双侧等速肌力训练对脑卒中偏瘫患者平衡功能和步行能力的影响

Effects of bilateral isokinetic muscle strength training on balance function and walking ability of stroke patients with hemiplegia

目的探讨等速肌力训练对脑卒中偏瘫患者步行能力和平衡功能的影响。方法62例脑卒中偏瘫患者随机分为单侧组和双侧组,各31例。2组均予以康复训练和药物治疗。单侧组仅开展偏瘫侧膝关节屈伸肌群等速肌力训练,双侧组开展双侧膝关节屈伸肌群等速肌力训练。观察2组患者干预前后等速测试生物力学指标、平衡功能以及步行能力。结果干预后,2组偏瘫侧等速测试生物力学指标均有改善,且双侧组改善优于单侧组,差异有统计学意义(P<0.05)。干预后双侧组非偏瘫侧等速测试生物力学指标较干预前改善,与单侧组比较,差异有统计学意义(P<0.05)。干预后,2组BBS评分均升高,且双侧组BBS评分高于单侧组,差异有统计学意义(P<0.05)。干预后,2组步行功能均有改善,且双侧组改善优于单侧组,差异有统计学意义(P<0.05)。结论脑卒中偏瘫患者开展双侧膝关节等速肌力训练有利于进一步改善其步行能力和平衡功能。

Objective To investigate the effect of bilateral isokinetic muscle strength training on balance function and walking ability of stroke patients with hemiplegia.Methods Sixty-two stroke hemiplegia patients were randomly divided into two equal groups:unilateral isokinetic group and bilateral isokinetic group,with 31 cases in each group.Patients participating in the study need to meet the research criteria and participated voluntarily,and received the same conventional rehabilitation treatment during the study treatment,such as conventional rehabilitation therapy,exercise therapy and physical factor therapy.Among them,the unilateral group received isokinetic muscle strength training of flexor and extensor muscles of knee joint,and the bilateral group received isokinetic muscle strength training of flexor and extensor muscles of knee joint of both groups.The isokinetic centripetal/centripetal model was used to test the patient.The Flat-top System was used before and after treatment,and outcomes of Biodex system-4 isometric training test System,10 m walking time,Berg Balance Scale(BBS),Holden walking function grading test were used to evaluate the lower limb motor function,balance ability and walking function of patients.Results After 6 weeks of treatment,PT and H/Q data of the hemiplegic knee joint showed that the patient was effectively treated,and the improvement of PT and H/Q in the bilateral group was better than that in the unilateral group(P<0.05).In the bilateral group,PT and H/Q of the non-hemiplegic knee joints were significantly improved compared with those before treatment(P<0.05).BBS data showed that the patients in the two groups were better,and the treatment outcome of the unilateral group was lower than that of the bilateral group(P<0.05).Walking function grading data also changed before and after treatment,and the data proved that the bilateral group was superior to the unilateral group,with statistically significant differences(P<0.05).Conclusion The walking ability and balance function of hemiplegic patients with stroke were improved after receiving isokinetic muscle strength training of lateral knee joint.