核心肌群训练对不完全性脊髓损伤患者站立能力的疗效

Efficacy of core muscle group training on standing ability of patients with incomplete spinal cord injury

目的探讨核心肌群训练对不完全性脊髓损伤(ISCI)患者站立能力的疗效。方法将64例ISCI患者按随机数字表法分为对照组及观察组,每组32例。对照组给予物理治疗、关节活动度训练等常规康复措施,观察组在此基础上予以核心肌群强化训练。比较两组干预前及干预3个月后下肢肌力[徒手肌力评定法(MMT评分)]、平衡功能[Berg平衡量表(BBS评分)、平衡测试(静态睁眼重心移动总轨迹长、静态闭眼重心移动总轨迹长、动态稳定极限范围)、下肢功能[美国脊髓损伤学会-下肢运动功能评定量表(ASIA-LEMS评分)]、功能独立性[脊髓独立测量量表第Ⅲ版(SCIMⅢ评分)]、应对能力[医学应对方式问卷中文版(MCMQ评分)]、希望水平[成人特质希望量表(ADHS评分)]的差异。结果干预3个月后,股四头肌及腘绳肌MMT评分、BBS评分、动态稳定极限范围、ASIA-LEMS评分、各领域SCIMⅢ评分、MCMQ评分、ADHS评分两组均较干预前升高(P<0.001),静态睁眼重心移动总轨迹长、静态闭眼重心移动总轨迹长则较干预前降低(P<0.001),且各项指标观察组与对照组比较差异有统计学意义(P<0.05)。结论核心肌群训练对ISCI患者干预效果显著,有利于促进患者身心健康恢复。

Objective To explore the efficacy of core muscle group training on standing ability in patients with incomplete spinal cord injury(ISCI).Methods The 64 patients with ISCI were divided into control group and observation group according to the random number table method,with 32 cases in each group.Control group was given conventional rehabilitation measures of physical therapy and range of motion training,and observation group was given core muscle group intensive training on this basis.The differences in muscle strength of lower extremities[manual muscle testing(MMT)],balance function[Berg Balance Scale(BBS),balance test(general locus length of gravity center movement of static blinking,general locus length of gravity center movement of static closure,limit range of dynamic stability)],lower limb function[American Spinal Injury Association-lower extremity motor scale(ASIA-LEMS)],and functional independence[Spinal Cord Independence MeasureⅢ(SCIMⅢ)],coping ability[medical coping mode questionnaire(MCMQ)]and hope level[Adult trait hope scale(ADHS)]were compared between the two groups before intervention and after 3 months of intervention.Results After 3 months of intervention,the MTT scores of quadriceps and hamstrings,BBS score,limit range of dynamic stability,ASIA-LEMS score,SCIMⅢscores in all areas,MCMQ score and ADHS score were higher than those before intervention(P<0.001),and general locus length of gravity center movement of static blinking and general locus length of gravity center movement of static closure were lower than those before intervention(P<0.001),and the various indexes had statistical differences between the observation group and control group(P<0.05).Conclusions Core muscle group training has significant intervention effects on ISCI patients,and it helps to promote the recovery of physical and mental health of patients.