计算机辅助姿态平衡训练对小脑卒中后平衡障碍的影响

目的 探讨计算机辅助姿态平衡训练系统联合Bobath平衡训练对小脑卒中后平衡障碍的疗效.方法 40例小脑卒中后平衡障碍患者随机分为联合训练组和对照组,每组各20例,对照组给予Bobath平衡训练等常规康复治疗,联合训练组在此基础上使用计算机辅助姿态平衡训练系统进行康复治疗.在治疗前后采用Berg平衡量表(Berg Balance Scale,BBS)、改良Barthel指数(modifiedBarthel Index,mBI)和Fugl-Meyer评定量表(Fugl-Meyer Assessment,FMA)评价平衡功能、日常生活活动能力以及运动功能,并采用计算机辅助姿态平衡训练系统根据重心轨迹长度、轨迹矩形面积和轨迹外周面积进行姿势平衡能力评定.结果 两组患者治疗前各项指标均无显著统计学差异,治疗后BBS、mBI和FMA评分均较治疗前显著提高(P均＜0.001),重心轨迹长、轨迹矩形面积和轨迹外周面积均较治疗前显著下降(P ＜0.001或0.05);除FMA评分外,联合训练组治疗后各项指标均显著优于对照组(P均＜0.05).结论 在Bobath平衡训练基础上使用计算机辅助姿态平衡训练系统能显著改善小脑卒中后的平衡障碍和肢体运动能力,从而提高日常生活活动能力.

Effect of computer-assisted postural balance training on balance disorders after cerebellar stroke

Objective To investigate the efficacy of computer-assisted postural balance training system combined with Bobath balance training on balance disorders after cerebellar stroke.Methods Forty patients with balance disorders after cerebellar stroke were randomly divided into either a combined training group or a control group (n =20 in each group).The control group was trained with Bobath balance training and routine rehabilitation treatment.On the basis of this,the combined training group used the computerassisted postural balance training system for rehabilitation treatment.The balance function,activities of daily living and motor function were evaluated with the Berg Balance Scale (BBS),modified Barthel Index,mBI)and Fugl-Meyer Assessment (FMA) before and after treatment,and the computer-assisted postural balance training system was used to conduct the postural balance ability according to the center of gravity track length,rectangle area of track,and peripheral area of track.Results There were no significant differences in various indexes before treatment between the patients of both groups.The scores of BBS,mBI and FMA after treatment were increased obviously (all P ＜ 0.001).The the center of gravity track length,rectangle area of track,and peripheral area of track were decreased compared before treatment (P ＜0.001 or 0.05).In addition to the FMA score,all the indexes of the combined training group after treatment were significantly better than those of the control group (all P＜0.05).Conclusions On the basis of Bobath balance training,using computer-assisted postural balance training system can obviously improve the balance disorder and extremities motion ability after cerebellar stroke,and thus improving the activities of daily living in cerebellar stroke patients.