Correlation between the Six-Minute Walk Test and Subjective Functional Class in Patients with Heart Failure

Introduction: The Six-Minute Walk Test (6MWT) is an inexpensive method to objectively evaluate physical capacity or limitation and stratify prognosis in patients with Heart Failure (HF). Since the clinical perception of symptoms may be adapted or compromised, regular evaluation from medical interviews often fails to determine functional classification. This study aimed to assess the correlation between New York Heart Association Functional Class (NYHA-FC) and the distance walked in the 6MWT. Methods: We conducted a cross-sectional observational study that included patients with HF with reduced ejection fraction followed up at an outpatient service of a teaching hospital, from August 2018 to April 2019. Patients in NYHA-FC I, II, or III were included. We compared NYHA-FC subjectively obtained during the consultation with the 6MWT performed after medical consultation, and the correlation between these two parameters was assessed. Results: The study included 70 patients with HF, 41 (58.6%) of whom were female. The mean age was 61.2 ± 12.7 years. The most prevalent etiologies were dilated idiopathic cardiomyopathy (35.7%) followed by ischemic cardiomyopathy (25.7%). The mean ejection fraction was 34.1% ± 9.8%. The average distance walked in the 6MWT by NYHA-FC I patients was 437.8 ± 95.8 meters, NYHA-FC II 360.1 ± 96.4, and NYHA-FC III 248.4 ± 98.3. Functional class measured by the 6MWT was different than that estimated by NYHA-FC in 34 patients (48.6%), 23 (32.9%) for a higher functional class and 11 (15.7%) for a lower one (p = 0.07). Pearson’s correlation coefficient between NYHA-FC and the 6MWT was -0.55. Conclusion: There was a moderate correlation between the subjective NYHA-FC and the 6MWT. The 6MWT revealed a different classification from NYHA-FC in almost half of the patients. Among those who presented discrepancies between methods, 6MWT reclassification towards a higher functional class was more common.

Comprehensive Rehabilitation Therapy of Traditional Chinese Medicine Combined with Modern Rehabilitation Training Improves the Spasticity and Motor Function of Hemiplegia after Stroke

Objective:To analyze the impact of comprehensive rehabilitation therapy of traditional Chinese medicine(TCM)(based on modern rehabilitation training)on the spasticity and motor function in stroke patients with hemiplegia.Methods:Seventy-nine stroke and hemiplegia patients admitted to the hospital from June 2021 to June 2023 were selected and randomly divided into a control group(39 cases)using modern rehabilitation training,and an observation group combined with comprehensive TCM rehabilitation therapy(40 cases),over 1 month.The clinical index data of the two groups were compared.Results:There were differences in the clinical index data between the two groups.The total effective rate after 2 treatment in the observation group(92.50%)was higher than that of the control group(74.36%)(χ^(2)=4.727,P<0.05).All central sensitization inventory(CSI)and stroke quality of life(PRO)scores in both groups were lower after treatment,with the observation group having lower scores as compared to the control group(P<0.05).The scores of FMA(upper limbs,lower limbs),Barthel index scores,and Functional Ambulation Categories(FAC)scores of both groups increased after treatment,with the observation group having higher scores as compared to the control group(P<0.05).Conclusion:Comprehensive TCM rehabilitation therapy had a significant therapeutic effect on patients with hemiplegia after stroke.It improved the patient’s spasticity,limb movement,and walking function.Their daily living abilities and quality of life were also enhanced.

An Assessment of Cardiovascular Functional Capacity of a Group of Chronic Heart Failure Patients Using the 6-Minute Walk Test in a Cameroonian Urban Setting

