听觉反馈步态训练对深感觉障碍的卒中偏瘫患者步行能力的效果观察

Effect of auditory feedback gait training on walking ability of stroke hemiplegia patients with deep sensory distrubance

目的探讨听觉反馈步态训练治疗深感觉障碍的卒中偏瘫患者步行能力的效果。方法选取2022年12月至2023年9月中国康复研究中心北京博爱医院住院治疗的深感觉障碍的卒中偏瘫患者36例,随机分为对照组和观察组,每组18例。对照组进行常规步态训练,观察组在对照组基础上增加听觉反馈步态训练。所有患者训练20 min/d,5 d/周,共3周。训练前后,分别采用三维步态分析系统、Fugl-Meyer下肢运动功能评定量表(Fugl-Meyer assessment lower extremity scale,FMA-LE)和Berg平衡量表(Berg balance scale,BBS)评估患者的步行能力。结果36例患者中男17例、女19例,年龄38~70岁,平均(55.6±13.9)岁。与训练前相比,训练后两组步速、患侧支撑期百分比和BBS得分更高,且观察组高于对照组,差异有统计学意义(P<0.05);训练后两组步宽、双侧支撑期百分比更低,且观察组低于对照组,差异有统计学意义(P<0.05)。结论相比常规步态训练,听觉反馈步态训练可以更好地改善深感觉障碍的卒中偏瘫患者的步行能力。

Objective To explore the effect of auditory feedback gait training on the walking ability of stroke hemiplegia patients with deep sensory disturbance.Methods A total of 36 stroke hemiplegia patients with deep sensory disturbance who were hospitalized at Beijing Boai Hospital of China Rehabilitation Research Center from December 2022 to September 2023 were selected,and were randomly divided into control group and observation group,with 18 cases in each group.The control group received routine gait training,while the observation group added auditory feedback gait training on the basis of the control group.All patients were trained for twenty minutes a day and five days a week for three weeks.Before and after training,three-dimensional gait analysis system,Fugl-Meyer assessment lower extremity scale(FMA-LE)and Berg balance scale(BBS)score were used to evaluate the patient's walking ability.Results Among the 36 patients,there were 17 males and 19 females,aged from 38 to 70 years,with an average age of(55.6±13.9)years.Compared with before training,the pace,stance period percentage of the affected side,and BBS score of the two groups were higher after training,and the results of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).Compared with before training,the step width and percentage of double support period in the two groups was lower after training,and the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusions Compared with conventional gait training,auditory feedback gait training can improve the walking ability of stroke hemiplegia patients with deep sensory disturbance better.