基于反复促通疗法的步行训练对脑卒中患者下肢功能重建的影响

目的:观察基于反复促通疗法(RFE)的步行训练对脑卒中患者下肢功能重建的影响。方法:选取本院康复科收治的脑卒中恢复期患者60例。随机分为对照组和观察组各30例，2组均接受药物基础治疗及常规康复训练，观察组采用基于RFE的步行训练，对照组进行常规步行训练，共4周。治疗前后分别比较2组患者的Fugl-Meyer运动量表下肢部分(FMA-LE)、Holden步行功能分级(FAC)、Berg平衡量表(BBS)评分以及步频、步幅、步速、患足足底压力比(PPF)和包络椭圆面积(EEA)等步态参数。结果:治疗后，2组患者FMA-LA、FAC、BBS评分及步频、步幅、步速、PPF值均较治疗前有所提高(P<0.05),且观察组FMA-LA、BBS评分及步频、步幅、步速、PPF值均高于对照组(P<0.05),2组患者FAC评级无显著性差异；治疗后，2组患者EEA值较治疗前明显降低(P<0.01),且观察组下降幅度大于对照组(P<0.05)。结论:基于反复促通疗法的步行训练对脑卒中患者下肢运动、平衡及步行功能的重建有积极的影响，可以改善步态。

Effect of Walking Training Based on Repetitive Facilitative Exercise on Lower Limb Function Reconstruction in Stroke Patients

Objective: To observe the effect of walking training based on repetitive facilitative exercise (RFE) on lower limb function reconstruction in stroke patients. Methods: A total of 60 patients with stroke in convalescent stage were selected from the Rehabilitation Department of our hospital. They were randomly divided into control group (n=30) and observation group (n=30). Both groups received basic drug treatment and routine rehabilitation training. The observation group received RFE walking training, and the control group received routine walking training, for 4 weeks. The scores of Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Functional Ambulation Category (FAC), Berg balance scale (BBS) and gait parameters such as stride frequency, stride, pace, proportion of the plantar pressure of the affected foot (PPF), envelope ellipse area (EEA) were compared between the two groups before and after treatment. Results: After treatment, the scores of FMA-LA, FAC, BBS, stride frequency, stride, pace and PPF in the two groups were improved as compared with those before treatment (P<0.05), and the scores of FMA-LA, BBS, stride frequency, stride, pace and PPF in the observation group were higher than those in the control group (P<0.05). There was no significant difference in FAC score between the two groups. After treatment, the EEA values of the two groups were significantly lower than those before treatment (P<0.01), and the decrease in the observation group was greater than that in the control group (P<0.05). Conclusion: Walking training based on RFE has a positive effect on the reconstruction of lower limb movement, balance and walking function in stroke patients, and can improve gait.