Background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This study aimed to assess the cardiovascular functional capacity of a group of patients suffering from heart failure using the 6-minute walk test (6 MWT). Methods: This was a cross-sectional study carried out in the cardiology unit of Douala’s general hospital for 4 months. We included all eligible patients aged 18 years or more who had stable chronic heart failure and gave informed consent. Those who had an acute coronary syndrome (≤1 month), tachycardia (HR ≥ 120 bpm), high blood pressure (SBP ≥ 180 mmHg and/or DBP ≥ 100 mmHg) and reduced mobility due to orthopaedic reasons were excluded. A 6 MWT was done according to the American Thoracic Society guidelines. The 6 MWT result was considered poor for - 450 m and good for >450 m. Results: We recruited a total of 81 patients (61.7% women) with a mean age of 65.9 ± 10.6 years. The most frequent risk factor for heart failure was high blood pressure (77.8%), alcohol consumption(69.1%) and a sedentary lifestyle (53.1%). The left ventricular ejection fraction was mostly preserved (42.0%) or mildly altered (46.9). The 6 MWT results were poor in 55.6% of cases, average in 19.8% of cases and good in only 24.7% of cases. More than half (59.3%) of the participants perceived the effort as being difficult. The cardiovascular functional capacity was significantly associated with age, heart failure stage and physical activity (p Conclusion: Most patients suffering from chronic stable heart failure in the general hospital of Douala have poor cardiovascular functional capacity.

Functional Capacity of Patients with Venous Thromboembolic Disease Six to Twelve Months after Treatment

Background: Venous thromboembolism (VTE) is among the leading causes of hospital-related disability-adjusted life years lost. We aimed to determine the prevalence and determinants of functional capacity impairment six to twelve months after an acute VTE event. Methods: This was a cross-sectional study conducted between January and April 2021 in two referral hospitals of Yaoundé, including consenting adult patients admitted to these hospitals six to twelve months ago for VTE. We excluded dead patients and those with any comorbidity or symptoms limiting physical activity. The functional outcome was assessed with the six-minute walk test. Functional capacity impairment was defined as walking distance lower than the expected value. Results: We included 27 cases in this study with a mean age of 53.2 ± 14.4 years. The prevalence of functional capacity impairment was 29.6% (95% CI: 14.8 - 48.1). Factors associated with poor functional outcome were obesity (OR: 59.5;95% CI: 4.6 - 767.2;p - 207.4;p = 0.017), massive PE (OR: 30;95% CI: 2.5 - 354;p = 0.004), and poor adherence to treatment (OR: 30.3;95% CI: 2.5 - 333.3;p = 0.004). Conclusion: Functional capacity impairment is common in the medium-term after VTE and factors associated with this poor outcome are obesity, the severity of the VTE, and poor adherence to treatment.

Six Minute Walk Test to assess functional capacity in chronic liver disease patients

AIM: To examine the utility of Six Minute Walk Test (6MWT) in patients with chronic liver disease (CLD). METHODS: Two hundred and fifty subjects between the ages of 18 and 80 (mean 47) years performed 6MWT and the Six Minute Walk Distance (6MWD) was measured. RESULTS: The subjects were categorized into four groups. Group A (n = 45) healthy subjects (control); group B (n = 49) chronic hepatitis B patients; group C (n = 54) chronic hepatitis C patients; group D (n = 98) liver cirrhosis patients. The four groups differed in terms of 6MWDs (P < 0.001). The longest distance walked was 421 ± 47 m by group A, then group B (390 ± 53 m), group C (357 ± 72 m) and group D (306 ± 111 m). The 6MWD correlated with age (r = -0.482, P < 0.01), hemoglobin (r = +0.373, P < 0.001) and albumin (r = +0.311, P < 0.001) levels. The Child-Pugh classification was negatively correlated with the 6MWD in cirrhosis (group D) patients (r = -0.328, P < 0.01). At the end of a 12 mo follow-up period, 15 of the 98 cirrhosis patients had died from disease complications. The 6MWD for the surviving cirrhotic patients was longer than for non-survivors (317 ± 101 vs 245 ± 145 m, P = 0.021; 95% CI 11-132). The 6MWD was found to be an independent predictor of survival (P = 0.024). CONCLUSION: 6MWT is a useful tool for assessing physical function in CLD patients. We suggest that 6MWD may serve as a prognostic indicator in patients with liver cirrhosis.

