三维运动平台训练对脑卒中偏瘫患者步行能力和日常生活活动能力的影响

Training on a three-dimensional motion platform can improve the walking and ability in the activities of daily living of hemiplegic stroke survivors

目的探讨三维运动平台训练对脑卒中偏瘫患者步行能力和日常生活活动能力的影响。方法选取脑卒中偏瘫患者70例,按照随机数字表法将其分为对照组和干预组,每组35例。2组患者均接受常规康复治疗,对照组在此基础上进行地面平衡训练,干预组在常规康复基础上进行三维运动平台训练。治疗前和治疗4周后(治疗后),采用Gait Watch三维步态分析系统、de Morton活动指数(DEMMI)、改良Bartherl指数(MBI)评估2组患者的步态、转移和步行能力、日常生活活动能力。结果治疗前,2组患者的步长、步速、步频、患侧站立相百分比、双支撑期百分比、DEMMI评分、MBI评分比较,差异均无统计学意义(P>0.05)。治疗后,2组患者的上述指标均较组内治疗前改善,差异有统计学意义(P<0.05)。治疗后,干预组步长[(42.26±3.06)cm]、步速[(38.49±2.05)cm/s]、步频[(52.40±3.10)次/分]、患侧站立相百分比[(69.91±2.90)%]、双支撑期百分比[(17.06±1.75)%]、DEMMI评分[(49.49±4.53)分]、MBI评分[(68.57±7.23)分]较对照组改善优异,差异有统计学意义(P<0.05)。结论三维运动平台训练能改善脑卒中后偏瘫患者的步行能力和日常生活活动能力。

Objective To explore the ability of training on a three-dimensional motion platform to improve the walking ability and skill in the activities of daily living of hemiplegic stroke survivors.Methods A total of 70 stroke survivors with hemiplegia were randomly divided into a control group(n=35)and an intervention group(n=35).In addition to routine rehabilitation,the control group received 40 minutes of ground balance training,while the intervention group received 40 minutes of training on a three-dimensional motion platform 6 times a week for 4 weeks.Before and after the intervention,step length,speed and frequency were evaluated in both groups using the Gait Watch 3D gait analysis system.Walking ability and ability in the activities of daily living were assessed using the de Morton mobility index(DEMMI)and the modified Barthel index(MBI).Results Before the treatment,there was no significant difference in average step length,speed or frequency between the two groups.The average standing phase percentage on the affected side,percentage of double support period,DEMMI score,and MBI score also were not significantly different.After the treatment those indicators had improved significantly in both groups.The intervention group′s averages were then all significantly better than those of the control group.Conclusions Three-dimensional motion platform training can improve the walking ability and skill in the activities of daily living of hemiplegic stroke survivors.