视觉反馈等速肌力训练在偏瘫患者下肢运动功能康复中的应用

目的：探讨卒中恢复期偏瘫患者下肢膝关节屈伸肌行视觉反馈等速肌力训练的效果,以及下肢功能评定与步行能力之间的相关性。方法：188例脑卒中患者随机分为观察组(95例)和对照组(93例),二组患者康复训练相同,观察组增加双下肢股四头肌、腘绳肌视觉反馈等速肌力训练18d。治疗前后分别采用Fugl-Meyer法、Barthel指数法及足印法对二组患者下肢功能及步态进行分析1]。结果：观察组患者步态较对照组有明显改善(P<0.01)，运动功能与活动能力显著提高(P<0.01)。步态的对称性与下肢运动功能、平衡功能显著相关(r=-0.77,-0.73，P<0.01),与活动能力无关(r=-0.23,P>0.05) ;步速与下肢运动功能、平衡功能、活动能力均显著相关(r=0.82，0.77，0.75,P<0.01)。结论：偏瘫患者早期运用双下肢膝屈伸肌群视觉反馈等速肌力训练对提高运动功能、步态改善和日常生活活动能力提高具有重要作用。

Effects of muscle isokinetic training with visual biofeedback on functional rehabilitation of lower extremity of stroke hemiplegic patients

Objective: To observe effects of muscle isokinetic training with visual biofeedback on functional rehabilitation of lower extremity of stroke hemiplegic patients during convalescent stage and to explore the relationship between the functional evaluation of the lower extremity and the gait analysis parameters. Method: One hundred and eighty-eight patients were randomly divided into an observation(n=95)group and a control(n=93) group. The patients in observation group were given muscle isokinetic training with visual biofeedback for the knee extensors and flexors in addition to the routine rehabilitation program in control group. Fugl-Meyer motor function scores and Barthel index were used to measure the lower extremity function and the footprint method was used for gait analysis. Result: The improvement of gait and motor functions in observation group was much greater than that in control group(P<0.01).The symmetry of gait was correlated significantly with lower extremity motor and balance functions(r=-0.77,-0.73,P<0.01),but irrelevant to movement functional independence(r=-0.23,P>0.05).The walking speed was correlated significantly with all the evaluated parameters(r=0.82,0.77,0.75, P<0.01).Conclusion:The lower extremity function, gait and ability of activity of daily living can be improved by muscle isokinetic training with visual biofeedback of knee extensors and flexors of both lower extremities during the convalescence of stroke patients.