全身振动治疗仪结合弹力带针对膝关节训练改善脑卒中患者步行能力的研究

目的探讨全身振动治疗仪结合弹力带对膝关节进行动态稳定性训练的应用价值及提高脑卒中患者步行能力的方法。 方法选取瑞盛康复医院康复科自2015年1月至2018年8月收治的刚开始独立步行的脑卒中患者30例，按随机数字表法分成对照组（15例）和治疗组（15例）。对照组进行常规康复治疗，治疗组在对照组基础上增加全身振动治疗仪上进行0°~30°蹲起站立训练，平衡杠内利用弹力带进行伸膝抗阻步行训练以及本体感觉滑板上原地踏步训练，2组患者均治疗2个周期（1个月为1个周期）。于治疗前后分别对2组患者进行下肢Fugl-Meyer运动功能（FMA）、10 m步行时间(MWS)、起立-行走测试(TUGT)、以及三维步态分析中的患肢支撑相时间评估。 结果治疗2个月后，2组患者进行组间比较，治疗组的FMA评分较对照组相比明显提高，TUGT时间、10 m MWS时间、患腿支撑相时间较对照组相比明显缩短，治疗组患者的步行能力及稳定性明显好于对照组，差异有统计学意义（P<0.05）。 结论全身振动治疗仪结合弹力带针对膝关节训练可以改善脑卒中患者步行稳定性，提高步行能力。

Improvement of walking ability of stroke patients with knee joint training by whole body vibration therapy apparatus combined with elastic belt

ObjectiveTo observe the effects of the dynamic stability of knee joint was trained by using the whole body vibration therapy apparatus and elastic belt to improve the walking ability of stroke patients. MethodsThirty stroke patients who just started to walk independently were selected and divided into control group (n=15) and treatment group (n=15) according to the random number table method. The control group received conventional rehabilitation treatment. After conventional rehabilitation treatment, the treatment group received 0° to 30° squatting and standing training on the additional whole-body vibration treatment device, and the balance bar used elastic belt to carry out the knee extension and resistance walking training, and piaffe training on the proprioception skateboard. The patients in the two groups were treated for 2 cycles (1 cycle for 1 month). Before and after the treatment, Fugl Meyer motor assessment for low extremity (FMA), 10 m maximum walking speed (MWS), timed up and go test (TUGT) and the time of supporting phase in 3 d gait analysis were conducted for the two groups of patients. ResultsAfter 2 months of treatment, the patients in the two groups were compared with each other. The FMA score in the treatment group was significantly higher than that in the control group; the TUGT time of 10 m MWS was significantly shorter than that in the control group; the walking ability and stability of the patients in the treatment group were significantly better than that in the control group, and the difference was statistically significant (P<0.05). ConclusionThe whole body vibration therapy apparatus combined with elastic band for knee joint training can improve the walking stability and walking ability of stroke patients.