脑卒中慢性期患者高强度重复步行训练的效果

Effect of high intensity and high repetition walking training for chronic stroke patients

目的探讨高强度重复训练对卒中慢性期患者步行能力的有效性和安全性。方法选取2020-09—2021-08慢性期脑卒中患者60例为观察对象,对照组和治疗组各30例,治疗组接受以训练时靶心率和步数为目标的步行训练,每周5 d,每天2 h康复训练,期间高强度重复性步行训练时间不少于1.5 h。对照组接受常规康复训练,每周5 d,每天2 d康复训练。分别于训练前和训练后2周后采用功能性步行分级量表(FAC)、Berg平衡量表(BBS)、10 m最大速度步行测试(10MWT)、6 min步行测试(6MWT)等指标评价治疗有效性。记录2组训练中发生的不良事件评价治疗的安全性。结果治疗组中因陪护原因未坚持训练而脱落1例,其余均完成2周治疗。训练2周后,治疗组恢复独自步行能力(FAC≥4)21例,明显高于对照组的10例(P<0.01);治疗组BBS评分(44.52±10.31)分,明显高于对照组的(34.67±12.54)分(P<0.01);治疗组10MWT为(0.69±0.31)m/s,明显高于对照组的(0.45±0.28)m/s(P<0.01);治疗组6MWT为(192.14±89.96)m,明显高于对照组的(129.63±70.77)m(P<0.01)。治疗组患者治疗期间除出现1例臀部肌肉酸痛外,其余无不良反应。结论高强度重复步行训练可以明显改善慢性期脑卒中患者的步行能力,且训练过程安全,无严重不良反应。

Objective To explore the availabity and security of high intensity and high repetition in walking ability of chronic stroke patients.Methods A total of 60 patients with chronic stroke from September 2020 to August 2021 were selected as the observation subjects and randomly divided into two groups,control group and treatment group each of 30 cases.The treatment group received walking training with the target heart rate and step number during training and 2 hours a day,5 days a week during that time the high intensity repetitive walking training not less than 1.5 hours.The control group was given routine rehabilitation training 2 hours a day,5 days a week.The functional walking scale(FAC),Berg balance scale(BBS),10 m maximum speed walking test(10MWT)and 6 min walking test(6MWT)were evaluated before and 2 weeks after training.Adverse effects during training were recorded to evaluated the safety of treatment group.Results In the treatment group,1 case were removed due to the accompanying reason and others completed 2 weeks treatment.After 2 weeks of training,21 patients in the treatment group recovered their walking ability(FAC≥4),which was significantly higher than that in the control group(P<0.01).The BBS score of the treatment group was(44.52±10.31)points,which was signifi⁃cantly higher than that of the control group((34.67±12.54)points,P<0.01).The 10MWT of the treatment group was(0.69±0.31)m/s,which was significantly higher than that of the control group((0.45±0.28)m/s,P<0.01).The 6MWT of the treatment group was(192.14±89.96)m,which was significantly higher than that of the control group((129.63±70.77)m,P<0.01).In the treatment group,there were no adverse reactions except 1 case of hip muscle soreness.Conclusion The high intensity and high repetition walking training can improve significantly the walk⁃ing ability of patients with chronic stroke,and the training process is safe without serious adverse reactions.