三维运动平台训练对脑卒中患者平衡与步行功能的效果

doi:10.3969/j.issn.1006-9771.2023.04.015

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (4): 485-490.doi: 10.3969/j.issn.1006-9771.2023.04.015

三维运动平台训练对脑卒中患者平衡与步行功能的效果

王路(), 陈艳, 苏久龙, 杜志伟, 于瑞, 胡楠, 曾一鸣, 余绵绚, 洪靖

广州医科大学附属第二医院康复医学科，广东广州市 510260

收稿日期:2022-09-13 修回日期:2023-03-12 出版日期:2023-04-25 发布日期:2023-05-19
通讯作者: 王路，E-mail： Lu364607763@126.com
作者简介:王路(1986-)，男，汉族，广东广州市人，主管技师，主要研究方向：神经与骨科康复。
基金资助:
1.广东省医学科学技术研究基金项目指令性课题(C2021075);2.广州医科大学学科建设项目(02-410-2206092)

Effect of three-dimensional motion platform training on balance and walking function of stroke patients

WANG Lu(), CHEN Yan, SU Jiulong, DU Zhiwei, YU Rui, HU Nan, ZENG Yiming, YU Mianxuan, HONG Jing

Department of Rehabilitation, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510260, China

Received:2022-09-13 Revised:2023-03-12 Published:2023-04-25 Online:2023-05-19
Contact: WANG Lu, E-mail: Lu364607763@126.com
Supported by:
Commanding Project of Guangdong Medical Science and Technology Research Fund(C2021075);Disciplinary Construction Program of Guangzhou Medical University(02-410-2206092)

摘要/Abstract

摘要：

目的探讨三维运动平台训练对脑卒中患者平衡和步行功能的作用。
方法 2021年8月至2022年8月，广州医科大学附属第二医院脑卒中患者80例随机分为对照组(n = 40)和观察组(n = 40)。对照组采用常规康复训练，观察组在常规康复训练基础上增加三维运动平台训练，共4周。分别于治疗前后，采用Berg平衡量表(BBS)、功能性步行量表(FAC)和三维步态分析(步速、步频、患侧支撑期百分比、双支撑期百分比)评估患者的平衡和步行功能。
结果治疗4周后，两组BBS评分、FAC分级、步速、步频、患侧支撑期百分比、双支撑期百分比均显著改善(|t| > 4.423, |Z| > 5.292, P < 0.001)，且观察组各项指标均优于对照组(|t| > 3.748, |Z| = 2.646, P < 0.05)。
结论三维运动平台训练有利于改善脑卒中患者的平衡和步行功能。

关键词: 脑卒中, 三维运动平台, 平衡, 步行

Abstract:

Objective To explore the clinical efficacy of three-dimensional motion platform training on balance and walking function of stroke patients.
Methods From August, 2021 to August, 2022, 80 stroke patients from Second Affiliated Hospital of Guangzhou Medical University were selected and randomly divided into control group (n = 40) and experimental group (n = 40). The control group received routine rehabilitation training, and the experimental group received three-dimensional motion platform training on the basis of routine rehabilitation training. Before and four weeks after treatment, the Berg Balance Scale (BBS), Functional Ambulation Category (FAC) and 3D gait analysis (step speed, step frequency, percentage of standing phases on the affected side, percentage of double support phase) were used to assess the balance and walking function of patients.
Results Four weeks after treatment, the scores of BBS, FAC, and step speed, step frequency, percentage of standing phases on the affected side and percentage of double support phase significantly improved in both groups (|t| > 4.423, |Z| > 5.292, P < 0.001), and they were better in the experimental group than in the control group (|t| > 3.748, |Z| = 2.646, P < 0.05).
Conclusion Three-dimensional motion platform training could facilitate to improve the balance and walking function of stroke patients.

Key words: stroke, three-dimensional motion platform, balance function, walking function

中图分类号:

R743.3

王路, 陈艳, 苏久龙, 杜志伟, 于瑞, 胡楠, 曾一鸣, 余绵绚, 洪靖. 三维运动平台训练对脑卒中患者平衡与步行功能的效果[J]. 《中国康复理论与实践》, 2023, 29(4): 485-490.

WANG Lu, CHEN Yan, SU Jiulong, DU Zhiwei, YU Rui, HU Nan, ZENG Yiming, YU Mianxuan, HONG Jing. Effect of three-dimensional motion platform training on balance and walking function of stroke patients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(4): 485-490.

图/表 4

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组别	n	性别/n		年龄/岁	病程/d	病变性质/n		偏瘫侧别/n		Brunnstrom分期/n
组别	n	男	女	年龄/岁	病程/d	脑出血	脑梗死	左	右	Ⅳ	Ⅴ
对照组	40	22	18	61.45±6.78	92.68±7.55	17	23	16	24	25	15
观察组	40	20	20	60.76±7.12	92.12±8.49	19	21	17	23	27	13
t/χ²/Z值		0.201		0.444	0.312	0.202		0.052		-1.414
P值		0.654		0.658	0.756	0.653		0.820		0.157

组别	n	治疗前	治疗后	t值	P值
对照组	40	34.68±4.45	43.83±3.34	-10.401	< 0.001
观察组	40	35.21±4.23	49.17±3.21	-16.627	< 0.001
t值		-0.546	-7.291
P值		0.587	< 0.001

组别	n	治疗前						治疗后						Z值	P值
组别	n	0级	1级	2级	3级	4级	5级	0级	1级	2级	3级	4级	5级	Z值	P值
对照组	40	0	0	0	29	11	0	0	0	0	5	31	4	-5.292	< 0.001
观察组	40	0	0	0	29	11	0	0	0	0	3	28	9	-5.916	< 0.001
Z值		0						-2.646
P值		1.000						0.008

步态参数	对照组(n = 40)		观察组(n = 40)		t值^a	P值^a	t值^b	P值^b	t值^c	P值^c	t值^d	P值^d
步态参数	治疗前	治疗后	治疗前	治疗后	t值^a	P值^a	t值^b	P值^b	t值^c	P值^c	t值^d	P值^d
步速/m·s^-1	0.43±0.09	0.78±0.07	0.45±0.08	1.01±0.08	-19.415	< 0.001	-31.305	< 0.001	-1.050	0.297	-13.684	< 0.001
步频/min^-1	35.26±2.12	51.18±2.67	34.89±2.64	59.42±2.55	-29.533	< 0.001	-42.268	< 0.001	0.691	0.492	-14.115	< 0.001
患侧支撑期百分比/%	47.76±2.76	55.14±2.53	48.02±3.02	59.91±2.91	-12.466	< 0.001	-17.931	< 0.001	-0.402	0.689	-7.824	< 0.001
双支撑期百分比/%	26.53±3.36	23.28±3.21	26.76±3.27	20.56±3.28	4.423	< 0.001	8.466	< 0.001	-0.310	0.757	3.748	< 0.001

三维运动平台训练对脑卒中患者平衡与步行功能的效果

Effect of three-dimensional motion platform training on balance and walking function of stroke patients

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