基于镜像神经元理论指导下的步行稳定性训练在脑卒中偏瘫患者中的应用效果

Application effect of walking stability training guided by mirror neuron theory in stroke patients with hemiplegia

目的探讨基于镜像神经元理论指导下的步行稳定性训练对脑卒中偏瘫患者平衡功能及运动功能的影响。方法选择2019年1月至2020年6月山东省菏泽市立医院收治的脑卒中偏瘫患者67例为研究对象,采用随机数字表法分为试验组34例、对照组33例。在常规康复训练的基础上,对照组给予减重平板步行训练,试验组给予镜像视觉反馈疗法联合减重平板步行训练,训练时间8周。训练前后分别采用Fugl-Meyer平衡量表(FM-B)、Berg平衡量表(BBS)、Tinetti步态评估量表(TGA)、功能性步行量表(FAC)、脑卒中专用生命质量量表(SS-QOL)评估2组患者肢体平衡功能、肢体运动功能、生命质量。结果2组患者训练前FM-B、BBS、TGA、SS-QOL、FAC评分(或分级)比较差异无统计学意义(P>0.05)。试验组患者训练后FM-B、BBS、TGA、FAC评分(或分级)分别为(11.35±1.32)分、(47.33±6.20)分、(9.32±1.12)分、(3.54±0.61)级,对照组分别为(9.86±1.25)分、(42.14±6.35)分、(8.25±1.32)分、(3.15±0.54)级,2组比较差异有统计学意义(t值为2.768~4.741,P<0.05)。试验组患者训练后SS-QOL中精力、活动能力、情绪、自理能力、思维、上肢功能评分及总分分别为(10.31±1.43)、(21.46±4.45)、(17.64±3.36)、(17.32±3.15)、(16.23±2.21)、(159.11±16.34)分,对照组分别为(8.46±1.21)、(17.32±3.24)、(15.35±3.11)、(14.78±2.32)、(8.45±1.25)、(13.45±1.54)、(141.65±17.24)分,2组比较差异有统计学意义(t值为2.893~7.096,P<0.05)。结论基于镜像神经元理论指导下的步行稳定性训练有助于恢复脑卒中偏瘫患者肢体平衡功能及运动功能,改善其生命质量。

Objective To study effects of balance and motor function of walking stability training guided by mirror neuron theory for stroke patients with hemiplegia.Methods A total of 67 stroke with hemiplegia from January 2019 to June 2020 in Heze Municipal Hospital were divided into experimental group(34 cases)and control group(33 cases).All patients were given conventional rehabilitation training,the control group was given body weight support treadmill training,the experimental group was given mirror visual feedback therapy combined with body weight support treadmill training.The training time was 8 weeks.The body balance function,body motor function and life quality were evaluated by Fugl-Meyer Balance scale(FM-B),Berg Balance Scale(BBS),Tinetti Gait Analysis(TGA),Functional Ambulation Category scale(FAC),Stroke-Specific Quality of Life scale(SS-QOL)and compared before and after training between the two groups.Results There was no significant difference in the score(classification)of FM-B,BBS,TGA,SS-QOL,FAC before training between the two groups(P>0.05).The score(classification)of FM-B,BBS,TGA,FAC after training were(11.35±1.32),(47.33±6.20),(9.32±1.12)points and(3.54±0.61)grades in the experimental group and(9.86±1.25),(42.14±6.35),(8.25±1.32)points and(3.15±0.54)grades in the control group.There were statistically significant of differences(t values were 2.768-4.741,P<0.05).The score of energy,activity ability,emotion,self-care ability,thinking,upper limb function and life quality total score of SS-QOL were(10.31±1.43),(21.46±4.45),(17.64±3.36),(17.32±3.15),(16.23±2.21),(159.11±16.34)points in the experimental group and(8.46±1.21),(17.32±3.24),(15.35±3.11),(14.78±2.32),(8.45±1.25),(13.45±1.54),(141.65±17.24)points in the control group.There were statistically significant of differences(t values were 2.893-7.096,P<0.05).Conclusions Walking stability training based on mirror neuron theory help to restore limb balance and motor function,and improve life quality in stroke patients with Hemiplegia.