平衡针结合核心稳定性训练对脑卒中偏瘫的影响

Effect of Balance Needle Combined with Core Stability Training on Hemiplegiaafter Stroke

目的:探讨平衡针结合核心稳定性训练对脑卒中偏瘫影响及部分作用机制。方法:将68例脑卒中偏瘫患者随机分为对照组和观察组各34例。对照组常规康复训练,观察组加用平衡针和核心稳定训练,均治疗8周,观察治疗前后在相关评分、平衡能力、表面肌电图、三维步态、血液流变学等指标变化并进行比较。结果:治疗后两组运动功能评分量表(FAM)、Berg平衡量表(BBS)、Rivermead评分较治疗前均升高,功能性步行量表(FAC)中的3级、4级、5级比率较治疗前升高(P<0.05),且观察组均高于对照组(P<0.05);治疗后两组60s、10s的轨迹面积、摆动长度、股四头肌、胫骨前肌、腓肠肌的均方根振幅(RMS)、全血黏度、血浆黏度(PV)、红细胞压积(PCV)、纤维蛋白原(FIB)较治疗前显著下降(P<0.01),且观察组显著优于对照组(P<0.01);治疗后两组股四头肌、胫骨前肌、腓肠肌的肌电积分值(iEMG)、步速、步频、跨步长比率较治疗前均显著升高。结论:平衡针结合核心稳定性训练可通过改善脑卒中偏瘫患者表面肌电图和平衡能力,促进微循环,从而改善偏瘫运动平衡力。

Objective:To explore the effect of balance acupuncture combined with core stability training on stroke hemiplegia and its mechanism.Methods:68 hemiplegic patients with stroke were randomly divided into control group(n=34)and observation group(n=34).The control group received routine rehabilitation training,while the observation group was treated with balance needle and core stability training for 8 weeks.The changes of related scores,balance ability,surface electromyography,three-dimensional gait and hemorheology were observed and compared before and after treatment.Results:After treatment,the scores of(FAM),Berg balance scale(BBS)and Rivermead in the two groups were higher than those before treatment,and the ratios of grade 3,grade 4 and grade 5 in the functional walking scale(FAC)were higher than those before treatment,and those in the observation group were higher than those in the control group(P<0.05).After treatment,the track area,swing length,musculi quadriceps femoris,musculi tibialis anterior,root mean square amplitude(RMS),whole blood viscosity,plasma viscosity(PV),hematocrit(PCV)and fibrinogen(FIB)of quadriceps femoris,tibialis anterior muscle and gastrocnemius muscle in the two groups decreased significantly compared with those before treatment,and the observation group was significantly better than the control group(P<0.01).After treatment,the musculi quadriceps femoris,musculi tibialis anterior,myoelectric integral value((iEMG)),walking speed,walking frequency and stride length ratio in both groups were significantly higher than those before treatment.Conclusion:Balance acupuncture combined with core stability training can promote the microcirculation and improve the balance force of hemiplegic movement by improving surface electromyography and balance ability of stroke patients with hemiplegia.