核心稳定性训练对社区脑卒中患者下肢运动功能的作用

The effects of core stability training on stroke patients' motor function

目的探讨核心稳定性训练对社区脑卒中偏瘫患者躯干控制能力、平衡功能、运动功能、步行能力、步态及日常生活活动能力的影响。方法选取武汉市钢都社区居民中脑卒中患者100例,随机分为核心稳定性训练组(简称训练组)50例和对照组50例。对照组患者均自行在家进行家居康复,自行功能锻炼,定期门诊复查,不适随诊。训练组在社区卫生服务中心由本院康复科医师和治疗师定期指导,社区医生、治疗师共同对患者进行腹横肌和多裂肌协同收缩训练、躯干控制能力训练及髂腰肌及臀肌肌力训练等核心稳定性训练。2组患者分别于治疗前及治疗2个月后进行躯干控制能力(TCT)、平衡功能(BBS)、运动功能(FMA)、步行能力(FAC)、步速、步长、步宽等步态相关参数及改良Barthel指数(MBI)评定。结果干预前2组TCT评分、BBS评分、FMA上下肢评分、FAC评分、步速、步长、步宽等步态相关参数及MBI评分比较差异均不明显(P>0.05)。治疗2个月后训练组患者TCT评分、BBS评分、FMA上下肢评分、FAC评分、步速、步长、步宽等步态相关参数及MBI评分均较治疗前及对照组明显提高(P均<0.05),对照组亦有提高,但治疗前后差异不明显(P>0.05)。结论对社区脑卒中恢复期患者实施核心稳定性训练能明显提高社区脑卒中恢复期患者躯干控制能力、平衡功能、运动功能、步行能力、步态及日常生活活动能力。

Objective To investigate the impact of core stability training on trunk control ability,bal ance function,Motor function,walking ability,gait and ability in activities of daily living of stroke patients with hemiplegia in community.Methods 100 stroke patients in Gangdu Community were randomly divided into 2 groups：core stability training group with 50 patients and control group with 50 patients.The patients in con trol group were set to home rehabilitation and functional training all on their own,meanwhile they were asked to have regular outpatient referral and do the follow clinic when feeling indisposed.Core stability training group was under the instruction of therapists from our hospital regularly.The core stability training,such as,the collaborative contraction training of transverse abdominal muscle and crack more muscle,trunk control a bility training and the strength training of iliopsoas and gluteal muscles were under the rehabilitation assess ment by community doctors and therapists together.Trunk control ability（TCT）,balance function （BBS）,motor function （FMA）,walking ability（FAC）,pace step,step length and width and abilities in activities of daily living（MBI） in two groups were evaluated before interposed and two months later.Results Before inter posed,the difference in the comparison of TCT score,BBS score,the FMA upper and lower limbs score as well as the MBI score are not statistically significant （P＞0.05）.After two months of therapy,TCT score,BBS score,the FMA upper and lower limbs score,FAC score,the data of pace step,step length and width and MBI score in core stability training group have been significantly improved compared to the situation before cinterposed and the controls＇ （P＜0.05 average）.The controls also improved,however,the difference are not statistically significant （P＞0.05）.Conclusions To perform core stability training on stroke patients within community can significantly improve their trunk control ability,balance function,motor function,walking a bility,gait and ability in activities of daily living.