缺血性脑卒中偏瘫患者两种状况下步行训练对康复效果的影响

Comparative Study of the Impact of Different Time Selection on the Efficacy of Walking Exer-cise for Patients with Ischemic Stroke

【目的】评价缺血性脑卒中偏瘫患者两种状况下步行训练对康复效果的影响。【方法】选择缺血性脑卒中偏瘫患者80例，随机分为观察组和对照组各40例。对照组进行常规步行康复训练，需具备站立平衡≥3级；能够支持75％以上自身体质量，且患肢具有主动屈伸功能的以上3个条件时才选择对偏瘫患者进行步行训练，观察组在患者肌张力不低于肌张力Ashworth分级Ⅰ级的条件下开始进行步行训练。两组患者在康复训练前、训练后1个月、6个月及1年时分别采用平衡量表（BBS ）、运动功能量表（FM A ）、功能性步行量表（FAC ）进行功能分级评价比较。【结果】与训练前相比，随着锻炼时间的延长两组患者的BBS、FM A、FAC评分都有明显的改善（P ＜0．05），而观察组改善较对照组更为显著（P ＜0．05）。【结论】在患者肌张力不低于Ⅰ级的条件下，早期进行科学步行训练，有利于缺血性脑卒中偏瘫患者步行能力的恢复。

[Objective]To evaluate the impact of different time selection on walking exercise efficacy of pa-tients with ischemic stroke .[Methods]Totally 80 patients with ischemic stroke were chosen and randomly di-vided into observation group and control group with 40 patients in each group .While the affected limb had the standing balance grade ≥3 ,and could support over 75% of body weigh ,and had active flexion and extension function ,the control group received routine walking exercise .While muscular tension was normal and Ash-worth class I ,the observation group started walking exercise .Berg balance scale （BBS） ,Fugl-Meyer assess-ment（FMA） and functional ambulation category （FAC） were used for functional classification of two groups before ,1 month ,6 months and 1 year after rehabilitation .[Results] Compared with before exercise ,BBS , FMA and FAC scores of two groups were obviously improved with the prolongation of exercise time （ P 〈0 .05） ,and those of the observation group were improved more significantly than the control group （ P 〈0 .05） .[Conclusion]Compared with control group ,walking time selection in observation group is more help-ful for the recovery of walking ability .