减重支持步行训练联合本体感觉训练改善CIS患者平衡及步行能力的效果

Effects of body weight support treadmill training combined with proprioception training on balance and walking ability in patients with CIS

目的观察减重支持步行训练(BWSTT)联合本体感觉训练改善急性缺血性脑卒中(CIS)患者平衡及步行能力的效果。方法选择分别行BWSTT治疗(对照组)、BWSTT+本体感觉训练(观察组)的CIS偏瘫患者各32例。治疗前及治疗6周后,采用简化Fugl-Meyer下肢功能评定(FMA)、Berg平衡量表(BBS)、Holden步行功能分级(FAC)、6分钟步行试验(6MWT)分别评估患者的下肢运动功能、平衡能力及步行能力;采用Prokin 254P型本体感觉评估训练系统中的平均轨迹误差(ATE)、评估完成时间(Time)评估患者的下肢本体感觉功能;比较两组患者以上各项指标。结果治疗前,两组患者FMA、BBS、FAC、6MWT、ATE、Time比较,差异均无统计学意义(均P>0.05);治疗后,观察组FMA、BBS、FAC、6MWT均较对照组明显增加(均P<0.05),ATE、Time均较对照组明显降低(均P<0.05)。治疗前后比较,对照组FMA、FAC、6MWT均明显增加(均P<0.05),而BBS、ATE、Time均未见改善(均P>0.05);观察组FMA、BBS、FAC、6MWT、ATE、Time均明显改善(均P<0.05)。结论 BWSTT联合本体感觉训练能有效改善CIS患者的下肢运动功能及本体感觉,提高患者的平衡及步行能力。

Objective To observe the effects of body weight support treadmill training （BWSTT） combined with proprioception training on balance and walking ability in patients with acute cerebral ischemic stroke （CIS）.Methods 64 cases of hemiplegic stroke patients were randomly divided into control group （BWSTT treatment,n=32） and observation group （BWSTT and proprioceptive training,n=32）.Before and 6 weeks after treatment,the simple FugI-Meyer low limb Assessment （FMA）,the Berg balance scale（BBS）,the functional ambulation classification（FAC） and the 6-minute walk test （6MWT） were used to evaluate their low limb motor function,balance and walking ability,the average track error （ATE） and the time of evaluation （Time） were used to evaluate their proprioceptive ability with the proprioceptive assessment training system （TecnoBody Prokin 254P）;all the above indicators were compared between the two groups.Results Before treatment,there was no significant difference between the two groups with the FMA,BBS,FAC,6MWT,ATE and Time （P 〉0.05）.After treatment,the FMA,BBS,FAC,and 6MWT were significantly increased,while the ATE and Time were significantly decreased in the observation group （P〈0.05）.After treatment,the FMA,FAC,and 6MWT had improved significantly in the control group （P〈0.05）,but they showed no significant change in the BBS,ATE and Time （P 〉0.05）.The FMA,BBS,FAC,6MWT,ATE and Time had all improved significantly in the observation group （P〈0.05）.Conclusion BWSTI combined with proprioception training can effectively improve the motor function of lower,proprioception,balance and walking ability of the patients with CIS.