强化躯干肌训练对脑卒中偏瘫患者下肢运动功能影响的Meta分析

Meta analysis of effects of trunk muscle training on lower extremity function in patients with stroke hemiplegia

目的系统评价强化躯干肌训练对脑卒中偏瘫患者下肢运动功能的效果。方法采用计算机检索中国知网数据库、万方数据库、中国生物医学文献数据库(CBM)、维普数据库、PubMed、Cochrane、Medline,收集所有躯干肌训练对脑卒中偏瘫患者下肢运动功能影响的临床随机对照试验的文献,根据资料提取表提取数据,用Cochrane系统评价手册中的文献质量评价标准对纳入的文献进行评价,最后采用Rev Man 5.0软件进行Meta分析。结果最终纳入24个临床试验研究,共1 664例受试者,下肢功能结局指标Meta分析结果分别为FMA下肢功能评分[WMD=4.39,95%CI=(3.53,5.25),Z=10.01,P<0.000 01]、FAC评分[WMD=0.71,95%CI=(0.48,0.94),Z=5.96,P<0.000 01]、步速[WMD=3.04,95%CI=(1.87,4.21),Z=5.10,P<0.000 01]、TUGT[WMD=6.64,95%CI=(5.18,8.10),Z=8.90,P<0.000 01],差异均具有统计学意义。结论强化躯干肌训练能够有效改善脑卒中偏瘫患者下肢运动功能。

Objective To evaluate the effectiveness of training muscle on walking in patients with hemiplegia caused by stroke.Methods Literatures were searched for,which involed all the randomized controlled trials(RCTs) about the effects of trunk muscle training on lower extremity function with hemipiegia from China National Knowledge Infrastructure(CNKI),VIP Database,China Biology Medicine disc(CBMdisc),Wanfang Data,PubMed,Cochrane,Medline.Data were extracted according to data extraction table,the literature quality evaluation standard in Cochrane system evaluation handbook was used to evaluate the quality of the needing literature.Finally,Rev Man5.0 software was used for Meta analysis.Results Finally,24 clinical trials were included,involving 1 664 subjects.The result of Meta analysis included the score of FMA lower extremity function[WMD=4.39,95%CI=(3.53,5.25),Z=10.01,P<0.000 01],the score of FAC[WMD=0.71,95%CI=(0.48,0.94),Z=5.96,P<0.000 01],the score of step speed[WMD=3.04,95%CI=(1.87,4.21),Z=5.10,P<0.000 01],the score of TUGT[WMD=6.64,95%CI=(5.18,8.10),Z=8.90,P<0.000 01],there were statistically significant differences.Conclusion Strengthening trunk muscle training can effectively improve the lower limb motor function of stroke patients with hemiplegia.