强化髋外展肌群对脑卒中偏瘫患者平衡功能和步行安全性的影响

The effects of training abductors of hip on balance function and ambulation safety in hemiplegic patients

目的:探讨强化髋外展肌群对脑卒中偏瘫患者平衡功能和步行安全性的影响。方法:将符合入选标准的脑卒中偏瘫患者随机分为观察组(20例)和对照组(20例),两组患者均采用以Bobath为主的现代康复技术进行平衡训练和步行训练,在此基础上,观察组加入强化髋外展肌群的训练方法,在治疗前和6周治疗结束后,分别用Berg平衡评分量表和Holden功能步行分类对两组患者进行平衡功能和步行能力的评定,随访并统计治疗结束后半年期间两组患者的跌倒发生率。结果:6周治疗后,两组的BBS和Holden功能步行分类的级别均较治疗前有明显提高(P<0.01)。观察组的BBS和Holden功能步行分类的级别均优于对照组,差异具有显著性意义(P<0.05,P<0.01)。通过随访,治疗结束半年内观察组的跌倒发生率比对照组低,差异有非常显著性意义(P<0.01)。结论:在常规平衡训练的基础上,强化患侧髋外展肌群的训练,能更有效地提高脑卒中偏瘫患者的平衡功能,增加步行的安全性。

Objective：To study the effects of training abductors muscles of hip on balance function and ambulation safety in hemiplegic patients. Method： Subjects were assigned randomly to either experimental group（n=20） or control group（n=20）. Both groups received Bobath routine balance training and ambulation training. In addition, experimental group received training of abductors of hip. Subjects were assessed with Berg Balance Scale （BBS） and Holden functional ambulation classification （Holden FAC） before and after 6 week-training. Fall frequencies of two groups in half year after training were counted. Result： After 6 week training both groups scored higher on BBS and the level of Holden FAC than before training. Furthermore, a comparison of mean changes revealed significant difference between two groups, the effects in experimental group was better on the two assessments than that in control group（P〈0.05, P〈0.01）. After 6 week-training in the half year follow-up period there was a significant lower fall frequency in experimental group （P〈0.01）. Conclusion： After 6 week-training, balance function and ambulation safety of patients in experimental group had a significant improvement when compared with control group. For the balance function and ambulation safety of stroke hemiplegic patients, the effects of training abductor of hip was better than routine balance training.