强化躯干核心肌群对脑卒中患者躯干控制平衡步行及日常生活能力的康复效果

目的探讨躯干核心肌群训练的强度对脑卒中患者躯干控制、平衡步行及日常生活能力的康复效果。方法选择2017年4月至2018年3月在华中科技大学同济医学院附属协和医院康复医学科住院治疗的90例脑卒中偏瘫患者为研究对象,按照随机数字表法将患者分为A、B、C组,每组各30例,3组患者均在常规治疗基础上联合不同强度的躯干核心肌群训练,其中A组每天训练1次,B组每天训练2次,C组每天训练3次,每次训练30 min,每周5天,共训练3个月。3组患者治疗1个月、2个月和3个月时采用躯干控制能力测试(TCT)、Berg平衡量表(BBS)评价躯干控制能力,采用步行功能评级(FAC)评定平衡步行功能、采用日常生活能力(MBI)评定日常生活能力。比较3组患者上述评分差异。结果治疗前3组患者躯干控制能力、平衡步行功能和生活能力评分比较差异无统计学意义(P> 0. 05),3组患者治疗1个月、2个月、3个月后躯干控制、平衡步行和日常生活能力评分均逐渐提高,差异均有统计学意义(P均<0. 05);且在1～3个月期间躯干控制和平衡能力评分C组高于B组,B组高于A组,差异均有统计学意义(P均<0. 05),但3个月时差异无统计学意义(P> 0. 05)。3组患者步行和日常生活能力在1个月期间组间差异无统计学意义(P> 0. 05),但1个月后C组较B组,B组较A组均有统计学意义(P均<0. 05)。结论强化躯干核心肌力量可以显著提高患者躯干控制、平衡步行和日常生活能力,缩短康复时间。

Effect of intensive training of trunk core muscle group on trunk control, balanced walking and daily living ability of stroke patients

Objective To investigate the rehabilitation effect of training intensity of trunk core muscle group on trunk control, balanced walking and daily living ability of stroke patients.Methods Ninety stroke hemiplegic patients hospitalized in the Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from April 2017 to March 2018 were randomly divided into group A, B and C according to random numerical table method, with 30 cases in each group. On the basis of routine treatment, the patients in the three groups were trained with different intensities of trunk core muscle group training, including group A once/day, group B twice/day, and group C 3 times/day, 30 min for each training, for 5 days every week and for altogether three months. (TCT), (BBS), (FAC), (MBI) test were used respectively to assess the balance, trunk control function, walking and daily living ability of the three groups in 1 month, 2 months and 3 months before and after treatment.Results There was no significant difference in trunk control ability, balanced walking function and living ability score among three groups before treatment (P>0.05). The scores of trunk control, balanced walking and ability of daily living in three groups increased gradually after 1 month, 2 months and 3 months of treatment (P<0.05). After 3 months and 2 months, and after 2 months and 1 month, the score of trunk control and balanced ability in group C was higher than that in group B, that in group B was higher than that in group A, and the differences were statistically significant (all P<0.05). There was no significant difference in walking and daily living ability among three groups during one month (P>0.05), but one month later, there was significant difference between group C and group B (P>0.05), and between group B and group A after one month (all P<0.05).Conclusions Strengthening the core muscle strength of the trunk can significantly improve the patients'' ability of trunk control, balanced walking and daily living ability, and shorten the recovery time.