肌力训练对偏瘫步态的影响及下肢功能评定与步态分析间的相关性

目的　本文探讨了偏瘫患者在恢复期行患肢膝关节屈伸肌群肌力训练的效果 ,以及下肢功能评定与步态分析之间的相关性。方法　 5 0例脑卒中患者随机分为观察组 ( 30例 )和对照组 ( 2 0例 ) ,二组患者康复训练相同 ,观察组患者在恢复期增加患肢股四头肌、绳肌肌力训练。治疗前后分别采用Fugl Meyer法、Barthel指数法及足印法对二组患者下肢功能及步态进行分析。结果　观察组患者步态较对照组明显改善 (P<0 .0 1)、运动功能与活动能力显著提高 (P <0 .0 1)。步态的对称性与下肢运动功能、平衡功能显著相关 (r =-0 .79,-0 .71、P <0 .0 1) ,与活动能力无关 (r =-0 .2 1,P >0 .0 5 ) ;步速与下肢运动功能、平衡功能、活动能力均显著相关 (r =0 .80、0 .78、0 .76 ,P <0 .0 1)。结论　偏瘫患者在恢复期行患肢膝屈伸肌群肌力训练有助于运动功能提高、步态改善 ;通过足印法步态分析可初步了解下肢步行能力。

Effects of muscle strengthening exercise on gait of stroke patients and the relationship between the evaluation of gait analysis and functional assessment

Objective To observe the effects of muscle strengthening exercise on gait of stroke patients during convalescent stage and to explore the relationship between functional evaluation and gait analysis parameters. Methods Fifty patients were randomly divided into two groups: the observation group (n=30) and the control group (n=20). The patients in the observation group were subject to muscle strengthening exercise of knee extensors and flexors during convalescence. The lower extremity function was measured using Fugl-Meyer motor functional (FM) scores and Barthel index of ADL. The footprint was used for gait analysis. Results Functional improvement of the observation group was significantly better than that of control group (P<0.01). The symmetry of gait was correlated significantly with lower extremity motor and balance functions (r=-0.79, -0.71, P<0.01 ), but irrelevant to functional independence (r=-0.21, P>0.05). The walking speed was correlated significantly with all the evaluated parameters (r=0.80, 0.78, 0.76, P<0.01). Conclusion The lower extremity function and gait can be improved by muscle strengthening exercise of knee muscles during convalescence of stroke patients.