神经松动术联合康复训练对脑卒中恢复期偏瘫患者下肢功能的影响

目的：探讨神经松动术联合康复训练对脑卒中恢复期偏瘫患者下肢功能的影响。方法：将脑卒中恢复期偏瘫患者49例分为观察组25例和对照组24例。2组均采用常规治疗，观察组同时加用神经松动术治疗。治疗前后分别采用综合痉挛量表（CSS）评定踝关节痉挛，Fugl—Meyer运动评分量表（FMA）中下肢部分评定下肢运动功能，Berg平衡量表（BBS）评定平衡功能和改良Barthel指数（MBI）评定日常生活活动（ADL）能力。结果：治疗4周后，2组患者患侧CSS均较治疗前显著降低（均P〈0．01），且观察组更低于对照组（均P〈0．01）；2组患者FMA、BBS及ADL能力均较治疗前显著提高（均P〈0．01），且观察组更高于对照组（P〈0．05，0．01）。结论：神经松动术联合康复训练能有效降低脑卒中恢复期偏瘫患者的踝关节痉挛，提高下肢运动功能、平衡功能及日常生活活动能力。

Effect of nerve mobilization plus rehabilitation therapy on function of lower extremity in patients with hemiplegia after stroke

Objective：To observe the effect of nerve mobilization combined with rehabilitation therapy on function of lower extremity in patients with hemiplegia after stroke. Methods：Forty-nine stroke patients were randomly divid- ed into observation group （n= 25） and control group （n = 24）. Both groups were given conventional rehabilitation training,and observation group received treatment of nerve mobilization additionally. Composite spasticity scale （CSS） was used for assessing the ankle planter flexor,Fugl-Meyer motor assessment （FMA） for the lower extremi- ty,Berg balance scale （BBS） for stability and modified Barthel index （MBI） for activities daily living （ADL） before and after the treatment. Results： After four weeks of treatment,CSS scores of the hemiplegic lower limb in both groups were significantly decreased as compared with pre-treatment （P〈0.01）, and those in observation group were lower than in control group （P〈0.01）;FMA, BBS and ADL scores in both groups were increased significantly as compared with pre-treatment （P〈0.01）, and those in observation group were higher than in control group （P〈 0.05,0.01）. Conclusion：Nerve mobilization combined with rehabilitation therapy in the treatment of stroke patients can decrease ankle spasticity and improve motor function of lower extremity, stability and activities of daily living.