四肢联动训练对脑卒中偏瘫患者运动及日常生活活动能力的影响

Effect of limbs joint training on stroke patients with hemiplegia

目的探讨四肢联动训练对脑卒中偏瘫患者运动及日常生活活动能力的影响。方法将2012年9月—2013年9月北京电力总医院收治的80例脑卒中偏瘫患者分为对照组(37例)和联动组(43例),对照组采用常规康复训练方法,联动组在此基础上加用四肢联动训练。治疗前及康复治疗8周后对两组患者采用Ashworth痉挛量表、简化Fugl-Meyer运动功能评价量表(FMA)、Berg平衡量表(BBS)、Barthel指数对患者进行痉挛、肢体运动功能、平衡功能、日常生活活动能力进行评价。结果两组患者治疗后偏瘫肢体痉挛评分均高于治疗前,差异有统计学意义(P=0.010,0.019),治疗后联动组偏瘫肢体痉挛程度显著轻于对照组(P=0.029)。治疗后对照组和联动组FMA评分、BBS评分、Barthel指数分别为23.1±3.1和26.3±2.5、46.7±4.0和50.0±5.2、55±20和57±19,均显著高于治疗前的12.0±2.8和12.2±3.0、25.5±3.8和25.1±2.9、18±12和21±15(均P<0.05);治疗后联动组FMA、BBS改善显著优于对照组(均P<0.05),但日常生活活动能力评分差异无统计学意义(P=0.110)。结论四肢联动训练对脑卒中偏瘫患者的运动功能及日常生活活动能力的恢复有较好的促进作用。

Objective To investigate the efficacy of limbs joint training in stroke patients with hemiplegia. Methods From September 2012 to September 2013,80 cerebral apoplexy hemiplegia patients treated in Beijing Electric Power General Hospital were divided into the control group （37 cases） and the joint rehabilitation group （43 cases ） , The control group with conventional rehabilitation training method, the joint rehabilitation group on the basis of the linkage with Limbs joint trainin. Before treatment and after 8 weeks of rehabilitation treatment, the Ashworth scale of spasm, simplified Fugl - Meyer motor function assessment scale （ FMA ）, Berg balance scale （ BBS ）, Barthel index were assessed on two groups of patients. Results After treatment the hemiplegia limb spasm score were higher than that before the treatment in two groups （P = 0. 010,0. 019 ） , the hemiplegia limb spasm degree of joint rehabilitation group after treatment was sig- nificantly lighter than that of the control group （P = 0. 029 ） . After treatment, the control group and the joint rehabilita- tion group FMA score, BBS score, Barthel index were （23.1 ±3.1 ） and （ 26.3 ± 2. 5 ） , （46. 7 ± 4. 0 ） and （ 50. 0 ± 5.2）, （55 ± 20 ） and （ 57 ± 19 ）, they were significantly higher than that before treatment （ 12. 0 ± 2. 8 ） and （ 12. 2 ± 3.0 ）, （25.5 ± 3.8 ） and （25.1 ± 2. 9 ）, （ 18 ± 12 and 21 ±15 ） （ all P 〈0. 05 ）. After treatment, the FMA, BBS of Joint rehabilitation group improved significantly better than the control group（ all P 〈0. 05 ）, but there was no statistically sig- nificant difference in daily life activities ability score （P = 0. 110）. Conclusion Limbs joint training has a good role in promoting of the recovery of motor function and daily life activities ability on stroke patients with hemiDlezia.