脑卒中患者偏瘫侧下肢肌力与运动功能、平衡、步行速度及ADL的关系

目的探讨脑卒中患者偏瘫侧下肢肌力与运动功能、平衡、步行速度及日常生活活动能力 (ADL)等临床变量之间的相互关系。方法对 85例脑卒中偏瘫患者 ,用Motricity指数评测患侧下肢肌力 ;用Fugl Meyer法评测下肢运动功能 ;用Berg平衡量表测定平衡功能 ;测定 10m最大步行速度 ;用独立功能量表 (FIM )测量ADL能力。对偏瘫下肢肌力与运动功能、平衡、步行速度和ADL能力临床变量之间进行Pearson相关分析 ,然后进行逐步回归分析确定影响临床变量最重要的下肢肌力因素。结果患者偏瘫侧下肢肌力与运动功能、平衡、步行速度和ADL之间呈高度正相关 (r =0 5 92 -0 811,P <0 0 0 1) ;偏瘫侧踝屈曲肌力、膝伸展肌力和髋屈曲肌力分别是运动功能 (R2 =0 3 77,P <0 0 0 1)、平衡 (R2 =0 3 2 1,P <0 0 0 1)、步行速度 (R2 =0 173 ,P <0 0 0 1)、ADL(R2= 0 42 ,P <0 0 0 1)最重要的决定因素。结论脑卒中患者的偏瘫侧下肢肌力明显影响着患者运动功能、平衡、步行速度和ADL能力的恢复 ,合理地评价和改善偏瘫侧肌力 ,对优化康复治疗程序有重要意义。

Relationship between strength of the paretic lower limb and motor, balance, walking speed,ADL for hemiparetic stroke patients

ObjectiveTo investigate the relationship between strength of the paretic lower limb and motor function, balance, walking speed, ability of daily living (ADL) in hemiparetic stroke patients.Methods85 stroke subjects, who were able to walk in the study, were evaluated in the strength of the paretic lower limb, motor function, balance, walking speed and ADL with Motricity Index, Fugl-Meyer Assessment, Berg Balance Scale, 10 m walking speed test and Functional Independence Measure (FIM). The levels of association between them were examined with Pearson's correlation coefficients and with multiple linear regression analyses by using the stepwise method. ResultsStrengths of the paretic lower limb were significantly positive related to motor function, balance, walking speed and ADL (r=0.592-0.811,P<0.001). The paretic ankle dorsiflexors, knee extensors, hip flexors were important clinical factor to consider in determining motor function(R 2=0.377, P<0.001), balance(R 2=0.321, P<0.001)and walking speed(R 2=0.173,P<0.001), ADL(R 2=0.42, P<0.001). ConclusionStrengths of the paretic lower limb of stroke patients may play an important role in their motor function, balance, walking speed and ADL.