模拟马术训练对脑卒中后共济失调的效果

doi:10.3969/j.issn.1006-9771.2022.11.015

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (11): 1349-1354.doi: 10.3969/j.issn.1006-9771.2022.11.015

模拟马术训练对脑卒中后共济失调的效果

迟茜茜^1,²,张悦^1,²,张小年^1,²()

1.首都医科大学康复医学院，北京市 100068
2.中国康复研究中心北京博爱医院，北京市 100068

收稿日期:2021-10-12 修回日期:2022-07-25 出版日期:2022-11-25 发布日期:2022-12-20
通讯作者: 张小年 E-mail:youthzxn@163.com
作者简介:迟茜茜(1984-)，女，汉族，北京市人，硕士，主治医师，主要研究方向：神经康复。|张小年(1978-)，男，汉族，浙江台州市人，博士，主任医师，硕士研究生导师，主要研究方向：神经康复。
基金资助:
首都临床特色应用研究专项(Z181100001718170)

Effects of horse-riding simulator exercise on post-stroke ataxia

CHI Qianqian^1,²,ZHANG Yue^1,²,ZHANG Xiaonian^1,²()

1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
2. Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2021-10-12 Revised:2022-07-25 Published:2022-11-25 Online:2022-12-20
Contact: ZHANG Xiaonian E-mail:youthzxn@163.com
Supported by:
Capital Clinical Application Special Project(Z181100001718170)

摘要/Abstract

摘要：

目的探索模拟马术训练对后循环卒中共济失调患者姿势控制、平衡、步行和日常生活活动能力的效果。

方法选择2018年9月至2021年8月北京博爱医院脑卒中住院患者49例，随机分为对照组(n = 27)和治疗组(n = 22)，两组均接受常规药物治疗和康复，治疗组增加骑马机训练，共4周。治疗前后，采用神经病联合会国际合作共济失调量表(ICARS)、Fugl-Meyer评定量表平衡部分(FMA-B)、Berg平衡量表(BBS)、脑卒中患者姿势评定量表(PASS)、计时起立-行走测验(TUGT)、改良Barthel指数(MBI)进行评定。

结果治疗后，两组各项评分均显著改善(|t| > 6.019, P < 0.001)，治疗组BBS和PASS评分、TUGT时间优于对照组(|t| > 2.212, P < 0.05)。

结论模拟马术训练可以进一步改善卒中后共济失调患者的姿势控制、平衡和步行能力。

关键词: 脑卒中, 共济失调, 马术训练

Abstract:

Objective To explore the effects of horse-riding simulator exercise on posture control, balance, walking and activities of daily living (ADL) in patients with ataxia after posterior circulation stroke.

Methods From September, 2018 to August, 2021, 49 stroke inpatients in Beijing Bo'ai Hospital were randomly divided into control group (n = 27) and exercise group (n = 22). Both groups accepted routine medicine and rehabilitation, while the exercise group accepted horse-riding exercise in addition, for four weeks. They were assessed with International Cooperative Ataxia Rating Scale (ICARS), Fugl-Meyer Assessment-Balance (FMA-B), Berg Balance Scale (BBS), Postural Assessment Scale for Stroke Patients (PASS), Timed 'Up and Go' Test (TUGT) and modified Barthel Index (MBI) before and after treatment.

Results All the indexes improved after treatment in both groups (|t| > 6.019, P < 0.001), while the scores of BBS and PASS, and timed of TUGT were better in the exercise group than in the control group (|t| > 2.212, P < 0.05).

Conclusion Horse-riding simulator exercise can further improve the postural control, balance and walking abilities for patients with ataxia after stroke.

Key words: stroke, ataxia, horse-riding exercise

中图分类号:

R743.3

迟茜茜,张悦,张小年. 模拟马术训练对脑卒中后共济失调的效果[J]. 《中国康复理论与实践》, 2022, 28(11): 1349-1354.

CHI Qianqian,ZHANG Yue,ZHANG Xiaonian. Effects of horse-riding simulator exercise on post-stroke ataxia[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(11): 1349-1354.

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项目	对照组 (n = 27)	治疗组 (n = 22)	χ²/t值	P值
性别(男/女)/n	25/2	20/2	0.000	1.000
年龄/岁	58.81±11.17	54.45±11.66	1.333	0.189
病程/d	90.15±93.89	88.73±85.82	0.055	0.957
性质(梗死/出血)/n	22/5	17/5	0.000	0.994

组别	n	治疗前	治疗后	t值	P值
对照组	27	34.59±9.13	24.04±8.35	17.845	< 0.001
治疗组	22	35.86±12.34	21.59±11.27	13.553	< 0.001
t值		0.414	-0.873
P值		0.681	0.387

组别	n	治疗前	治疗后	t值	P值
对照组	27	9.09±1.72	10.50±1.57	-6.019	< 0.001
治疗组	22	8.48±2.06	10.07±1.71	-9.465	< 0.001
t值		1.107	0.901
P值		0.274	0.372

组别	n	治疗前	治疗后	t值	P值
对照组	27	24.09±12.21	41.73±9.11	-13.906	< 0.001
治疗组	22	20.26±10.02	32.52±10.06	-21.011	< 0.001
t值		1.207	3.323
P值		0.234	0.002

组别	n	治疗前	治疗后	t值	P值
对照组	27	24.14±4.59	29.73±2.66	-10.487	< 0.001
治疗组	22	22.70±4.57	27.74±3.12	-15.406	< 0.001
t值		1.089	2.366
P值		0.282	0.022

模拟马术训练对脑卒中后共济失调的效果

Effects of horse-riding simulator exercise on post-stroke ataxia

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组别	n	治疗前	治疗后	t值	P值
对照组	27	50.13±6.25	38.14±8.79	10.555	< 0.001
治疗组	22	51.34±5.06	42.66±5.87	23.826	< 0.001
t值		-0.749	-2.212
P值		0.457	0.031

组别	n	治疗前	治疗后	t值	P值
对照组	27	57.73±16.81	76.36±13.47	-7.847	< 0.001
治疗组	22	59.07±11.35	73.33±13.80	-15.046	< 0.001
t值		-0.334	0.773
P值		0.740	0.443

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