减重平板步行训练对完全性脊髓损伤患者下肢骨骼肌萎缩与步行能力的影响

Effects of Body-weight Support Treadmill Training on Lower Extremity Muscle Atrophy and Ambulatory Capacity in Complete Spinal Cord Injured Patients

目的研究减重平板步行训练对完全性脊髓损伤患者下肢骨骼肌萎缩与步行能力的影响。方法20例胸段完全性脊髓损伤患者分为对照组与减重组各10例。所有患者均采用综合康复治疗方法,减重组在身体条件许可的情况下及早接受减重平板步行训练3个月。在训练前后对患者进行大腿周经测量、功能独立性评定(FIM)步行能力评定、10m步行速度、日常生活活动能力(ADL)评定。减重组患者还在减重平板步行训练前后进行下肢大腿中部肌肉MRI检查。结果减重组患者训练后,MRI示下肢肌肉均较训练前相对肥大。减重组步行能力、10m步行速度的恢复优于对照组(P<0.05)。治疗前后减重组与对照组大腿周经、ADL评分无显著性差异(P>0.05)。结论减重平板步行训练不仅能够改善脊髓损伤引起的下肢骨骼肌萎缩,而且能够提高脊髓损伤患者的步行能力。

Objective To explore the effect of body-weight support treadmill training （BWSTT） on lower extremity muscle atrophy and ambulatory capacity in complete spinal cord injured （SCI） patients. Methods 20 patients with complete SCI at the thoracic level were divided into control and BWSTT group. They all received comprehensive rehabilitation, and patients in BWSTT group also received BWSTT for 3 months when the physical condition was permitted. They were assessed before and after treatment with measurement of thigh girth, ambulatory capacity measure of Functional Independence Measure （FIM）, 10 meters ambulatory velocity and activity of daily living （ADL） evaluation. Patients in BWSTT group also received middle thigh MRI examination before and after BWSTT. Results The muscles at the mid-thigh of the BWSTT group looked larger after BWSTT than before. The scores of FIM ambulatory function, the 10 miters ambulatory velocity of BWSTT group improved significantly when compared with that of the control group （P〈0.05）. The thigh girth and the scores of ADL were no different between these two groups before and after treatment （P〈0.05）. Conclusion BWSTT may ameliorate lower extremities skeletal muscle atrophy and improve ambulatory capacity for SCI patients.