脑卒中早期双侧下肢康复管理对步态及下肢运动功能的疗效观察

Observat ion on effect of rehabilitation management on both lower limbs on gait and lower extremity motor function for early stroke

目的观察脑卒中早期双侧下肢运动康复管理对改善偏瘫步态及下肢运动功能的临床效果。方法将300例脑卒中患者按随机数字表分为观察组150例和对照组150例。两组均进行运动康复治疗,对照组采用常规健侧康复治疗,观察组采用两侧下肢交替运动和姿势管理康复疗法。在康复训练前后对患者进行FAC评分和Fugl-Meyer评分,治疗1个月后测定患者的步行参数,对两组患者治疗前后的评分进行比较,对治疗后的步行参数进行组间比较,并且分析步行参数和两种评分的相关性。结果两组患者治疗后的FAC评分和Fugl-Meyer评分均显著高于治疗前,治疗后两组患者的评分差异具有统计学意义(P<0.05)。治疗后的步行参数,观察组相比于对照组在患侧步长上显著提高,在步宽和左右步幅差上显著下降,相对于对照组,观察组10 m步行速度所用时间显著下降,且差异具有统计学意义(P<0.05)。相关性分析显示,观察组在步行参数与两项评分的相关性高于对照组,其中患侧步长与评分呈现正相关,步宽、左右步幅差、10 m步行速度呈负相关。结论双侧下肢康复管理对脑卒中患者的偏瘫步态和运动功能恢复具有良好的临床效果。

Objective To observe the clinical effect of rehabilitation management on both lower limbs on gait and lower extremity motor function for patients with early stroke. Method Divide 300 stroke patients into observation group（n=150）and control group（n=150） by random number table. All patients receive exercises for rehabilitation. Patients in control group receive routine exercise rehabilitation on healthy side. Patients in observation group receive rehabilitation of alternate exercise of both two limbs and postural management. Test the FAC and Fugl-Meyer scores on patients before and after rehabilitation exercise. Test patients＇ walking parameter 1 month after treatment. Compare the score before and after treatment for patients in two groups. Compare the walking parameter after treatment between two groups. Analyze the correlation between walking parameter and two scores. Result FAC and Fugl-Meyer scores for patients in both two groups all increase after treatment.There is significant difference on scores after treatment between patients in two groups（ P0.05）. The increase on step length of affected side is more obvious in observation group than in control group. The decrease on step width and difference between left and right stride is less in observation group than in control group. Patients in observation group need less time to walk 10 meters than patients in control group. The difference is significant（ P0.05）. Correlation analysis shows that there is higher correlation between walking parameter and two scores in observation group than in control group. Step length of affected side has positive correlation with two scores. Step width, difference between left and right stride and 10 m walking time have negative correlation with two scores. Conclusion Rehabilitation management on both lower limbs has nice clinical effect on hemiplegic gait and motor function recovery for stroke patients.