不同靶心率运动促进脑卒中痉挛下肢功能的研究

目的：探讨不同靶心率智能踏车训练对老年脑卒中恢复期患者痉挛下肢功能的影响。方法：选取2012—2015年在康复科住院的120例老年脑卒中恢复期且下肢痉挛的患者，随机分为治疗组（90例）和对照组（30例），各组均采用常规康复训练方法，治疗组加用智能踏车训练并根据不同靶心率（60%、70%、80%最大心率）分为3个亚组（每组30例）。于治疗前、治疗后3周末、治疗后6周末行偏瘫侧下肢伸肌改良Ashworth量表评级、Fugl?Meyer运动功能评定（FMA）及Barthel指数评分（BI），训练过程中实时监测患者的心率和血压。结果：80%最大心率组因不能耐受试验被随机分配至60%最大心率组及70%最大心率组，经治疗后70%最大心率组的下肢改良Ashworth量表评级及FMA均较治疗前及60%最大心率组有改善（P < 0.05）。结论：当靶心率为70%最大心率时可较好地改善老年脑卒中恢复期患者的下肢痉挛及运动功能。

Study on different target heart rate training on stroke patients with spasticity of lower limbs

Objective: To investigate the effects of different target heart rate(THR) of intelligence cyclical training system on motor function of spastic lower limb in the elderly patients with chronic stroke in convalescence stage. Methods: A totally of one hundred and twenty elderly stroke patients in our hospital from 2012 to 2017 were randomly divided into treatment group(n=90) and control group(n=30), treatment group were divided into three subgroups according to the different maximum heart rate (60%maxHR, 70%maxHR, 80%maxHR). All patients were treated with routine physical training, while patients in treatment group were added intelligence cyclical training. Outcomes were assessed using the Modified Ashworth Scale(MAS), Fugl-Meyer Assessment(FMA) and the Barthel Index(BI) before and after treatment at the 3rd week and the 6th week. Besides,heart rate and blood pressure were measured in real time continuously during the treatment. Results: The MAS and FMA of 70% maxHR group were significantly improved after treatment (P < 0.05),and higher than 60% maxHR group. Conclusion: 70% maxHR as THR can have better effect on improvement of the lower limb spasticity and motor function in the elderly patients with chronic stroke in convalescence stage.