步行训练的时机选择对偏瘫患者康复疗效的影响

目的观察步行训练的时机选择对偏瘫患者康复疗效的影响。方法选择脑血管病偏瘫患者126例随机分为试验组62例和对照组64例,试验组在肌张力不低下的条件下早期进行科学的步行训练,对照组需具备患肢能够支持3/4以上体重、站立平衡>3级、患肢具有主动屈/伸膝、屈/伸髋、踝关节背屈功能的3个条件后进行步行训练。2组在训练前、训练后1个月、2个月及发病后1年分别采用Holden步行功能分级(FAC)、Berg平衡量表(BBS)、Bathel指数(MBI)评定患者步行能力、平衡功能及日常生活活动能力。结果与训练前比较,试验组和对照组训练后1个月、2个月及发病后1年FAC、BBS、MBI评分明显改善,差异有统计学意义(P<0.05,P<0.01);与训练后2个月比较,试验组发病后1年FAC、MBI评分明显改善,差异有统计学意义(P<0.05,P<0.01)。与对照组比较,试验组训练后1个月、2个月及发病后1年FAC、BBS、MBI评分明显改善,差异有统计学意义(P<0.01)。结论肌张力恢复正常的偏瘫患者,尽早开始科学的步行训练能有效提高步行能力、平衡功能及日常生活活动能力,尤其远期康复疗效更显著。

Effect of walking training time on rehabilitation of hemiplegic patients

Objective To observe the effect of walking training time on rehabilitation of hemiplegic patients.Methods One hundred and twenty-six hemiplegic patients were randomly divided into experimental group(n=62)and control group(n=64).Patients in experimental group started scientific walking training when their muscular tension was normal and those in control group started scientific walking training when their affected limb could support over 3/4 of their body weight,flex and adduct the knee,extend hip and dorsiflex ankle,and their standing balance was >grade 3.Their walking ability,balance function and daily activities were assessed before and 1 month and 2 months after training,and 1 year after onset of the disease following the Holden walking function classification,Berg balance scale,and Bathel index.Results The Holden walking function classification,Berg balance scale and Bathel index scores were significantly higher in experimental group and control group 1 month and 2 months after training,and 1 year after onset of the disease than before training,and 2 months after training and 1 year after onset of the disease than before training(P<0.05,P<0.01),and in experimental group than in control group 1 month and 2 months after training,and 1 year after onset of the disease than before training(P<0.05,P<0.01).Conclusion Hemiplegic patients with normal muscular tension should start scientific walking training as early as possible in order to improve their walking ability,balance function and daily activities,and speed up their rehabilitation.