Role-Based Network Embedding via Quantum Walk with Weighted Features Fusion

Role-based network embedding aims to embed role-similar nodes into a similar embedding space,which is widely used in graph mining tasks such as role classification and detection.Roles are sets of nodes in graph networks with similar structural patterns and functions.However,the rolesimilar nodes may be far away or even disconnected from each other.Meanwhile,the neighborhood node features and noise also affect the result of the role-based network embedding,which are also challenges of current network embedding work.In this paper,we propose a Role-based network Embedding via Quantum walk with weighted Features fusion(REQF),which simultaneously considers the influence of global and local role information,node features,and noise.Firstly,we capture the global role information of nodes via quantum walk based on its superposition property which emphasizes the local role information via biased quantum walk.Secondly,we utilize the quantum walkweighted characteristic function to extract and fuse features of nodes and their neighborhood by different distributions which contain role information implicitly.Finally,we leverage the Variational Auto-Encoder(VAE)to reduce the effect of noise.We conduct extensive experiments on seven real-world datasets,and the results show that REQF is more effective at capturing role information in the network,which outperforms the best baseline by up to 14.6% in role classification,and 23% in role detection on average.

Novel Walking Stability-Based Gait Recognition Method for Functional Electrical Stimulation System Control

Gait recognition is the key question of functional electrical stimulation (FES) system control for paraplegic walking. A new risk-tendency-graph (RTG) method was proposed to recognize the stability information in FES-assisted walking gait. The main instrument was a specialized walker dynamometer system based on a multi-channel strain-gauge bridge network fixed on the walker frame. During walking process, this system collected the reaction forces between patient's upper extremities and walker and converted them into RTG morphologic curves of dynamic gait stability in temporal and spatial domains. To demonstrate the potential usefulness of RTG, preliminary clinical trials were done with paraplegic patients. The gait stability levels of two walking cases with 4- and 12-week FES training from one subject were quantified (0.43 and 0.19) from the results of temporal and spatial RTG. Relevant instable phases in gait cycle and dangerous inclinations of patient's body during walking process were also brought forward. In conclusion, the new RTG method is practical for distinguishing more useful gait stability information for FES system control.

自我节律性引导对脑卒中偏瘫患者步行功能的即刻影响

目的:观察自我节律性引导对脑卒中偏瘫患者步行功能的即刻影响。方法:选取2023年2—8月就诊于安徽医科大学第一附属医院康复医学科,并符合本次研究入组标准的20例脑卒中肢体偏瘫患者,在节律引导前及自我节律性引导步行过程中,均使用意大利BTS公司的P-WALK平板压力测试系统进行数据采集。采集的参数指标包括:步速、步幅、步态周期、患侧预承重期、患侧单支撑期、患侧预摆动期、患侧摆动期。结果:与节律引导前步行比较,20例测试患者自我节律性引导步行患者步速、患侧步幅、健侧步幅均明显提高(P<0.05),患侧步态周期及健侧步态周期均明显缩短(P<0.05)。患侧预承重期和预摆动期占患侧步态周期比例均显著减小,患侧单支撑期和摆动期占患侧步态周期的比例均明显提高(P<0.05)。结论:脑卒中偏瘫患者行自我节律性引导步行时,可以一定程度提高步速和步幅,同时偏瘫肢体的预承重期、预摆动期、单支撑期和摆动期占患侧步态周期比例均不同程度趋于正常。因此,脑卒中偏瘫患者在下肢步行康复训练过程中行自我节律性引导,可以改善步行功能及纠正偏瘫患者异常步态。

作业疗法联合减重平板步行训练对脑卒中偏瘫患者平衡与功能性步行能力的影响

目的:探讨作业疗法联合减重平板步行训练对脑卒中偏瘫患者平衡与功能性步行能力的影响。方法:选取2019年7月—2021年6月河南科技大学第一附属医院新区医院康复医学科收治的90例脑卒中偏瘫患者作为研究对象,采用随机数表法分为试验组(常规康复护理)与对照组(作业疗法联合联合减重平板步行训练),每组各45例。比较两组患者干预前及干预3个月的平衡功能与功能性步行能力。结果:干预3个月,试验组患者Berg平衡量表(BBS)、功能性步行量表(FAC)评分显著高于对照组,差异有统计学意义(t=23.279、5.555,P<0.05);试验组患者脑卒中专用生活质量量表(SS-QOL)各项评分显著高于对照组,差异有统计学意义(t=8.424、8.637、26.306、5.162、7.579、15.302、8.918、8.080、20.745、10.862、1.397、6.806,P<0.05)。结论:作业疗法联合减重平板步行训练可有效提高脑卒中偏瘫患者平衡功能及功能性步行能力,有利于改善患者的生活质量。

