高强度间歇性呼吸肌训练在缺血性脑卒中患者康复中的应用效果

Application effect of high-intensity intermittent respiratory muscle training in the rehabilitation of patients with ischemic stroke

目的探究高强度间歇性呼吸肌训练在缺血性脑卒中患者康复中的应用效果。方法选取2018年2月至2021年2月苏州工业园区星海医院收治的81例缺血性脑卒中患者作为研究对象,根据治疗方式的不同分为常规组(n=39)与研究组(n=42)。常规组予以常规呼吸肌训练,研究组在常规组基础上采用高强度间歇性呼吸肌训练。比较两组呼吸肌最大收缩能力[最大吸气压(MIP)、最大呼气压(MEP)、吸气流量峰值(PIF)]、肺功能指标(用力肺活量、第1秒用力呼气流速、呼气峰流速)、运动功能和日常生活能力[Fugl-Meyer运动功能评估量表(FMA)、莫顿活动指数(DEMMI)、改良巴氏指数(MBI)评分]、动脉血气指标(血氧饱和度、血氧分压)、步态指标(步速、步频、步幅)。结果训练后,两组MIP、MEP均高于训练前,PIF大于训练前,且研究组MIP、MEP均高于常规组,PIF大于常规组,差异有统计学意义(P<0.05)。训练后,两组用力肺活量均小于训练前,研究组第1秒用力呼气流速、呼气峰流速均快于训练前,常规组呼气峰流速慢于训练前,且研究组用力肺活量大于常规组,第1秒用力呼气流速、呼气峰流速均快于常规组,差异有统计学意义(P<0.05)。训练后,两组DEMMI、FMA、MBI评分均高于训练前,且研究组高于常规组,差异有统计意义(P<0.05)。训练后,两组血氧饱和度、血氧分压均高于训练前,且研究组高于常规组,差异有统计学意义(P<0.05)。训练后,两组步速、步频均快于训练前,步幅均大于训练前,且研究组步速、步频均快于常规组,步幅大于常规组,差异有统计学意义(P<0.05)。结论高强度间歇性呼吸肌训练能有效提高缺血性脑卒中患者呼吸肌力,促进肺功能恢复,提高患者日常生活能力和运动功能,临床应用价值较高。

Objective To explore the application effect of high-intensity intermittent respiratory muscle training in the rehabilitation of patients with ischemic stroke.Methods 81 patients with ischemic stroke treated in Rehabilitation department of Xinghai Hospital in Suzhou Industrial Park from February 2018 to February 2021 were selected as the research subjects,and they were divided into the routine group(n=39)and the research group(n=42)according to the different treatment methods.The routine group was given routine respiratory muscle training,and the research group was given high-intensity intermittent respiratory muscle training on the basis of the routine group.The maximum contractility of respiratory muscles(maximum inspiratory pressure[MIP],maximum expiratory pressure[MEP],peak inspiratory flow[PIF]),pulmonary function indicators(forced vital capacity,forced expiratory flow rate in the first second,peak expiratory flow rate),motor function and ability of daily living(Fugl-Meyer assessment of motor recovery scale[FMA],De Moryon mobility index[DEMMI],modified Barthel index[MBI]score),arterial blood gas index(blood oxygen saturation,blood oxygen partial pressure),gait index(stride speed,stride frequency,stride length)were compared between the two groups.Results After training,the MIP and MEP of the two groups were higher than those before training,and the PIF was larger than that before training,and the MIP and MEP in the research group were higher than those in the routine group,and the PIF was larger than that in the routine group,and the differences were statistically significant(P<0.05).After training,the forced vital capacity of the two groups were smaller than that before training,the forced expiratory flow rate in the first second and peak expiratory flow rate in the research group were faster than those before training,the peak expiratory flow rate in the routine group was slower than that before training,and the forced vital capacity in the research group was larger than that in the routine group,and the forced expiratory flow rate in the first second and peak expiratory flow rate were faster than those in the routine group,the differences were statistically significant(P<0.05).After training,the DEMMI,FMA and MBI scores of the two groups were higher than those before training,and the research group was higher than the routine group,the differences were statistically significant(P<0.05).After training,the blood oxygen saturation and blood oxygen partial pressure of the two groups were higher than those before training,and the research group was higher than the routine group,the differences were statistically significant(P<0.05).After training,the step speed and step frequency of the two groups were faster than those before training,and the stride length was greater than that before training,and the step speed and step frequency in the research group were faster than those in the routine group,and the stride length was greater than that in the routine group,the differences were statistically significant(P<0.05).Conclusion High-intensity intermittent respiratory muscle training can effectively improve the respiratory muscle strength of patients with ischemic stroke,promote the recovery of lung function,improve the ability of daily living and motor function,and has high clinical application value.