全身振动训练对脑卒中偏瘫患者下肢肌张力及步行功能的影响

Effects of whole-body vibration training on lower-limb muscle tension and walking ability in stroke patients with hemiplegia

目的观察全身振动训练对脑卒中偏瘫患者下肢肌张力及步行功能的影响。方法40例脑卒中偏瘫患者,随机分为实验组和对照组,每组20例。两组患者均进行常规肢体运动康复训练,实验组在常规肢体运动康复训练基础上给予全身振动训练。比较两组患者治疗前后下肢肌力、肌张力;治疗前后日常生活自理能力量表(ADL)评分、Holden步行功能评分、Berg平衡量表(BBS)评分;治疗前后步幅、步频、髋关节屈曲度、膝关节屈曲度、步态周期。结果治疗后,两组患者伸髋肌群、伸膝肌群的肌张力改良阿什沃思量表(MAS)评分均较治疗前下降,屈髋肌群、伸膝肌群的肌力评分均较治疗前明显升高,差异均有统计学意义(P<0.05);且实验组伸髋肌群和伸膝肌群的肌张力MAS评分、屈髋肌群和伸膝肌群的肌力评分改善程度均显著优于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者BBS评分、Holden步行功能评分、ADL评分均较治疗前明显升高,差异均有统计学意义(P<0.05);实验组BBS评分(43.15±5.45)分、Holden步行功能评分(3.80±0.51)分均较对照组的(39.40±5.70)、(3.30±0.73)分显著升高,差异均有统计学意义(P<0.05);但两组ADL评分比较差异无统计学意义(P>0.05)。治疗后,两组患者步幅、步频、髋关节屈曲度、膝关节屈曲度、步态周期均较治疗前改善,且实验组步幅、步频、膝关节屈曲度、步态周期均较对照组改善显著,差异均有统计学意义(P<0.05);但两组髋关节屈曲度比较差异无统计学意义(P>0.05)。结论全身振动训练配合肢体运动康复能够更有效地改善脑卒中偏瘫患者下肢肌张力,并提高步行功能。

Objective To observe the effects of whole-body vibration training on lower-limb muscle tension and walking ability in stroke patients with hemiplegia.Methods A total of 40 stroke patients with hemiplegia were randomly divided into experimental group and control group,with 20 cases in each group.Both groups of patients received conventional limb movement rehabilitation training,and the experimental group was given whole body vibration training on this basis.The lower-limb muscle strength,muscle tension,activities of daily living(ADL)score,Holden walking function score,Berg balance scale(BBS)score,stride length,stride frequency,hip flexion,knee flexion,gait cycle before and after treatment were compared between the two groups.Results After treatment,the modified Ashworth scale(MAS)scores of the hip extensors and knee extensors of the two groups were lower than those before treatment,and the muscle strength scores of the hip flexors and knee extensors were significantly higher than those before treatment,and the difference is statistically significant(P<0.05).The MAS scores of the hip extensors and knee extensors and muscle strength scores of the hip flexors and knee extensors of the two groups were obviously higher than those of the control group,and the difference was statistically significant(P<0.05).After treatment,BBS score,Holden walking function score and ADL score of the two groups were obviously higher than those before treatment,and the difference was statistically significant(P<0.05).BBS score(43.15±5.45)points,Holden walking function score(3.80±0.51)points of the experimental group were significantly higher than(39.40±5.70)and(3.30±0.73)points of the control group,and the difference was statistically significant(P<0.05).But there was no statistically significant difference in ADL score between the two groups(P>0.05).After treatment,the stride length,stride frequency,hip flexion,knee flexion and gait cycle of the two groups were improved than that before treatment,and the stride length,stride frequency,knee flexion and gait cycle of the experimental group was better than that of the control group,and the difference was statistically significant(P<0.05).But there was no statistically significant difference in hip flexion between the two groups(P>0.05).Conclusion Whole-body vibration training combined with limb movement rehabilitation can effectively improve the lower-limb muscle tension and walking ability of stroke patients with hemiplegia.