日常的温暖:“为人”的公共空间

后疫情时代背景下,我国城市建设中尤其需要重视“以人为本”的规划设计,实现环境品质的精细化提升。文章针对快速建设中城市公共空间的规划设计重宏大叙事、轻日常使用的现象,通过问题和症结解析,强调公共空间营造需顺应时代发展下的新需求新动向,突出“为人”的初心,成就“日常温暖”的公共场所,并提出了“径、空、用、场”四项关键原则,即“步行力可及、空间好体验、日常多功用、场所有归属”。

中西医结合康复对不完全性脊髓损伤的影响

目的探讨中西医结合康复对不完全性脊髓损伤(ISCI)患者的影响。方法选择64例不完全性脊髓损伤患者,采用随机数字表简单化分组法(余数法)分为观察组与对照组,各32例,对照组给予常规物理治疗+康复训练,观察组在对照组基础上联合针刺+中医特色功能训练。通过评估美国脊柱损伤学会运动评分(ASIA-MS)、疼痛视觉模拟评分(VAS)、日常生活能力评分(ADL)、10 m最快步行速度测试(10MWT)、6 min步行耐力测试(6MWT)、计时起立-行走测试(TUGT)、Berg平衡量表(BBS)变化情况,分析2组康复效果。结果康复治疗4周时,观察组ASIA-MS、ADL评分高于对照组(P<0.05),VAS评分低于对照组(P<0.05);治疗4周、6周、8周时,观察组10MWT均低于对照组(P<0.05),6MWT均高于对照组(P<0.05);观察组治疗8周时TUGT低于对照组(P<0.05);观察组治疗8周、12周时BBS评分高于对照组(P<0.05)。结论中西医结合康复治疗有利于不完全性脊髓损伤神经再生修复,促进患者步行能力、平衡能力提升。

头针联合助行功能性电刺激促进脑卒中后步行及平衡功能的前瞻性研究

目的:探讨头针联合助行功能性电刺激(FES)对脑卒中患者步行及平衡功能的影响。方法:采取平行随机对照研究,纳入符合标准的脑卒中步行功能障碍患者36例,随机分为头针联合助行FES组和助行FES组,每组各18例。两组在常规康复治疗基础上,助行FES组加助行FES,头针联合助行FES组增加头针干预。训练及头针每次30min,两组干预均为1次/d,持续1周。分别在干预前、干预1周后行功能性步行能力量表(FAC)、起立-行走计时测试(TUG)、10m步行计时测试(10MWT)6min步行试验(6MWT)和平衡功能(睁、闭眼运动轨迹面积及长度)的评定并分析干预周期中不良事件的发生率。结果:(1)36例研究对象均完成了整个试验,两组干预基线情况一致(P>0.05);(2)干预前后组内对比,步行功能(TUG、10MWT、6MWT)和平衡功能(睁、闭眼运动轨迹面积和长度)均较干预前提高(P<0.05);(3)干预前后组间对比:头针联合助行FES组对平衡功能闭眼时运动轨迹面积和长度的改善优于单纯助行FES组(P<0.05),步行功能和平衡功能(睁眼状态下),两组干预前后差值对比无显著性意义(P>0.05);(4)研究中无不良事件,无脱落。结论:头针联合助行FES可以有效改善脑卒中后步行功能及平衡功能,其改善平衡功能的效果优于单纯助行FES。

Effects of Water Weight-Loss Walking Training on Lower Limb Motor Function and Gait in Stroke Patients

Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.

