全身振动训练在脑卒中偏瘫患者中的应用效果

Application effect of whole-body vibration training in stroke patients with hemiplegia

目的探讨全身振动训练对脑卒中偏瘫患者平衡功能、跌倒风险及生活质量的影响。方法本研究为随机对照试验。按照随机数字表法将2020年1月至2022年9月威海市中心医院收治的104例脑卒中偏瘫患者分为对照组和研究组,每组52例。对照组男31例,女21例,年龄(63.06±6.54)岁,接受临床常规康复治疗+假性全身振动训练;研究组男29例,女23例,年龄(63.37±6.59)岁,接受临床常规康复治疗+全身振动训练。采用前后倾斜角度(F-BIA)、左右倾斜角度(L-RIA)、患侧单腿站立时间评估患者平衡功能,采用Morse跌倒风险评估量表(MFS)评估患者跌倒风险,采用生活质量综合评定问卷(GQOLI-74)评估患者生活质量。比较治疗前后两组患者的平衡功能、跌倒风险、生活质量。计量资料采用两独立样本t检验及配对t检验比较,计数资料用四格表χ^(2)检验比较。结果治疗后,两组F-BIA、L-RIA、患侧单腿站立时间均高于同组治疗前,且研究组均高于对照组[(1.37±0.76)°比(1.03±0.62)°、(3.24±1.36)°比(2.11±1.03)°、(4.58±2.17)s比(3.12±1.43)s](均P<0.05);两组MFS评分均低于同组治疗前[(31.07±4.12)分比(82.57±8.67)分、(43.54±5.26)分比(82.15±8.62)分](均P<0.05),且研究组低于对照组(t=13.458,P<0.001);两组躯体功能、心理功能、物质功能、社会功能评分及生活质量总分均高于同组治疗前,研究组均高于对照组(均P<0.05)。结论与常规康复治疗相比,联合全身振动训练可以明显改善脑卒中偏瘫患者的平衡功能,降低跌倒风险,提高生活质量,有临床推广价值。

Objective To explore the effects of whole-body vibration training on the balance function,fall risk,and quality of life in stroke patients with hemiplegia.Methods It was a randomized controlled trial.By the random number table method,104 stroke patients with hemiplegia admitted to Weihai Central Hospital from January 2020 to September 2022 were divided into a control group(52 cases)and a study group(52 cases).The control group consisted of 31 males and 21 females,aged(63.06±6.54)years.The study group consisted of 29 males and 23 females,aged(63.37±6.59)years.The control group received clinical routine rehabilitation therapy+sham whole-body vibration training,while the study group received clinical routine rehabilitation therapy+whole-body vibration training.The patients'balance function was evaluated by the front-back tilt angle(F-BIA),left-right tilt angle(L-RIA),and standing time of the affected side.The patients'fall risk was assessed by the Morse Fall Risk Assessment Scale(MFS).The patients'quality of life was assessed by the Generic Quality of Life Inventory-74(GQOLI-74).The balance function,fall risk,and quality of life were compared between the two groups before and after treatment.The measurement data were compared by two independent samples t-test and paired t-test,and the count data were compared by four grid tableχ^(2) test.Results After treatment,the F-BIA,L-RIA,and standing time of the affected side were all higher than those before treatment in both groups,and those in the study group were higher than those in the control group[(1.37±0.76)°vs.(1.03±0.62)°,(3.24±1.36)°vs.(2.11±1.03)°,(4.58±2.17)s vs.(3.12±1.43)s](all P<0.05).After treatment,the MFS scores in both groups were lower than those before treatment[(31.07±4.12)points vs.(82.57±8.67)points,(43.54±5.26)points vs.(82.15±8.62)points](both P<0.05),and the MFS score in the study group was lower than that in the control group(t=13.458,P<0.001).After treatment,the scores of physical function,psychological function,material function,and social function and total score of quality of life in both groups were higher than those before treatment,and those in the study group were higher than those in the control group(all P<0.05).Conclusion Compared with conventional rehabilitation therapy,combined whole-body vibration training can significantly improve the balance function in stroke patients with hemiplegia,reduce their fall risk,and improve their quality of life,which has clinical promotion value.