镜像疗法联合减重平板步行训练对脑卒中偏瘫患者步行功能的改善效果研究

背景　步行功能障碍是脑卒中后常见并发症之一，会严重影响患者日常生活能力，如何尽早改善脑卒中患者步行功能尤为重要，而临床鲜见通过镜像疗法（MT）联合减重平板步行训练（BWSTT）促进脑卒中患者步行功能的相关报道。目的　观察MT联合BWSTT对脑卒中偏瘫患者步行功能的改善效果。方法　选取2019年5月-2020年9月在广西医科大学第二附属医院康复医学科治疗的脑卒中偏瘫患者120例，依据随机数字表法分为常规组（n=40）、减重组（n=40）和联合组（n=40）。三组患者均接受常规康复治疗，减重组患者在此基础上增加BWSTT，联合组患者在减重组基础上增加MT；每周训练6 d，共持续4周。比较三组患者治疗前和治疗后Fugl-Meyer评定量表（FMA）中的下肢部分（FMA-LE）评分、Holden步行功能分级（HFAC）、Berg平衡量表（BBS）评分、改良Barthel指数（MBI）、6 min步行测试（6MWT）结果。结果　三组患者治疗前FMA-LE评分、HFAC、BBS评分、MBI、6MWT结果比较，差异无统计学意义（P>0.05）；减重组、联合组患者治疗后FMA-LE评分、HFAC、BBS评分、MBI、6MWT均优于常规组（P<0.05）；联合组患者治疗后FMA-LE评分、HFAC、BBS评分、MBI、6MWT结果优于减重组（P<0.05）。三组患者治疗后FMA-LE评分、HFAC、BBS评分、MBI和6MWT结果均优于组内治疗前（P<0.05）。结论　在常规康复治疗的基础上辅以MT联合BWSTT可有效改善脑卒中偏瘫患者的步行功能。

Effect of Mirror Therapy Combined with Body Weight Supported Treadmill Training on Walking Function in Post-stroke Hemiplegia Patients

Background　Walking dysfunction is a common post-stroke complication，seriously affecting the daily living ability.So it is particularly important to take measures to improve walking function in stroke patients as soon as possible.There are few reports about improving walking function in stroke patients using mirror therapy（MT）combined with body weight supported treadmill training（BWSTT）.Objective　To investigate the effect of MT combined with BWSTT on walking function in post-stroke hemiplegia patients.Methods　A total of 120 post-stroke hemiplegia patients who were hospitalized from May 2019 to September 2020 in Department of Rehabilitation Medicine，the Second Affiliated Hospital of Guangxi Medical University were recruited，and randomly divided into conventional group （n=40），BWSTT group （n=40） and combination group （n=40） by random number table.All groups underwent regular rehabilitation therapy，the BWSTT group underwent BWSTT and combination group underwent MT and BWSTT additionally，for 6 days per week，for a total of 4 weeks.The three groups were evaluated by Fugl-Meyer assessment of lower extremity （FMA-LE），Holden Functional Ambulation Classification（HFAC），Berg Balance Scale （BBS），modified Barthel index （MBI），and 6-minute walking test （6MWT） before and after intervention.Results　The assessment results of FMA-LE，HFAC，BBS，MBI and 6MWT were similar across the groups before intervention （P>0.05）.After intervention，the assessment results of above-mentioned five items improved in all groups（P<0.05），but improved more significantly in BWSTT and combination groups（P<0.05）.Furthermore，the combination group showed better post-intervention assessment results of FMA-LE，HFAC，BBS，MBI and 6MWT than BWSTT group（P<0.05）.Conclusion　Regular rehabilitation therapy with MT and BWSTT may effectively improve the recovery of walking function in post-stroke hemiplegia patients.