渐进式抗阻训练对脑卒中偏瘫患者下肢功能的影响

Progressive resistance exercise for improving lower limb motor function in hemiplegic stroke patients

目的观察渐进式抗阻训练对脑卒中偏瘫患者下肢功能的影响。方法将89例脑卒中偏瘫患者随机分成治疗组及对照组。2组患者均给予常规康复训练，治疗组在此基础上增加渐进式抗阻训练，对照组则采用股四头肌训练仪进行辅助治疗。于治疗前及治疗4周后采用下肢Fugl—Meyer评分、功能性步行能力分级（FAC）及改良Barthel指数（MBI）对2组患者进行评定。结果治疗前2组患者下肢Fugl-Meyer评分、FAC分级及MBI评分组间差异均无统计学意义（P〉0．05），治疗后2组患者上述指标均较治疗前显著改善（P〈0．05），且以治疗组的改善幅度较显著，与对照组比较，组间差异均有统计学意义（P〈0．05）。结论联合常规康复训练及渐进式抗阻训练治疗脑卒中偏瘫患者，可进一步提高患者下肢运动功能、步行能力及日常生活活动能力。

Objective To investigate the efficacy of progressive resistance exercise for improving the lower limb motor function of hemiplegic stroke patients. Methods Eighty-nine hemiplegic patients were randomly divided into a treatment group （n = 46） and a control group （n = 43 ）. Both groups received routine rehabilitation training, while the treatment group also undertook progressive resistance training. The control group received extra quadriceps femoris training. Before and after the treatment, motor function was evaluated with the Fugl-Meyer lower limb assessment, functional ambulation category （FAC） classification and the modified Barthel index （MBI）. Results Before intervention, there were no significant differences between the two groups in any of the assessments. Four weeks later, all the assessment scores obtained with the Fugl-Meyer lower limb assessment, FCA classification and MBI in the treatment group were significantly better than those in the control group. Conclusion Progressive resistance training combined with routine rehabilitation treatment can improve motor function in the lower limbs, ambulation and ability in the activities of daily living of hemiplegic patients after stroke.