减重步行训练对脑卒中患者步行功能改善的作用

The effects of body weight support treadmill training on hemiplegic patients after stroke

目的:观察不同减重量步行训练(BWSTT)和传统神经发育疗法对脑卒中后患者的步行功能恢复的影响。方法:60例脑卒中患者随机分为30%BWS组、0%BWS组和对照组,每组各20例。入组后,30%BWS组患者予30%初始减重量加电动跑台,0%BWS组患者予无减重量加电动跑台,对照组予传统神经发育疗法训练;每次30min,每天1次,每周5d,连续4周。应用Berg平衡量表(BBS)、功能性步行分级(FAC)、Tinetti步态评测表、步速和步长、步行距离评估患者治疗前后的步行功能。结果:三组患者治疗前BBS、FAC、Tinetti、步速和步长、步行距离比较差异均无显著性意义(P>0.05),具有可比性。治疗后,30%BWS组和0%BWS组患者BBS、FAC、Tinetti、步速和步长、步行距离均明显改善,分别与治疗前比较差异均有显著性意义(P<0.05),且30%BWS组上述指标改善情况优于0%BWS组(P<0.05);对照组患者BBS、FAC和步行距离分别与治疗前比较差异均有显著性意义(P<0.05);0%BWS组患者BBS、步速和步行距离的改善情况优于对照组(P<0.05)。结论:在减重加电动跑台条件下,改善患者步态和步行能力的效果最佳,无减重加电动跑台次之,传统神经发育疗法的效果较慢。

Objective： To invest the effects of body weight support treadmill training （BWSTT） on walking ability in hemiplegic patients after stroke. Method： Sixty patients who suffered cerebrovascular diseases were randomly divided into three groups： 30%BWS group （20 cases）, 0%BWS group （20 cases） and control group （20 cases）. Patients in 30%BWS group and 0%BWS group were trained to walk on a treadmill with 30%BWS and bearing full weight, while the control group was given conventional training. Three groups received 30 min a session, five days a week for 4 weeks. The walking ability was assessed with the Berg Balance Scale （BBS）, Functional Ambulation Category （FAC）, Tinetti Gait Test,velocity and step length, endurance.Result： There was no significant difference between three groups before training on the BBS, FAC, Tinetti ,velocity and step length, endurance （P〉0.05）. After training, the BBS, FAC, Tinetti ,velocity and step length, endurance were significantly improved in 30%BWS group compared with 0%BWS group （P〈0.05）; all of the test variables were significantly improved in 30%BWS group compared with 0%BWS group（P〈0.05）.The BBS, FAC and endurance were significantly improved in control group（P〈 0.05）.The test variables of BBS, velocity and endurance were significantly improved in 0%BWS group compared with control group （P〈0.05）. Conclusion：Treadmill training with partial body weight support has best effects on walking ability for patients with stroke, treadmill training with no body weight support was better.