减重支持训练对脑损伤后偏瘫步态与步行功能相关性的初步研究

A preliminary investigation on the correlation of partial body weight support training with hemiplegic gait and ambulation function after brain injury

目的:定量分析减重支持训练系统(partialbodyweightsupport,PBWS)对偏瘫痉挛步态步行时间距离参数、平衡等的影响,定性分析PBWS对步行功能影响。分析步态各参数与步行功能、平衡之间的内在规律,探讨其相关性。方法:中山大学附属第三医院康复科收治20例脑卒中和脑损伤患者,均经CT,MRI确诊,有明显的步行功能障碍,有或没有帮助的情况下能站立,有良好的认知功能,排除合并其他步行障碍、认知障碍和超重患者,随机分为两组,治疗组使用PBWS进行步态训练,对照组使用传统方法进行步态训练。治疗前后分别用足印法评定步行参数,用步行功能分类(FAC)评定步行功能,用Berg量表评定平衡功能。结果:治疗组患者步行速度加快,治疗前为(5.45±2.97)m/min,治疗后为(11.37±6.41)m/min,差异有显著性意义(t=2.76,P<0.05),两组步行能力及平衡能力的改善均具有非常显著性意义(t=6.09～11.7,P<0.01)。但两组治疗后上述3项参数组间比较差异均无显著性意义(P>0.05)。患者的步行功能主要与步行速度和平衡功能有明显相关性(r=0.615,P<0.05),而步行速度与平衡能力之间无明显统计学意义上的相关性(r=0.607,P>0.05)。结论:PBWS与传统治疗方法均能明显提高患者的步行功能和平衡能力,但两者之间的差异尚有待于进一步的研究来判断。患者的步?

AIM:To analyze the effect of partial body weight support system(PBWS) on hemiplemic spastic gait time-distance parameters,balance quantitatively and on ambulation function qualitatively, and to analyze the inter-regularities among the parameters,ambulation function and balance,so as to explore the correlation. METHODS:Twenty patients with stroke or brain injury were selected from the Department of Rehabilitation of Sun Yat-sen University.All the patients were diagnosed by CT or MRI to have obvious ambulation dysfunction but good cognitive function,and could stand up with or without help,and those with other ambulation dysfunctions and bad cognitive function were excluded.The 20 patients were randomly divided into treatment group(receiving PBWS training) and control group(receiving traditional gait training). Footprint analysis was used to assess the gait time-distance parameters,ambulation function was assessed by functional ambulation classification(FAC) and balance function by Berg balance scale(BBS) before and after treatment respectively. RESULTS:The walking velocity in the treatment group was improved significantly from(5.45±2.97) to(11.37±6.41) m per minute(t=2.76,P< 0.05).The FAC and BBS in the two groups were both improved very significantly(t=6.09-11.7,P< 0.01),but there were no significant differences in the indexes mentioned above between two groups after treatment(P >0.05).The ambulation function was obviously correlated with walking velocity and balance(r=0.615,P< 0.05),while there was no obvious significance between walking velocity and balance(r=0.607,P >0.05). CONCLUSION:Both PBWS training and traditional gait training can improve the ambulation function and balance of patients,but the difference between them needs further investigation.The ambulation function has obviously positive correlation with walking velocity and balance.