A型肉毒毒素联合运动程序起站训练对脑卒中后下肢肌痉挛以及平衡能力的影响

Effect of Botulinum Toxin A Combined with Exercise Program Sit-to-stand Training on Lower Limb Spasticity and Balance Ability in Patients with Stroke

目的观察A型肉毒毒素联合运动程序起站训练对脑卒中患者下肢肌痉挛以及平衡能力的疗效。方法选取2020年1月~2021年12月笔者医院收治的脑卒中恢复期患者84例,随机将其分为对照组42例,治疗组42例。对照组给予运动程序起站训练康复治疗,治疗组给予A型肉毒毒素联合运动程序起站训练康复治疗。比较两组治疗前、治疗后4、8和12周的改良Ashworth量表(modified Ashworth scale,MAS)、简易下肢Fugl-Meyer运动功能评定量表(Fugl-Meyer assessment,FMA)、Berg平衡量表(Berg balance scale,BBS)、Barthel指数(Barthel index,BI)以及脑卒中专用生活质量量表(stroke-specific quality of life,SS-QOL)。结果两组临床基线资料比较,差异无统计学意义(P>0.05)。两组治疗后4、8和12周的MAS较术前明显降低,FMA、BBS、BI、SS-QOL评分较术前明显升高,差异有统计学意义(P<0.05)。两组间比较,治疗组治疗后4、8和12周的MAS、FMA、BBS、BI、SS-QOL评分均优于同时间点的对照组,差异均有统计学意义(P<0.05)。结论A型肉毒毒素联合运动程序起站训练可显著缓解脑卒中患者下肢肌痉挛,改善患肢运动功能及平衡能力,提高日常生活能力及生活质量,值得在临床推广、应用。

Objective To observe the effect of botulinum toxin A combined with exercise program sit-to-stand training on lower limb spasticity and balance ability in patients with stroke.Methods A total of 84 patients with stroke admitted to our hospital from January 2020 to December 2021 were randomly divided into control group(n=42)and treatment group(n=42).The control group was treated with the exercise program sit-to-stand training alone.The treatment group was treated with botulinum toxin A combined with exercise program start-up training.The modified Ashworth scale(MAS),Fugl-Meyer assessment(FMA),Berg balance scale(BBS),Barthel index(BI),and stroke-specific quality of life(SS-QOL)were compared between the two groups before treatment,and 4,8,and 12 weeks after treatment.Results No significant difference in clinical baseline data was found between the two groups(P>0.05).The MAS of the two groups at 4,8 and 12 weeks after treatment was significantly lower,while the FMA,BBS,BI,and SS-QOL were significantly higher than those before treatment(P<0.05).Compared with the control group,the improvement of MAS,FMA,BBS,BI,and SS-QOL at 4,8 and 12 weeks after treatment was better than those in the control group(P<0.05).Conclusion Botulinum toxin A combined with exercise program sit-to-stand training can significantly alleviate lower limb spasticity in patients with stroke,improve motor function and balance ability,and improve the ability of daily life and quality of life,which is worthy of clinical promotion and application.