音乐节奏刺激对缺血性卒中偏瘫患者下肢运动功能康复的影响

目的探讨音乐节奏刺激(RAS)辅助康复训练中,对缺血性卒中偏瘫患者下肢运动功能的影响。方法前瞻性纳入2013年3—8月在广东省第二人民医院神经内科住院的缺血性卒中康复期偏瘫患者40例,按数字法随机分为试验组和对照组,每组20例。对两组患者均进行常规治疗及康复训练,同时给予试验组患者RAS,连续治疗30 d。对两组患者均于第1、15、30天采用Fugl-Meyer评分与足印法对下肢运动功能及步态进行评价。结果 (1)对照组和试验组患者经过30 d的康复治疗,各项指标与训练前比较,差异均有统计学意义(P均0.05),表现为患者跨步长增加,分别增加29.5%和52.4%;患健两侧步长差缩短,分别缩短32.2%和42.5%;步频加快,分别加快9.5%和15.7%;最大步行速度加快,分别加快18.9%和29.5%。(2)试验组Fugl-Meyer积分在第15、30天均高于对照组,差异有统计学意义(P0.05),并且试验组第30天Fugl-Meyer积分高于同组第15天(P0.05);试验组第30天步态与对照组比较,差异有统计学意义(P0.05)。结论 RAS能够在短期内改善缺血性卒中偏瘫患者的下肢运动功能,是有效的康复治疗辅助方法。

Effect of music rhythm stimulation on the lower limb motor function in ischemic stroke patients with hemiplegia

Objective To investigate the effect of music rhythm stimulation with the assisted rehabilitation training on the lower limb motor function in ischemic stroke patients with hemiplegia. Methods Forty ischemic stroke patients with hemiplegia in the rehabilitation period at the Department of Neurology ,Guangdong No. 2 Provincial People＇s Hospital were enrolled prospectively from March to August 2013. They were divided into either a test group or a control group （n = 20 in each group） according to the random number method. The patients of both groups conducted conventional treatment and rehabilitation training. At the same time, the patients were given music rhythm stimulation and were treated continuously for 30 days in the test group. Fugl-Meyer score and footprint method were used to evaluate the lower limb motor function and gait at day 1,15, and 30 in patients of both groups. Results （ 1 ） Compared to before training, there were significant differences in each indicator after a 30-day rehabilitation treatment between the control group and the test group （ all P 〈 0.05 ）. The patients showed increased stride length, and increased 29. 5% and 52. 4% respectively;the step length differences between the ipsilateral and contralateral stride lengths were shortened. They were shortened 32.2% and 42.5% respectively;the pace frequencies were accelerated,they were accelerated 9.5% and 15.7% respectively; the maximum walking speeds were accelerated, they were accelerated 18.9% and 29.5% respectively. （2）The Fugl-Meyer scoresof the test group at day 15 and 30 were significantly higher than those of the control group. There was significantly difference （ P 〈 0.05 ）. The Fugl-Meyer scores of the test group at day 30 were higher than those of the same group at day 15 （P 〈0.05）. There was significant difference in gait at day 30 between the test group and the control group （ P 〈 0.05）. Conclusion Music rhythm stimulation can improve the lower limb motor function in ischemic stroke patients with hemiplegia in a short term. It is an effective assistance method for rehabilitation.