倒退步行平板训练对脑卒中患者下肢功能的影响

目的探讨倒退步行平板训练对脑卒中偏瘫患者下肢运动功能、平衡功能和步行速度的影响。方法下肢Brunnstrom分级为3或4级、在不使用拐杖和矫形器情况下可独立步行10m以上的26例脑卒中偏瘫患者,随机分为试验组（13例）和对照组（13例）。对照组的患者接受常规步行训练治疗60min,试验组的患者在接受常规步行训练治疗30min基础上附加倒退步行平板训练治疗30min,每周5次,连续3周。两组患者在治疗前和3周治疗后进行下肢运动功能评价（Fusl—Meyer法）、平衡功能评估（Berg平衡量表）、步行速度评定（10m最大步行速度测量）。结果经过3周治疗后,在下肢运动功能、平衡功能和步行速度改善上,试验组明显优于对照组,P值分别为0．033、0．001和0．034。结论倒退步行平板训练可以改善脑卒中偏瘫患者下肢运动功能、平衡功能和步行速度。

Effectiveness of backward walking treadmill training in lower extremity function after stroke

OBJECTIVE: To examine the effectiveness of backward walking treadmill training for restoration of motor function, balance and walking speed in patients with stroke. METHODS: Twenty-six patients with stroke, 17 males and 9 females, aged 36 - 64, with the lower extremity Brunnstrom motor recovery stage at 3 or 4, able to walk for 10 m without walking aid or orthosis, were randomly divided into two equal groups: The patients in the control group were to participate in a 60-minutes conventional training five times a week for three weeks, and the patients in the experimental group received 30-minute conventional training and then 30-minute backward walking training five times a week for three weeks. Before the training and 3 weeks after the training, Fugl-Meyer assessment was used to assess the motor function of the lower extremity (FMA-L), Berg balance scale (BBS) was used to assess the balance function, and 10 m maximum walking speed was measured. RESULTS: After the three-week training period, the FMA-L score of the experimental group was 28.0 +/- 3.3, significantly higher than that of the control group (25.5 +/- 2.3, P = 0.033); the BBS score of the experimental group was 51.4 +/- 1.8, significantly higher than that of the control group (47.3 +/- 3.7, P = 0.001, and 10 m MWS of the experimental group was 57 +/- 17, significantly higher than that of the control group (43 +/- 16, P = 0.034). CONCLUSION: A safe and feasible intervention, additional backward walking therapy helps improve the damaged motor function, balance, and walking speed of the patients with stroke.