改善偏瘫步态的抗阻训练及其疗效观察

Resistance training for improving the gait of cerebrovascular accident patients and its curative effects

目的：观察脑血管意外患者恢复期患肢膝屈伸肌群、髋外展肌群、髋内收肌群抗阻训练的效果，探讨下肢功能评定与步态分析之间的相关性。方法：５０例脑血管意外患者随机分为观察组（３０例）和对照组（２０例）。两组患者均接受常规的训练，观察组在恢复期接受患肢股四头肌、髋外展肌群、髋内收肌群抗阻训练。治疗前后分别采用ＦｕｇＬ－Ｍｅｙｅｒ法、Ｂａｒｔｈｅｌ指数法、简易步态定量分析法对两组患者下肢功能及步态进行分析。结果：观察组与对照组比较步态明显改善（Ｐ＜０．０１）、运动功能与活动能力显著提高（Ｐ＜０．０１）；步速与下肢活动功能及活力能力均显著相关（ｒ＝０．７６─０．８０，Ｐ＜０．０１），步态的对称性与下肢运动功能显著相关（ｒ＝０．７９，Ｐ＜０．０１）。结论：脑血管意外患者恢复期患肢膝的屈伸肌群、髋的内收外展肌群抗阻训练有助于下肢综合能力的提高和步态改善；简单的定量步态分析可客观观察下肢行走能力的改善状况。

Objective: To observe curative effects of resistance training of knee extensor, and flexors including hip abductor and adductor in cerebrovascular accident patients during convalescence and the relationship between functional evaluation and gait analysis. Method :50 patients were randomly divided into two groups ,observed group (n =30) and control group (n=20). They were all treated with the routine method. The observed patients group were treated with resistance training of knee extensor, and flexors including hip abductor and adductor during convalescence. The lower extremity function was measured by Fugl-Meyer motor functional( FM) scores and Barthel index of ADL as well as simply quantificationally analyzed for gait during the before-and-after treatment. Result: The improvement of the observed group was better than the control group in lower extremity synthetical function and gait( P <0. Cl). The walking speed was correlated significantly with all evaluating scores(r = 0. 76─0. 80, P <0. 01 ). The symmetrical degree of gait was correlated significantly with lower extremity motor function (r = 0. 79 , P <0. 01). ConclusIon: The lower extremity function and gait were improved by resistance training of knee extensor, and flexore including coxa abductor and adductor for cerebrovascular accident patients during convalescence. The walking ability can be predicted by simple quantificational analysis.