核心肌群训练改善脑卒中偏瘫患者下肢运动功能和行走功能的效果研究

Effect of core muscle training on improving motor function and walking function of the lower extremity in patients with apoplexy hemiparalysis

目的研究核心肌群训练对脑卒中偏瘫(apoplexy hemiparalysis,AH)患者的应用效果。方法随机抽取116例接受治疗的AH患者;数字编号信封法分为A组(n=59)和B组(n=60)。A组采取常规康复训练,B组在A组基础上联合核心肌群训练。以Berg平衡量表(Berg balance scake,BBS)评估训练前后患者平衡功能,以步行患者例数、10 m最大步行速度(MWS)评估训练前后患者行走功能,以简化Fugl-Meyer Assessment(FMA)评估训练前后患者下肢运动功能,以改良Barthel指数(Modified Barthel Index,MBI)评估训练前后患者日常生活活动能力,以SF-36量表评估训练前后患者生活质量,并对上述指标进行对比分析。结果训练后B组BBS评分(由坐到站、独立站立、独立坐、由站到坐、由床向椅子转移)、步行者例数、MWS、FMA评分(上肢坐位运动功能、腕运动功能、手运动功能、下肢仰卧位运动功能、下肢坐位运动功能)、MBI评分(穿衣进食、洗澡修饰、上下楼梯、行走、转移床椅)、SF-36评分(躯体功能、社会功能、生理功能、心理功能、精神健康)优于A组(P<0.05)。结论AH患者在常规康复训练的基础上联合核心肌群训练,能显著提高患者下肢运动功能、日常生活活动能力、生活质量,同时有利于改善患者行走和平衡能力。

Objective To analyze the effect of core muscle training on patients with apoplexy hemiparalysis(AH).Methods A total of 116 AH patients treated in our hospital were randomly selected.Using the randomly numbered envelops,patients were divided into group A(n=59)and group B(n=60).Routine rehabilitation training was applied to all recruited patients,and those in group B were additionally managed by the core muscle training.The balance function before and after training was assessed using the Berg Balance Scale(BBS).Walking function was assessed by the number of walkers and the 10-m Maximum Walking Speed(MWS).Motor function of the lower extremity was assessed using the simplified Fugl-Meyer Assessment scale(FMA).Activities of daily living was assessed using the Modified Barthel Index(MBI).The quality of life was assessed using the 36-Item Short Form Survey(SF-36).The above indices were compared and analyzed.Results After training,patients in group B presented significantly better BBS scores(including the scores of the sitting to standing,standing unsupported,sitting unsupported,standing to sitting,and transfers),case number of walkers,MWS,FMA scores(including the scores of the motor functioning in the upper extremity at sitting,movement of the wrist,movement of the hand,motor functioning in the lower extremity in the supine position and motor functioning in the lower extremity at sitting),MBI scores(including the scores of the independency in feeding,dressing,bathing,grooming,going up and down stairs,walking on a level surface,and moving from wheelchair to bed and return)and SF-36 scores(including the scores of the physical activities,social activities,physical health,psychological health and mental health)than those of group A(all P<0.05).Conclusion Core muscle training combined with routine rehabilitation training can significantly improve the motor function of the lower extremity,activities of daily living and quality of life of AH patients,which is conducive to improving the walking and balance abilities.