早期康复训练联合行为学疗法治疗老年脑卒中偏瘫患者的效果分析

Combined effect of early rehabilitation training and behavioral therapy for elderly post-stroke hemiplegic patients

目的探讨早期康复训练联合行为学疗法治疗老年脑卒中偏瘫患者的效果。方法依据随机数字表将75例老年脑卒中偏瘫患者随机分为对照组(38例)和观察组(37例),两组均给予早期康复训练,仅观察组在此基础上加用行为学疗法;分析治疗前和治疗3、6个月后的步态能力(功能性运动量表FAC),下肢运动功能和平衡功能(简式Fugl-Meyer运动功能评定量表FMA),步行相关指标(步速和跨步长度),日常生活活动能力(Barthel指数)及偏侧空间忽略情况(直线二等分、线段划消及画钟试验)。结果观察组治疗3个月后的FMA评分中的运动功能、Barthel指数均优于对照组(P<0.05),且治疗6个月后的FAC评分、FMA评分、步行相关指标、Barthel指数及偏侧空间忽略情况均优于对照组(P<0.05)。结论早期康复训练联合行为学疗法治疗老年脑卒中偏瘫患者的效果较好,不仅可改善偏瘫步态和下肢功能,而且可改善偏侧空间忽略,可在脑卒中偏瘫患者患侧功能训练中实施。

Objective To explore the combined effect of early rehabilitation training and behavioral therapy for elderly post-stroke hemiplegic patients. Methods Totally 75 elderly post-stroke hemiplegic patients admitted to The Affiliated Hospital of Inner Mongolia Medical University were randomly assigned into the control group（ n = 38） and the observation group（ n = 37）. Both groups were given early rehabilitation training,while only the observation group received behavioral therapy additionally. We analyzed the gait ability（ Functional Ambulation Category,FAC）,upper extremity motor function and balance function（ simplified Fugl-Meyer motor function assessment scale,FMA）,walking relevant indicators（ pace and stride length）,activities of daily living（ Barthel Index）,unilateral spatial neglect（ line Bisection test,line cross-out test and clock drawing test） before treatment,3 months,and 6 months after the treatment.Results The motor function of FMA score,Barthel index of observation group 3 months after treatment were superior to those of control group（ P〈0. 05）,and the FAC score,FMA score,walking relevant indicators,Barthel Index and the spatial neglect related to laterality of observation group 6 months after treatment were also better than those of control groups（ P〈0. 05）. Conclusions The combined effect of early rehabilitation training and behavioral therapy for elderly post-stroke hemiplegic patients is better.