下斜坡步行训练改善脑卒中偏瘫患者膝过伸临床疗效分析

Clinical effect of lower slope walking training in the treatment of patients with knee extension secondary from hemiplegia after stroke

目的 探讨下斜坡步行训练改善脑卒中偏瘫患者膝过伸临床效果.方法 选取合并膝过伸脑卒中偏瘫患者共120例,采用随机数字表法分为对照组（60例）和观察组（60例）,分别采用常规康复锻炼单用和在此基础上加用下斜坡步行训练辅助治疗;比较两组临床疗效,治疗前后VAS评分、膝关节ROM、FMA评分及起立-行走测试时间等.结果 对照组、观察组总有效率分别为73.33%、91.67%,观察组总有效率显著高于对照组,差异有统计学意义（χ2=9.64,P〈0.05）;观察组治疗后VAS评分显著低于对照组、治疗前,差异均有统计学意义（t=3.15、3.31、3.87,均P〈0.05）;同时观察组治疗后膝关节ROM、FMA评分及起立-行走测试时间均显著优于对照组、治疗前,差异均有统计学意义（t=2.88、2.54、2.91;3.01、3.36;3.18、3.48;3.41、3.87,均P〈0.05）.结论 下斜坡步行训练治疗脑卒中偏瘫患者膝过伸可显著缓解临床症状,降低疼痛程度,提高关节活动,并有助于改善肢体运动功能恢复效果.

Objective To investigate the clinical effect of lower slope walking training in the treatment of patients with knee extension secondary from hemiplegia after stroke. Methods 120 patients with knee extension secondary from hemiplegia after stroke,and they were randomly divided into two groups according to the digital table. The control group （ 60 patients ） received conventional rehabilitation exercise alone, and the observation group （60 patients） received lower slope walking training on the basis of control group. The clinical effect,the VAS score, knee joint ROM , FMA score and standing walking test time before and after treatment of the two groups were compared. Results The total effective rates of the control group and observation group were 73. 33%,91. 67%, respectively. The clinical effect of the observation group was significantly better than that of the control group（χ2 =9. 64,P〈0. 05）. After treatment,the VAS score of the observation group was significantly lower than those of the control group and before treatment（t=3. 15,3. 31,3. 87,all P〈0. 05）. After treatment,the knee joint ROM,FMA score and standing walking test time of the observation group were significantly better than those of the control group and before treatment（t=2. 88,2. 54,2. 91;3. 01,3. 36;3. 18,3. 48;3. 41,3. 87,all P〈0. 05）. Conclusion Lower slope walking training in the treatment of patients with knee extension secondary from hemiplegia after stroke can effectively relieve the clinical symptoms,reduce the pain degree,higher the joint activity and is helpful to improve the recovery effects of limb motor function.