水中平板步行训练对脑卒中偏瘫患者双侧腹肌厚度及平衡功能的疗效

doi:10.3969/j.issn.1006-9771.2022.05.006

摘要/Abstract

摘要：

目的探讨水中平板步行训练对脑卒中偏瘫患者腹肌厚度和平衡功能的影响。方法 2021年3月至10月,选取脑卒中偏瘫患者60例,随机分为对照组(n = 20)、悬吊组(n = 20)和水中平板组(n = 20)。在综合康复训练基础上,对照组行平板步行训练,悬吊组行天轨悬吊步行训练,水中平板组行水中平板步行训练,共4周。治疗前后采用肌骨超声测量双侧腹外斜肌、腹内斜肌、腹横肌厚度,采用脑卒中姿势控制量表(PASS)和计时起立-行走测试(TUGT)进行疗效评定。结果治疗后,三组健侧腹外斜肌、腹内斜肌厚度,PASS评分和TUGT时间均改善(|t| > 2.135, P < 0.05);水中平板组患侧腹外斜肌、腹内斜肌和腹横肌厚度显著增加(|t| > 5.567, P < 0.001)。水中平板组PASS评分,TUGT时间,患侧腹外斜肌、腹内斜肌厚度较对照组和悬吊组改善(P < 0.05)。结论水中平板步行训练能有效强化患侧腹肌,从而进一步改善平衡功能。

关键词: 脑卒中, 偏瘫, 水中平板步行训练, 腹肌厚度, 平衡功能

Abstract:

Objective To explore the effect of aquatic treadmill training on abdominal muscle thickness and balance function in patients with hemiplegia after stroke. Methods From March to October, 2021, 60 patients with hemiplegia after stroke were randomly divided into control group (n = 20), suspension group (n = 20) and aquatic treadmill group (n = 20). On the basis of comprehensive rehabilitation training, the control group received treadmill training, the suspension group received skyrail suspension walking training, and the aquatic treadmill group received treadmill training in water, for four weeks. The curative effect was evaluated by musculoskeletal ultrasound with muscle thickness of bilateral external oblique, internal oblique and transverse abdominal muscles. And they were assessed with Postural Assessment Scale for Stroke Patient (PASS) and Timed 'Up & Go' Test (TUGT) before and after treatment. Results After treatment, the thickness of external oblique and internal oblique muscles on the unaffected side, the PASS score and the TUGT time improved in all the three groups (|t| > 2.135, P < 0.05); while the thickness of external oblique, internal oblique and transverse abdominal muscles in the aquatic treadmill training group increased (|t| > 5.567, P < 0.001). The PASS score, the TUGT time, and the thickness of external oblique and internal oblique muscles on the affected side improved more in the aquatic treadmill training group than in the control group and the suspension group (P < 0.05). Conclusion The aquatic treadmill training is more effective in strenghthening abdominal muscle to improve balance function.

Key words: stroke, hemiplegia, aquatic treadmill training, abdominal muscle thickness, balance function

中图分类号:

R743.3

王亚囡,刘惠林,朱琳,杜雪晶,朱晓敏,刘元旻. 水中平板步行训练对脑卒中偏瘫患者双侧腹肌厚度及平衡功能的疗效[J]. 《中国康复理论与实践》, 2022, 28(5): 524-529.

WANG Yanan,LIU Huilin,ZHU Lin,DU Xuejing,ZHU Xiaomin,LIU Yuanmin. Effect of aquatic treadmill training on bilateral abdominal muscle thickness and balance function in stroke patients with hemiplegia[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(5): 524-529.

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组别	n	性别(男/女)/n	年龄/岁	病程/月	性质(出血/梗死)/n
对照组	20	10/10	37.20±6.42	4(2)^a	9/11
悬吊组	20	9/11	42.95±7.70	4(2)^a	9/11
水中平板组	20	12/8	41.45±10.26	3.5(3)^a	6/14
χ²/F/K值		0.934	2.593	0.728	1.250
P值		0.627	0.084	0.695	0.535

组别	n	治疗前	治疗后	t值	P值
对照组	19	5.63±1.65	6.32±1.38	-2.135	0.047
悬吊组	20	4.91±0.77	5.84±1.58	-2.342	0.030
水中平板组	19	5.07±0.87	5.72±1.22	-4.435	< 0.001
F值		0.847	0.799
P值		0.434	0.455

组别	n	治疗前	治疗后	t值	P值
对照组	19	5.95±0.65	7.56±1.38	-6.135	< 0.001
悬吊组	20	5.50±1.19	7.08±1.38	-4.480	< 0.001
水中平板组	19	5.23±1.18	6.65±1.75	-4.194	0.001
F值		2.030	1.717
P值		0.141	0.189

组别	n	治疗前	治疗后	t值	P值
对照组	19	3.00±0.70	2.64±0.36	1.957	0.066
悬吊组	20	2.74±0.27	2.57±0.85	1.050	0.307
水中平板组	19	2.78±0.57	2.49±0.81	1.921	0.071
F值		1.282	0.222
P值		0.286	0.801

组别	n	治疗前	治疗后	t值	P值
对照组	19	4.99±0.82	5.10±0.74	-1.319	0.204
悬吊组	20	5.02±1.29	4.91±0.77^a	0.590	0.562
水中平板组	19	5.26±0.65	5.89±0.50^b,c	-5.823	< 0.001
F值		0.445	11.272
P值		0.643	< 0.001