多模态运动干预对脑卒中患者下肢肢体功能、心理状态和疲劳状态的影响

Effects of multimodal exercise intervention on lower limb function,mental state,and fatigue state in patients with stroke

目的探讨多模态运动干预对脑卒中患者下肢肢体功能、心理状态和疲劳状态的影响。方法选择2020年3月—2022年3月苏州大学附属第一医院康复科收治的98例脑卒中患者,按随机数表法分为对照组和研究组,每组49例。对照组采用常规康复治疗,研究组在常规康复治疗的基础上采用多模态运动干预。采用简易精神状态检查量表(MMSE)评估认知功能,采用Fugl-Meyer评定量表(FMA)评估肢体功能,采用日常生活能力评定量表-巴氏指数(BI)评定表评估日常生活能力;采用状态-特质焦虑问卷(STAI)评估心理状态,采用一般自我效能感量表(GSES)评估自我效能;采用足印法进行步态分析;采用多维度疲乏量表(MFI-20)评估两组患者疲劳程度。比较两组认知功能、肢体功能、日常生活能力、心理状态和自我效能、步态参数、疲劳程度。结果两组干预后MMSE、FMA、BI、GSES评分均比干预前高,步速、步频均比干预前快,步幅较干预前大,S-AI、T-AI、精神疲乏、活动减少、身体疲乏、活动下降、总体疲乏评分均比干预前低(P<0.05);研究组干预后MMSE、FMA、BI、GSES评分均比对照组高,步速、步频均比对照组快,步幅较对照组大,S-AI、T-AI、精神疲乏、活动减少、身体疲乏、活动下降、总体疲乏评分均比对照组低(P<0.05)。结论多模态运动干预应用于脑卒中患者的效果明显,不仅可有效缓解不良情绪和疲劳状态,提高自我效能,还可改善患者下肢运动功能,提高行走能力和日常生活能力。

Objective To explore the effect of multimodal exercise intervention on lower extremity motor function and fatigue in patients with stroke.Methods A total of 98 stroke patients from March 2020 to March 2022 in the first affiliated hospital of Soochow University were randomly divided into control group(n=49)and study group(n=49).The control group was treated with routine rehabilitation therapy,and the research group was treated with multimodal exercise intervention on the basis of routine rehabilitation therapy.The cognitive function,limb function,ability of daily living,psychological status and self-efficacy,gait parameters,and fatigue degree were compared between the two groups.Results After intervention,the scores of MMSE,FMA,BI,GSES,pace,stride length,and stride frequency of the two groups were higher than those before intervention,and the scores of S-AI,TAI,mental fatigue,activity decrease,physical fatigue,activity decrease,and overall fatigue were all lower than those before intervention(P<0.05).After intervention,the scores of MMSE,FMA,BI,GSES,pace,stride length,and stride frequency of the research group were higher than those of the control group,and the scores of S-AI,T-AI,mental fatigue,activity decrease,physical fatigue,activity decrease,and overall fatigue were all lower than those of the control group(P<0.05).Conclusion The effect of multimodal exercise intervention on stroke patients is obvious.It can not only relieve the bad mood and fatigue state,improve self-efficacy,but also improve the motor function of lower limbs,walking ability,and daily life ability.