基于丰富环境理论的多感官反馈步态训练对脑卒中患者步行功能的效果

Effect of enriched environment theory-based multisensory feedback gait training on walking function in stroke patients

目的探讨基于丰富环境理论的视觉和听觉等多感官反馈步态训练对脑卒中患者步行功能恢复的影响。方法2021年7月至2023年6月,选取复旦大学附属华山医院80例脑卒中患者,随机分为对照组(n=40)和试验组(n=40)。两组均接受卧位和坐位下常规康复治疗,每次40 min。对照组接受地面步行训练,每次20 min;试验组接受基于丰富环境理论的多感官反馈步态训练,每次20 min。分别在干预前和干预4周后,采用数字化运动监控跑台测量步速,健侧和患侧步长,髋、膝关节平均摆动角度和双侧负重对称性,采用Berg平衡量表(BBS)、Fugl-Meyer评定量表下肢部分(FMA-LE)和Barthel指数(BI)进行评定。结果干预后,两组髋关节平均摆动角度、健侧和患侧步长、步速明显改善(|t|>3.162,P<0.01),且试验组均优于对照组(|t|>2.568,P<0.05);试验组膝关节平均摆动角度和双侧负重对称性明显改善(|t|>3.249,P<0.01);两组BBS、FMA-LE和BI评分明显提高(|t|>3.569,P<0.01),且试验组均优于对照组(|t|>2.922,P<0.05)。结论基于丰富环境理论的多感官反馈步态训练可以有效改善脑卒中患者的步行能力和平衡功能,增加日常生活独立性。

Objective To explore the effect of multi-sensory artificial intelligence feedback gait training on the recovery of walking function in stroke patients based on enriched environment theory.Methods From July,2021 to June,2023,a total of 80 stroke patients in Huashan Hospital Affiliated to Fudan University were randomly divided into control group(n=40)and experimental group(n=40).Both groups received routine rehabilitation in the lying and seated positions,for 40 minutes.The control group received ground walking training,for 20 minutes,while the experimental group received multi-sensory feedback gait training in enriched environment,for 20 minutes.Before and after four weeks intervention,the digital motion monitoring treadmill was used to mearsure step speed,step length,hip and knee swing angle and weight symmetry.They were assessed with Berg Balance scale(BBS),Fugl-Meyer Assessment-Lower Extremities(FMA-LE)and Barthel Index(BI).Results After intervention,the hip swing angle,step length of both sides and step speed significantly improved in both groups(|t|>3.162,P<0.05),and they were better in the experimental group than in the control group(|t|>2.568,P<0.05);the average knee joint swing angle and bilateral weight-bearing symmetry significantly improved in the experimental group(|t|>3.249,P<0.01);the scores of BBS,FMA-LE and BI improved in both groups(|t|>3.569,P<0.01),and they were better in the experimental group than in the control group(|t|>2.922,P<0.05).Conclusion Multi-sensory feedback gait training based on enriched environment theory could effectively improve the walking and balance of stroke patients,and increase the ability of independence.