核心肌群强化训练对不完全性脊髓损伤患者下肢功能的作用及训练依从性相关影响因素分析

Effects of intensified training on the lower limb function in the patients with incomplete spinal cord injury and analysis of the influential factors affecting training compliance

目的探究核心肌群强化训练对不完全性脊髓损伤(ISCI)患者下肢功能的影响;并分析影响训练依从性的相关因素。方法抽取上海长海医院虹口院区骨科2019年10月至2020年10月收治的70例ISCI患者,分为对照组与观察组,各35例。对照组行常规功能训练,观察组行核心肌群强化训练。对比2组患者徒手肌力评定法评分(MMT)、Berg平衡量表(BBS)、Fugl⁃Meyer评定量表(FMA)评分。并分析影响2组患者训练依从性的相关因素,提出对策。结果训练3个月后观察组MMT评分优于对照组(P<0.05);训练前与训练1个月后2组患者FMA、BBS评估结果差异无统计学意义(P>0.05),训练2、3个月后评分高于对照组(P<0.05),2组各指标改善水平均优于训练前(P<0.05)。分析发现家属陪同、生活质量、合并基础疾病、训练周期是影响患者康复训练依从性的相关因素。结论核心肌群强化训练对改善ISCI患者下肢肌力、平衡能力及下肢运动功能有一定促进作用。训练过程中应积极挖掘导致患者依从性下降的各项因素并进行针对性干预。

Objective To explore the effects of intensified training on the lower limb function in the patients with incomplete spinal cord injury and also to analyze the influential factors affecting training compliance.Methods A total of 70 patients with incom⁃plete spinal cord injury(ISCI)admitted to the Department of Orthopedics of Changhai Hospital from October 2019 to October 2020 were recruited as research subjects and were randomly divided into the control group and the study group,each consisting of 35 patients.The control group received routine functional training,while the observation group was treated with the core muscle strengthening training.MMT,BBS and FMA scores were compared between the patients of the 2 groups,and then correlative factors affecting the training com⁃pliance of the patients in the 2 groups were analyzed and related countermeasures were proposed.Results After 3 months of training,the MMT scores of the observation group were significantly better than those of the control group(P<0.05).No significant differences could be seen in the FMA and BBS scores,when comparisons were made between the 2 groups before training and 1 month after training(P>0.05).However,2 and 3 months after training,the FMA and BBS scores of the observation group were significantly superior to those of the control group(P<0.05),and all the indexes of the 2 groups were better than those before training.It was found that the accompanying of family members,life quality,basic diseases and training cycle were related factors affecting patients'compliance with rehabilitation training.Conclusion Intensified training of the core muscle group could improve lower limb muscle strength,balance function and lower limb motor function in the patients with ISCI.In the course of training,various factors leading to the decline of pa⁃tient compliance should be duly identified and targeted interventions should be implemented in a timely manner.