脑卒中偏瘫患者下肢功能与ADL移动动作能力的关系

Relationship between the function of the paretic lower limb and ambulation of ADL function in hemiparetic stroke patients

目的:改善ADL能力是脑卒中康复主要目标。本文通过对脑卒中偏瘫患者ADL移动动作能力与患侧下肢功能之间关系的研究,判别影响ADL移动动作能力的下肢功能因素。方法:对55例患者用功能独立性测量中的转移和行进项目来评价患者的ADL移动动作能力,用简式Fugl-Meyer评价法评价下肢运动功能,用Motricity指数评价患侧下肢肌力,用Berg平衡量表评价患者的平衡能力。用Pearson相关分析方法来确定ADL移动动作能力和下肢功能之间的相关性;然后以ADL移动动作能力作为因变量用多元回归分析法的逐步回归法和路径分析法来确定影响ADL移动动作能力的下肢功能因素。结果:患者患侧下肢功能与ADL移动动作能力之间呈高度相关(r=0.541—0.670,P<0.001);其中平衡功能是影响ADL移动动作能力最重要的直接因素(R2=0.45,P<0.05)。结论:脑卒中偏瘫患者的下肢功能尤其是平衡功能是影响ADL移动动作能力的重要因素。

Objective: To improve ADL function is an important program and goal for stroke rehabilitation. Method: Fifty-five stroke subjects were assessed in the study . The ambulation of ADL function,motor function, strengths of the paretic lower limb and balance were evaluated with the ambulation item of FIM? Fugl-Meyer Assessment, Motricity Index, and Berg balance scale. Result: Balance, motor function and strength of the lower limb were significantly positive related to the ambulation of ADL function (Pearson′s r=0.541-0.670;P<0.001).The regression analysis balance was an important immediate factor to consider in determining ambulation of ADL function in the hemiparetic stroke patients(R2=0.45, P<0.05). Conclusion: Balance of stroke patients may play an important role in influencing on ambulation of ADL function and the results of this study may provide a guide for prescribing a more efficient at improvement of ADL function for stroke patients.Author′s address Dept. of Rehabilitation Medicine, The General Hospital of PLA, Beijing, 100853