康复外骨骼机器人对脑卒中下肢运动功能障碍疗效的Meta分析

目的:运用Meta分析方法系统评价康复外骨骼机器人对脑卒中患者下肢运动功能的康复疗效,并比较不同下肢外骨骼机器人的疗效差异,为脑卒中下肢运动功能障碍患者选择适合的外骨骼机器人提供科学理论依据。方法:计算机检索Cochrane Library、PubMed、Web of Science、Embase、中国知网、维普和万方数据库的相关文献,收集从建库至2022年11月发表的关于探讨下肢康复外骨骼机器人改善脑卒中患者下肢运动功能的随机对照临床试验。由2名研究人员进行文献检索与筛选,使用Cochrane 5.1.0偏倚风险评估工具和Jadad量表对纳入文献进行质量评价。采用RevMan 5.4和Stata 17.0软件对结局指标进行Meta分析。结果:①最终纳入22篇文献,Jadad评分显示均为高质量文献,共865例患者,试验组436例、对照组429例。②Meta分析结果显示,与对照组相比,外骨骼机器人可显著提高脑卒中患者下肢运动功能(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)评分(MD=2.63,95%CI:1.87-3.38,P<0.05)、平衡功能(Berg Balance Scale,BBS)评分(MD=3.62,95%CI:1.21-6.03,P<0.05)、站起-走测试量表(Timed Up and Go,TUG)评分(MD=-2.77,95%CI:-4.48至-1.05,P<0.05)和步频(MD=3.15,95%CI:1.57-4.72,P<0.05),但对功能性步行量表(Functional Ambulation Category Scale,FAC)评分(MD=0.30,95%CI:-0.01-0.61,P>0.05)和6 min步行测试(6-minute walk test,6MWT)评分(MD=3.77,95%CI:-6.60-14.14,P>0.05)的提高不明显。③网状Meta分析结果显示,FMA-LE评分:平地行走式外骨骼(MD=10.23,95%CI:3.81-27.49,P<0.05)和减重式外骨骼(MD=33.66,95%CI:11.49-98.54,P<0.05)与常规康复治疗相比均能改善FMA-LE评分,排序结果为减重式外骨骼>平地行走式外骨骼>常规康复治疗;BBS评分:减重式外骨骼(MD=79.86,95%CI:2.34-2725.99,P<0.05)与常规康复治疗相比能显著改善BBS评分,排序结果为减重式外骨骼>平地行走式外骨骼>常规康复治疗;FAC评分:平地行走式外骨骼(MD=1.38,95%CI:1.00-1.90,P<0.05)与常规康复治疗相比能显著改善FAC评分,排序结果为平地行走式外骨骼>减重式外骨骼>常规康复治疗;TUG评分:减重式外骨骼与常规康复治疗相比(MD=0.07,95%CI:0.01-0.51,P<0.05)能显著改善TUG评分,排序结果为平地行走式外骨骼>减重式外骨骼>常规康复治疗。结论:康复外骨骼机器人可以改善脑卒中患者平衡、步行以及日常生活活动能力,其中减重式外骨骼在提高下肢运动功能和平衡功能方面疗效更优,平地行走式外骨骼在提高功能性步行和转移能力方面疗效更佳。

互动达标理论下分阶段康复训练对脑梗死患者步行功能、负性情绪及依从性的影响

目的 探讨互动达标理论下分阶段康复训练对脑梗死患者步行功能、负性情绪及依从性的影响。方法 选取2022年8月至2023年10月南华大学附属南华医院神经内科收治的110例脑梗死患者,按照随机数字表法将其分为两组,各55例。对照组接受常规护理和康复训练,观察组在对照组基础上接受互动达标理论下分阶段康复训练。比较两组干预前后的计时起立-行走测试(TUGT)、Holden步行功能分级量表(FAC)评分、负性情绪及康复训练依从性。结果 干预后,两组TUGT短于干预前、FAC评分高于干预前,且观察组TUGT短于对照组、FAC评分高于对照组(P<0.05)。干预后,两组焦虑自评量表、抑郁自评量表评分均低于干预前,且观察组低于对照组(P<0.05)。观察组康复训练依从性优于对照组(P<0.05)。结论 互动达标理论下分阶段康复训练可改善脑梗死患者的步行功能、减轻负性情绪及提高康复训练依从性。

