke. Methods Twenty-six patients with stroke, 17 males and 9 females, aged 36 -64, with the lower extremity Brunnstrom motor recovery stage at 3 or 4, able to walk for 10 m without walking aid or orthosis, were randomly divided into two equal groups： The patients in the control group were to participate in a 60-minutes conventional training five times a week for three weeks, and the patients in the experimental group received 30-minute conventional training and then 30 -minute backward walking training five times a week for three weeks. Before the training and 3 weeks after the training, Fugl-Meyer assessment was used to assess the motor function of the lower extremity （FMA-L）, Berg balance scale （BBS） was used to assess the balance function, and 10 m maximum walking speed was measured. Results After the three-week training period, the FMA-L score of the experimental group was 28.0 ± 3.3, significantly higher than that of the control group （25.5 ± 2. 3, P = 0. 033 ） ; the BBS score of the experimental group was 51.4 ± 1.8, significantly higher than that of the control group （47.3 ± 3.7, P = 0.001, and 10 m MWS of the experimental group was 57 ± 17, significantly higher than that of the control group （43 ± 16, P = 0.034）. Conclusion A safe and feasible intervention, additional backward walking therapy helps improve the damaged motor function, balance, and walking speed of the patients with stroke.