强化桥式运动及视觉反馈平衡训练对卒中患者下肢运动功能恢复的影响

目的观察强化桥式运动及视觉反馈平衡训练对卒中患者下肢运动功能的影响。方法前瞻性纳入2010年7月—2012年12月在暨南大学医学院第四附属医院接受康复治疗的卒中后偏瘫患者43例,按接诊时奇偶数将患者分为强化训练组(22例)和常规训练组(21例)。对两组患者均进行常规康复训练,1次/d,45 min/次,5 d/周,共治疗4周;强化训练组每天增加桥式运动及视觉反馈平衡训练1次,20 min/次。比较两组训练前,训练后2、4周的Fugl-Meyer量表(FMA)中下肢部分(FMA-L)评分、Berg平衡量表(BBS)评分及起立-行走计时测试(TUGT)的差异。结果 (1)与治疗前比较,随治疗时间延长,两组患者FMA-L、BBS评分均呈逐渐提高趋势,而TUGT测评时间呈加快趋势,差异均有统计学意义(P0.05)。(2)训练前及训练后2周,两组各量表评分差异无统计学意义(P0.05)。训练后4周后,强化训练组FMA-L、BBS量表评分,TUGT测评时间分别为(21.2±4.6)分、(19.4±2.6)分、(44.8±10.1)s;常规训练组分别为(18.7±3.3)分、(17.4±2.8)分、(57.6±7.7)s,两组各评分比较,差异均有统计学意义(P0.05)。结论强化桥式运动及视觉反馈平衡训练较常规康复训练能更明显改善卒中偏瘫患者下肢运动功能。随着强化训练时间的延长,其效果更加明显。

Effects of intensive bridging activities and visual feedback balance training on the recovery of lower limb motor function in patients with stroke

Objective To observe the effects of intensive bridging activities and visual feedback balance training on low limb motor function in patients with stroke. Methods Forty-three patients with hemiplegia who received rehabilitation treatment at the Fourth Affiliated Hospital of School of Medicine, Jinan University from July 2010 to December 2012 were enrolled prospectively. The patients were divided into either an intensive training group （ n = 21 ） 2 or a conventional training group （ n = 21 ） according to the random parity on admission. The patients of both groups were all received conventional rehabilitation training, once for 45 minutes, once a day, and 5 days a week for 4 weeks. The intensive training group also received intensive bridging activities and visual feedback balance training, once a day for 20 minutes. The differences of the Fugl-Meyer Assessment-L （FMA-L） score, Berg balance scale （BBS） score, and timed up and go test （TUG） in the FMA scale before training and 2 and 4 weeks after training in both groups were compared. Results （ 1 ） Compared to the state before treatment,as the time of treatment was prolonged, the FMA-L and BBS scores had a gradually increasing trend in the patients of both groups, the TUG evaluation time showed an accelerated trend. There were significant differences （P 〉0.05）. （2） Before training and 2 weeks after training, there were no significant differences in the scores of all scales （P 〉 0.05）. Four weeks after training, the FMA-L score, BBS score, and the testing time of TUG in theintensive training group were 21.2 ±4. 6, 19.4 ± 2. 6, and 44.8 ±10. 1, respectively, those in the conventional training group were 18.7 ± 3.3, 17.4± 2.8, and 57.6 ± 7.7 s, respectively. There were significant differences in the scores between the two groups （P 〈 0.05）. Conclusion The intensive bridging activities and visual feedback balance training may significantly improve the lower limb motor function in stroke patients with hemiplegia. With the extension of the intensive training time, its effect will be more obvious.