等速肌力训练对脑卒中偏瘫患者下肢运动功能影响的Meta分析

Influence of isokinetic muscle strength training on lower extremity motor function in stroke patients with hemiplegia:a Meta Analysis

目的:评价等速肌力训练对脑卒中偏瘫患者下肢运动功能障碍的临床疗效。方法:计算机检索中国知网、万方、维普、中国生物医学文献数据库、Cochrane Library、Medline、Web of Science、PubMed等数据库,检索时间均为建库至2020年6月。选择等速肌力训练干预脑卒中偏瘫患者下肢运动功能障碍的随机对照试验,运用RevMan5.3软件进行Meta分析。结果:(1)共纳入12篇文献,包括511例研究对象;(2)Meta分析结果显示:试验组Fugl-Meyer运动功能量表(FMA)下肢运动功能评分、Berg平衡功能量表(BBS)评分、屈肌峰力矩(PT)评分、伸肌PT评分、总功(TW)、起立-步行试验(TUGT)测试得分、6MWD、步行速度等均优于对照组(P<0.05或<0.01);而10m步行时间和MAS评分与常规康复训练效果相似,差异无统计学意义(P均>0.05)。偏倚分析显示发生偏倚的可能性小。结论:等速肌力训练对脑卒中偏瘫患者的下肢运动功能康复具有良好的疗效。

Objective:To evaluate therapeutic effect of isokinetic muscle strength training on lower limb motor dysfunction in stroke patients with hemiplegia.Methods:CNKI,Wanfang data,VIP,CBM,Cochrane Library,Medline,Web of Science,PubMed and other databases were searched by computer,and the retrieval time was from the establishment to June 2020.RCTs of isokinetic muscle strength training for the intervention of lower limb motor dysfunction in stroke patients with hemiplegia were selected for meta-analysis using RevMan5.3 software.Results:(1)A total of 12 literatures were enrolled,including 511 subjects;(2)Results of meta-analysis indicated that lower limb motor function score of Fugl-Meyer motor function scale(FMA),Berg balance function scale(BBS)score,flexor peak torque(PT)score,extensor PT score,total work(TW)score,time up and go to test(TUGT)score,6 MWD and walking speed in experimental group were better than those of control group(P<0.05 or<0.01).The 10-meter walking time and MAS score in experimental group were similar to those of routine rehabilitation training without significant difference(P>0.05 both).Bias analysis indicated that the probability of publication bias was small.Conclusion:Isokinetic muscle strength training possesses good therapeutic effect on the rehabilitation of lower limb motor function in stroke patients with hemiplegia.