等速肌力训练降低偏瘫患者跌倒风险的效果观察

Efficacy of isokinetic strength training in reducing fall risk in hemiplegic patients

目的观察等速肌力训练脑卒中患者偏瘫侧踝屈伸及内外翻对降低其跌倒风险的效果。方法采用分层抽样法将41例处于恢复期的初发脑卒中患者随机分为试验组(21例)和对照组(20例)。对照组采用常规康复训练方案,试验组在此基础上增加等速肌力训练,2组患者在训练前后均进行站立位静态平衡测试,采用Fugl-meyer平衡量表对患者的平衡功能及跌倒风险进行分析;采用30秒坐起测试(30CST)、计时站立起步测试(TUG)评价患者步行能力。采用改良Ashworth评定量表(MAS)评定患者患肢踝关节伸肌肌张力变化情况。结果训练后,2组患者各项静态平衡功能均有所改善(P<0.05),试验组前后标准差、前后平均运动速度、左右平均运动速度、包络面积以及动摇总轨迹长度较对照组下降更加显著(P<0.05);2组患者Fugl-meyer量表评分均显著升高(P<0.05),且试验组较对照组升高幅度更大(P<0.05);2组患者30CST均有显著升高(P<0.05),且试验组较对照组升高幅度更大(P<0.05);2组患者TUG均显著下降(P<0.05),且试验组较对照组下降幅度更大(P<0.05)。而2组患者MAS评分在训练前后均无明显差异(P>0.05)。结论等速肌力训练可通过提高患者下肢肌力、肌耐力以及改善患者平衡功能来更为显著地降低患者跌倒风险。

Objective To observe the effect of isokinetic strength training on dorsiflexion and plantarflexion,as well as inversion and eversion,of the hemiplegic ankle in stroke patients and its efficacy in reducing fall risk.Methods A total of 41 stroke patients in the recovery phase were randomly assigned to an experimental group(21 patients)and a control group(20 patients)using stratified sampling.The control group received conventional rehabilitation training,while the experimental group received additional isokinetic strength training.Both groups underwent static balance testing in the standing position before and after training.The Fugl-Meyer Assessment Scale was used to analyze balance function and fall risk,and the 30-second Sit-to-Stand Test(30CST)and Timed Up and Go Test(TUG)were used to evaluate walking ability.The Modified Ashworth Scale(MAS)was used to assess changes in muscle tension of the affected ankle joint.Results After training,static balance function improved significantly in both groups(P<0.05),with significant reductions in standard deviation,mean movement speed,mean lateral movement speed,envelope area,and total sway path length in the experimental group compared to the control group(P<0.05).Fugl-Meyer Assessment scores increased significantly in both groups(P<0.05),with a greater increase in the experimental group(P<0.05).Both groups showed significant improvements in 30CST scores(P<0.05)and significant reductions in TUG scores(P<0.05),with more significant changes in the experimental group(P<0.05).There were no significant differences in MAS scores before and after training in both groups(P>0.05).Conclusion Isokinetic strength training can significantly reduce fall risk in stroke patients by promoting lower limb muscle strength,muscle endurance,and balance function.