髋关节强化训练对脑卒中患者动态姿势稳定性的影响

The effects of hip intensive training on dynamic pose stability of patients with stroke

目的探讨髋关节强化训练对脑卒中偏瘫患者动态姿势稳定性的影响。方法选取2019年1月至9月在潍坊医学院附属医院康复医学科住院的脑卒中偏瘫患者56例为研究对象,采用随机数字表法分为强化组(n=28)和对照组(n=28)。2组均进行常规治疗,强化组在此基础上给予强化髋关节训练,训练内容包括局部肌肉振动训练、髋关节持续被动运动、渐进式抗阻训练、等速收缩训练、桥式运动、背墙伸髋训练、蹬地送髋训练。在治疗前和治疗6周后进行动态稳定裕度测定和步态评估量表(POMA-G)评分,统计2组患者治疗6周后及2个月内跌倒损伤情况。结果治疗前,2组患者各项评价指标比较差异均无统计学意义(P>0.05)。治疗6周后,2组患者前方动态稳定裕度值(MOSA)、侧方动态稳定裕度值(MOSL)等指标均较治疗前显著减小(P<0.05),步态量表评分较治疗前显著提高(P<0.05)。治疗后组间结果比较显示,强化组的MOSA、MOSL[(18.01±2.64)cm、(10.12±1.96)cm]明显低于对照组[(20.35±3.16)cm、(12.21±2.37)cm];POMA-G评分[(10.97±0.77)分]明显优于对照组[(9.50±1.03)分];强化组的跌倒发生率(14.3%)明显低于对照组(46.4%);上述差异均有统计学意义(P<0.05)。结论在常规训练的基础上辅以髋关节强化训练,有助于改善脑卒中偏瘫患者的动态姿势稳定性。

Objective To explore the effect of intensive hip joint training on the dynamic posture stability of hemiplegic patients with stroke.Methods 56 stroke patients with hemiplegia were randomly divided into the intensive group(n=28)and the control group(n=28).Both groups were given routine treatment,and the intensive group was given intensive hip joint training on this basis.The hip joint training includes local muscle vibration training,continuous passive motion,progressive resistance training,isokinetic muscle training technique,bridge pose,back wall and hip extension training,kicking training for holding hip forward.Margin of stability(MOS)measurement and gait assessment table(POMA-G)score were performed before and after 6 weeks of treatment.The fall in-jury of patients was counted after 6 weeks and 2 months of treatment.Results Before treatment,there was no significant difference between two groups(P>0.05).After 6 weeks of treatment,the anterior margin of stability(MOSA)and lateral margin of stability(MOSL)of two groups were significantly reduced(P<0.05).And the gait scale score was significantly improved(P<0.05).After treatment,the MOSA(18.01±2.64 cm)and the MOSL(10.12±1.96 cm)of the intensive group was significantly lower than that of the control group[(20.35±3.16)cm,(12.21±2.37)cm].The POMA-G score of the intensive group(10.97±0.77)was significantly better than that of the control group(9.50±1.03).The incidence of falls in the intensive group(14.3%)was significantly lower than that of the control group(46.4%).The difference of all above comparison was statistically significant(P<0.05).Conclusion The dynamic postural stability of stroke patients with hemiplegia can be improved by routine training combined with hip joint strengthening training.