呼吸肌训练联合悬吊技术对老年脑卒中患者腹部肌肉张力及平衡功能的影响

The influence of respiratory muscle training combined with sling exercise training on abdominal muscle tone and balance function in elderly patients with stroke

目的:探讨呼吸肌训练联合悬吊技术对老年脑卒中患者腹部肌肉张力和平衡功能的治疗效果。方法:选取符合入选条件的老年脑卒中患者60例,随机分为呼吸肌训练组、悬吊技术组和联合训练组,每组20例。3组患者均接受常规康复治疗,呼吸肌训练组在常规康复治疗的基础上采用呼吸肌抗阻训练,悬吊技术组在常规康复治疗的基础上采用悬吊技术,联合组在常规康复治疗的基础上配合呼吸肌训练和悬吊技术。所有患者均于治疗前和治疗4周后分别采用最大吸气压力(MIP)、最大呼气压(MEP)、腹直肌张力和腹外斜肌张力、Berg平衡量表(BBS)以及脑卒中患者姿势评定量表(PASS)进行疗效评定。结果:经过4周治疗后,3组患者的MIP、MEP、腹直肌张力和腹外斜肌张力、BBS评分、PASS评分均较治疗前有明显增加(P<0.001);组间比较,联合训练组的MIP和MEP、腹直肌张力、PASS评分、BBS评分均明显高于呼吸肌训练组和悬吊技术组(P<0.05)。腹外斜肌张力3组间差异无显著性意义(P<0.05)。结论:呼吸肌训练联合悬吊技术对老年脑卒中患者的吸气肌和呼气肌肌力、腹直肌张力、腹外斜肌张力、平衡功能、姿势控制功能改善效果显著,并且较单独使用呼吸肌训练或悬吊技术更有利于老年脑卒中患者的吸气肌和呼气肌肌力、腹直肌张力、平衡功能、姿势控制功能的恢复。临床中推荐对有平衡功能障碍的老年脑卒中患者进行联合悬吊技术的呼吸肌训练。

Objective:To explore the therapeutic effect of respiratory muscle training(RMT) combined with sling exercise training(SET) on abdominal muscle tone and balance function in elderly patients with stroke.Method:Sixty elderly patients with stroke who met the selection criteria were randomly divided into RMT group,SET and RMT+SET group,with 20 patients in each group. Based on conventional rehabilitation therapy,the RMT group added respiratory muscle resistance training,the SET group added sling exercise training,while the combination group received both respiratory muscle resistance training and sling exercise training. Before and after treatments,all patients were measured with MIP and MEP,RA and EOA muscle tone,BBS,PASS,for evaluation and comparison.Result:After 4-week treatments,the MIP,MEP,RA muscle tone,and EOA muscle tone,PASS,BBS were significantly increased within three groups respectively(P<0.001);MIP and MEP, RA muscle tone, PASS score and BBS score in RET+SET group were more improved than those in RMT group and SET group(P<0.05). However,there was no significant difference in EOA muscle tone among the three groups(P<0.05).Conclusion: RMT combined with SET can significantly improve inspiratory and expiratory muscle strength,RA and EOA muscle tone,balance function,and posture control function,in elderly stroke patients. The use of RMT combined with SET is more effective than using RMT or SET alone on improving RA muscle tone,inspiratory and expiratory muscle strength,balance function,and posture control functions in elderly stroke patients,which is recommended to clinical practice.