八段锦对脑卒中患者运动功能恢复影响的临床研究

Clinical study on the effect of Baduanjin on motor rehabilitation of stroke patients

目的运用中医八段锦对脑卒中后6个月内患者进行康复干预,观察评价其对肢体运动、平衡功能的康复疗效。方法 2018年7月—2019年3月符合纳入标准的脑卒中患者40例,随机分成八段锦组(八段锦结合常规康复)20例、对照组(常规康复)20例。八段锦组在进行常规康复的同时再给予八段锦训练,对照组给予常规康复训练。治疗时间为3周,在治疗前、后采用Fugl-Meyer运动功能量表、6分钟步行测试、Berg平衡量表、坐站平衡测试仪、Barthel指数评估两组患者干预前后的运动功能、平衡能力和日常生活能力。结果八段锦组和对照组在干预后,Fugl-Meyer运动功能量表、6分钟步行测试、Berg平衡量表、坐站平衡测试仪、Barthel指数评估患者运动功能、平衡能力、日常生活能力皆有明显改善(P<0.05);与对照组比较,八段锦组Fugl-Meyer运动功能量表、Barthel指数、Berg平衡量表及6分钟步行测试评分均显著增加[(72.25±20.91)vs.(57.90±20.25)分,(89.75±12.08)vs.(77.75±15.68)分,(53.25±5.74)vs.(47.80±9.77)分,(251.03±79.43)vs.(186.92±100.09)m;P<0.05],而坐-站-坐平衡中站立位的重心轨迹总长度、重心摆动平均速度、重心单位面积轨迹长度均显著降低[(235.86±76.08)vs.(303.60±123.01)cm,(11.67±3.37)vs.(15.76±7.05)cm/s,(2.53±0.99)vs.(3.40±1.28)cm/cm2;P<0.05],坐-站-坐平衡中坐位的重心轨迹总长度、重心摆动平均速度、重心单位面积轨迹长度也显著降低[(246.59±98.79)vs.(334.05±155.87)cm,(7.69±2.29)vs.(11.13±6.41)cm/s,(4.10±1.38)vs.(6.25±4.21)cm/cm2;P<0.05]。结论常规康复训练及在此基础上增加八段锦训练对脑卒中患者的运动功能、平衡功能、日常生活能力均有改善,常规康复联合八段锦训练的治疗效果优于常规康复训练。

Objective To observe the effect of Baduanjin on the motor function and balance function in patients within 6 months after stroke.Methods Between July 2018 and March 2019,a total of 40 stroke patients were randomly divided into the Baduanjin group and the control group.Twenty patients in the Baduanjin group received the treatment of Baduanjin training and conventional rehabilitation,while the other 20 patients in the control group were treated with conventional rehabilitation only.The duration of the treatment was 3 weeks;then the motor function,balance ability and the ability of daily life in the two groups were assessed by the Fugl-Meyer Assessment(FMA),the 6-minute Walking Test(6 MWT),the Berg Balance Scale(BBS),the balance tester and the Barthel Index(BI) respectively before and after treatment.Results After the 3-week treatment,the motor function,balance ability and the ability of daily life assessed by FMA,6 MWT,BBS,the balance tester,and BI were improved significantly in both groups(P<0.05).The post-treatment scores of FMA,BI,BBS and 6 MWT distance in the Baduanjin group were more than those in the control group[72.25±20.91 vs.57.90±20.25,89.75±12.08 vs.77.75±15.68,53.25±5.74 vs.47.80±9.77,(251.03±79.43) vs.(186.92±100.09) m;P<0.05].In the sit-to-stand balance test,compared with those in the control group,the total trajectory length of center of gravity,average swing speed of center of gravity,and unit area trajectory length of center of gravity in standing stance in the Baduanjin group reduced significantly [(235.86±76.08) vs.(303.60±123.01) cm,(11.67±3.37) vs.(15.76±7.05) cm/s,(2.53±0.99) vs.(3.40±1.28) cm/cm^2;P<0.05],and the total trajectory length of center of gravity,average swing speed of center of gravity,and unit area trajectory length of center of gravity in sitting stance in the Baduanjin group also reduced significantly [(246.59±98.79) vs.(334.05±155.87) cm,(7.69±2.29) vs.(11.13±6.41) cm/s,(4.10±1.38) vs.(6.25±4.21)cm/cm^2;P<0.05].Conclusion Conventional rehabilitation with or without Baduanjin can improve the motor function,balance function and the ability of daily life in patients after stroke,but the effect of rehabilitation with Baduanjin is better than conventional rehabilitation.