卒中患者四肢联动训练后平衡功能与步态参数的变化

Effects of limb joint training on balance and gait parameters of stroke patients

目的探讨四肢联动训练对卒中偏瘫患者平衡功能障碍及异常步态的疗效。方法选取2019年5月至2020年8月重庆医科大学附属康复医院及重庆医科大学附属大学城医院收治的30例卒中偏瘫患者,采用随机数字表法分成研究组和对照组,每组15例。对照组进行常规药物治疗及常规物理治疗,研究组在对照组基础上予以四肢联动治疗。除药物治疗,其余治疗6 d/周,共治疗4周。分别在治疗前及治疗4周后即刻采用Berg平衡量表(BBS)评估患者平衡功能,运用三维步态分析系统获得两组患者步态参数的定量数据。结果治疗前,两组BBS评分比较,差异无统计学意义(P>0.05),治疗后两组BBS评分均较本组治疗前明显增高,且研究组评分明显高于对照组,差异均有统计学意义(P<0.01)。两组治疗前步态时空参数各指标比较,差异均无统计学意义(P>0.05),研究组治疗后步速、步频、步幅、患肢步长、健肢步长明显高于对照组,双支撑相、患侧支撑相和健侧支撑相均较对照组明显降低,差异均有统计学意义(P<0.05)。治疗前两组患侧髋伸展最大角、膝屈曲最大角、踝背屈最大角比较,差异均无统计学意义(P>0.05),治疗后上述指标均较治疗前明显增加,研究组明显高于对照组,差异均有统计学意义(P<0.05)。结论四肢联动训练有效地改善卒中偏瘫患者的平衡功能及异常步态。

Objective To investigate the effect of limb joint training on balance dysfunction and abnormal gait of stroke patients with hemiplegia.Methods A total of 30 stroke patients with hemiplegia who met the inclusion criteria were selected from the Rehabilitation Hospital Affiliated to Chongqing Medical University and the University Town Hospital Affiliated to Chongqing Medical University,and they were randomly divided into experimental group and control group with 15 cases in each group.The control group received conventional drug therapy,physical factor therapy and exercise therapy,while the experimental group received limb joint therapy on the basis of the control group.In addition to drug treatment,the rest were treated for 6 d/week for 4 weeks.Berg Balance Scale(BBS)was used to evaluate the balance function of the patients before treatment and immediately after 4 weeks of treatment.The quantitative data of gait parameters of the two groups were obtained by using the 3 D gait analysis system of motion lab systems.Results Before treatment,there was no significant difference in BBS scores between the two groups(P>0.05).After treatment,the BBS scores of the two groups were significantly higher than those before treatment,and the score of the experimental group was significantly higher than that of the control group,and the differences were statistically significant(P<0.01).Before treatment,there was no significant difference in gait parameters between the two groups(P>0.05).After treatment the gait speed,step frequency,step length,step length of affected limb,step length of healthy limb,maximum angle of affected hip extension,maximum angle of knee flexion and maximum angle of ankle dorsiflexion in the experimental group were significantly higher than those in the control group;the double support phase,the affected support phase and the healthy support phase were significantly lower than those in the control group,and the differences were statistically significant in the experimental group(P<0.05).Conclusions Limb linkage training can effectively improve the balance function of hemiplegic patients,as well as has positive significance for correcting abnormal gait after stroke.