任务导向结合肌力训练对脑卒中后遗症患者下肢偏瘫的影响

The effect of task-oriented training combined with strength training on stroke patients with hemiplegia sequelae of lower extremity motor function and ADL ability

目的探讨任务导向结合肌力训练对脑卒中后遗症患者下肢运动功能和日常生活活动能力(ADL)的影响。方法选择2012年2月-2013年10月新疆医科大学第一附属医院康复医学科收治的80例脑卒中后遗症患者,随机分为试验组和对照组,每组40例。两组患者除均接受常规药物治外,对照组采用常规康复治疗措施,试验组采用任务导向结合肌力训练。比较两组患者训练前后评定运动功能量表(Fugl-Meyer)、日常生活能力评定量表(Barthel)指数及步速进行评价及临床疗效分析。结果两组患者治疗后下肢各项运动指标均有改善,但试验组患者Fugl-Meyer评分、Barthel指数及步速均明显高于对照组(P<0.01),试验组患者康复训练的总有效率(92.5%)明显高于对照组(70.0%),差异有统计学意义(χ2=6.749 1,P=0.034 2)。结论任务导向结合肌力训练对脑卒中后遗症期患者偏瘫下肢康复治疗效果良好,可显著改善脑卒中后遗症期患者的下肢运动功能,提高日常生活活动能力(ADL)。

Objective To investigate the effects of task-oriented training combined with strength training on stroke patients with hemiplegia sequelae of lower extremity motor function and ADL ability.Methods 80 cases with hemiplegia stroke sequelae,selected from the Department of Rehabilitation,the First Affiliated Hospital,Xinjiang Medical University,in 2012.2-2013.10,were randomly divided into experimental and control group,with 40 patients in each group.With the conventional drug treatment for 80 patients,the control group received conventional rehabilitation,and the experimental group received the task-oriented training combined with strength training as the rehabilitation training.Fugl-Meyer score,Barthel Index, the pace and tempo in two groups of patients before and after the training were compared and studied for the analysis on the rehabilitation effects.Results After treatment,the indices of lower limb movement in two groups were improved,and the Fugl-Meyer score,Barthel Index and Pace in the experimental group were significantly higher than those in the control group （P〈0.01）;The total effective rate of rehabilita-tion in the experimental group （92.5%）was significantly higher than that in the control group （70.0%）, with significant difference in statistics （χ2 =6.749 1,P =0.034 2）.Conclusion The task-oriented trainingcombined with strength training had good effects on the rehabilitation of patients with hemiplegia stroke sequelae,and it can significantly improve the patients′lower extremity motor function and ADL capacity.