下肢负重振动联合悬吊治疗对脑卒中后Pusher综合征的疗效观察

目的:观察下肢负重振动联合悬吊治疗对脑卒中后倾斜综合征(Pusher综合征)的治疗效果。方法:将42例脑卒中后Pusher综合征的患者随机分为观察组和对照组各21例。2组患者均进行常规康复训练和悬吊下的下肢和躯干训练。观察组增加振动训练器的下肢负重振动与悬吊训练相结合的训练方案，治疗6周。分别于治疗前后对2组患者进行躯干控制测试(TCT)、Berg平衡量表(BBS)、Fugl-Meyer运动功能量表下肢部分(FMA-LE)、对侧倾斜量表(SCP)及改良Barthel指数(MBI)评估。结果:治疗前2组患者TCT值、BBS、FMA-LE、SCP及MBI评分比较，差异均无统计学意义。治疗6周后，2组患者TCT值、BBS、FMA-LE及MBI评分均较治疗前明显升高(均P<0.05),SCP评分较治疗前降低(均P<0.05),且观察组TCT值、BBS、FMA-LE及MBI评分高于对照组，SCP评分低于对照组(均P<0.05)。结论:下肢负重振动联合悬吊治疗能更有效的改善脑卒中后Pusher综合征的倾斜程度，增强躯干核心稳定性，改善平衡功能及提高日常生活能力。

Effects of lower limb weight-loading vibration combined with sling training on post-stroke Pusher syndrome

Objective: To observe the effects of lower limb weight-loading vibration combined with sling training on post-stroke Pusher syndrome.Methods: A total of 42 patients with post-stroke Pusher syndrome were randomly divided into treatment group and control group, with 21 cases in each group. Both groups received routine rehabilitation training (40 min/d) and lower limb and trunk training under sling (20 min/d). In addition, the treatment group received the combination of lower limb weight-loading vibration and sling training. The lower limb weight-loading vibration training lasted for 5min, and the rest between groups was 1 min, for a total of 20 min.The control group only received closed chain movement training of the affected lower limb in sling treatment system. The above training was performed 5 days a week for 6 weeks.They were assessed with Trunk control test (TCT), Berg Balance Scale (BBS), Lower Extremity portion of the Fugl-Meyer Motor Assessment (FMA-LE), Scale for Contraversive Pushing (SCP), Modified Barthel Index (MBI) before and after treatment. Results: There were no significant differences in TCT, BBS, FMA-LE, SCP and MBI scores between the two groups before treatment. After 6 weeks of treatment, the TCT, BBS, FMA-LE and MBI scores in the two groups were significantly higher than those before treatment, and the SCP score was lower than that before treatment, and the differences were statistically significant (P<0.05).The scores of TCT, BBS, FMA-LE, SCP and MBI were significantly higher in treatment group than those in control group, the SCP score was lower than in the control group, and the differences were statistically significant (P<0.05). Conclusion: Lower limb weight-loading vibration combined with sling training can improve the tilt degree of Pusher syndrome after stroke, enhance the stability of trunk core, improve balance and improve the ability of daily living.