生物反馈助力电刺激对慢性非特异性腰痛患者下肢步行功能的改善

背景:国内外关于慢性非特异性腰痛生物反馈疗法和三维步态功能分析的相关研究已开展很多,但是对二者结合的研究少有报道。目的:利用三维步态分析采集步态参数数据,研究生物反馈助力电刺激对慢性非特异性腰痛患者步行能力的改变效果。方法:选择2021年6月至2022年9月在广东药科大学附属第一医院收治的60例慢性非特异性腰痛患者,男34例,女26例,年龄32-58岁。采用随机数字表法将60例患者分为对照组(n=30)与试验组(n=30),两组患者均接受腰部动态干扰电的常规治疗(20 min/次,1次/d,每周5次,持续治疗20次),对照组患者在常规治疗的基础上进行仰卧搭桥和俯卧搭桥的悬吊核心肌群训练(每周5次,持续治疗20次),试验组在对照组治疗的基础上进行生物反馈助力电刺激治疗(20 min/次,1次/d,每周5次,持续治疗20次)。比较分析两组患者治疗前后的腰痛评分、肌电信号平均值和步态参数。结果与结论:①两组患者治疗结束后的数字类比表评分、日本骨科协会(JOA)评分、Oswestry功能障碍指数均较治疗前明显改善(P<0.05),试验组治疗结束后的数字类比表评分、JOA评分、Oswestry功能障碍指数均优于对照组(P<0.05);②两组患者治疗结束后的腹直肌、臀大肌、竖脊肌表面肌电平均值均高于治疗前(P<0.05),试验组治疗结束后的腹直肌、臀大肌、竖脊肌表面肌电平均值均高于对照组(P<0.05);③两组患者治疗结束后的步宽、步速、步频、健患侧步长比值、健患侧支撑相比值、患健侧摆动相比值、健患侧髋关节及膝关节矢状面活动度和健患侧足偏角均优于治疗前(P<0.05),试验组治疗结束后的上述指标均优于对照组(P<0.05);④结果表明,生物反馈助力电刺激能明显缓解慢性非特异性腰痛,改善了患者下肢步行功能。

结合功能解剖选穴电针治疗脑卒中痉挛期步行功能障碍的临床效果

目的 观察结合功能解剖选穴电针治疗脑卒中痉挛期患者步行功能障碍的临床效果。方法 随机将130例脑卒中痉挛期步行功能障碍患者(2020年5月至2021年10月江油市中医医院心脑血管病科、神经外科、针灸康复科收治)分为观察组(66例)和对照组(64例)。对照组采取基础治疗加常规取穴电针治疗,观察组采取基础治疗加结合功能解剖选穴电针治疗,每次30 min,每日1次,6次/周。治疗前、治疗4周后进行偏瘫步行能力评定量表(FAC),简化Fugl-Meyer运动功能评分表下肢部分(FMA),Tinetti步态评估量表(TGA),日常生活活动能力评分表(改良Barthel指数)(MBI),髋、膝、踝主动关节活动度(AROM)评定。结果 两组治疗前各指标比较,差异无统计学意义(P> 0.05),治疗后两组各观察指标得分均较治疗前有显著增加(P <0.05),观察组治疗后的FMA、髋前屈/外展、膝屈曲、踝跖屈AROM优于对照组(P <0.05)。结论 结合功能解剖选穴电针疗法在FMA、髋前屈/外展、膝屈曲、踝跖屈AROM等几个方面优于常规取穴电针疗法。

脑机接口联合末端驱动型下肢机器人对脑卒中患者平衡及步行功能的影响

目的:观察脑机接口(brain computer interfaces,BCI)联合GEO System?下肢机器人(G-EO gait-therapy system,G-EO)对脑卒中患者平衡及步行功能的影响。方法:在无锡市中心康复医院招募40例脑卒中患者,随机分为对照组和试验组,每组20例。对照组患者在常规康复治疗基础上进行下肢主被动踏车训练和G-EO训练,试验组患者在常规康复治疗基础上进行脑机接口下肢踏车训练和G-EO训练。两组患者均在治疗前、治疗4周后采用Fugl-Meyer下肢运动功能量表(FMA-LE)、Berg平衡量表(Berg balance scale,BBS)、Tecnobody平衡评估系统和Gait Watch三维步态分析仪进行评估。结果:治疗前,两组患者FMA-LE、BBS、压力中心运动椭圆面积、压力中心运动轨迹长度、稳定极限、步频、步态周期、步幅、步速、步长对称性比、踝最大背屈角度无显著性差异(P>0.05)。治疗4周后,两组患者组内比较FMA-LE、BBS、压力中心运动椭圆面积、压力中心运动轨迹长度、稳定极限、步频、步态周期、步幅、步速、步长对称性比、踝最大背屈角度均比治疗前显著性改善(P<0.05)。组间比较,试验组FMA-LE、BBS、压力中心运动椭圆面积、压力中心运动轨迹长度、稳定极限、步频、步态周期、步幅、步速比对照组显著性改善(P<0.05)。结论:4周的BCI联合G-EO训练能够有效改善脑卒中患者的下肢运动功能,提高脑卒中患者平衡及步行能力,具有近期效果。

前庭康复训练对脑卒中患者平衡功能及步行能力的影响

目的探讨前庭康复训练对脑卒中患者平衡功能及步行能力的影响。方法选取首次发病脑卒中患者40例,随机分为治疗组和对照组,各20例。对照组采用常规的平衡功能训练,治疗组在此基础上加用前庭康复训练,3次/d,根据患者耐受情况,3~12 min/次,5 d/周,共干预8周。在干预前(T0)和干预8周后(T1)对患者进行Berg平衡量表(BBS)评分、计时起立-行走测验(TUGT)测试和Tinetti平衡与步态量表(POMA)评估。结果干预后2组患者的BBS评分、POMA评分均较干预前显著提高(P<0.05),治疗组BBS得分高于对照组(P<0.05),干预后2组POMA评分比较无统计学差异(P>0.05)。TUGT测试2组用时均较干预前减少,评分均较干预前降低,干预后治疗组TUGT评分低于对照组(P<0.05)。结论前庭康复训练结合常规平衡功能及步行训练,能更有效地改善脑卒中患者平衡功能及步行时的稳定性和安全性,减少跌倒风险。

基于叠加效应的全身振动联合蹲起同步训练对脑卒中患者步行功能的影响

目的:探讨基于叠加效应的全身振动联合蹲起同步训练对脑卒中患者步行功能的影响。方法:选取复旦大学附属华山医院康复医学科(浦东院区)40例监护或者辅助具下,可以独立步行的脑卒中患者,随机分为全身振动训练组(WBVT组)和对照组,两组均采用常规康复治疗,每天40min。WBVT组在常规康复治疗的基础上增加全身振动联合蹲起同步训练,20min/次/天。对照组在常规康复治疗的基础上增加在全身振动平台上无振动站立,20min/次/天。分别在入组时和干预4周后,采用穿戴式三维步态评估仪对患者步行能力进行评估,使用表面肌电图仪采集患者步行过程中的股直肌和股二头肌长头的肌电信号,并对干预前后的数据进行统计学分析。结果:经过4周干预,两组的步速和步幅均比治疗前有提高(P<0.05),且WBVT组均优于对照组(P<0.05);WBVT组膝关节摆动角度较治疗前有提高(P<0.05),明显优于对照组;在患侧单支撑相(SS),WBVT组双侧股直肌和股二头肌协同收缩率干预前后均有差异(P<0.05);在患侧摆动相(SW),两组双侧股直肌和股二头肌协同收缩率干预前后均有差异(P<0.05),但干预后WBVT组患侧优于对照组(P<0.05)。结论:基于叠加效应的全身振动联合有节律的蹲起同步训练能够改善患者步行速度、步幅和下肢肌肉协同收缩率,改善患者步行功能。