基于自我效能理论的数字化步行功能训练对脑卒中患者下肢功能的效果

doi:10.3969/j.issn.1006-9771.2023.05.002

摘要/Abstract

摘要：

目的观察基于自我效能理论的数字化步行功能训练对脑卒中患者下肢功能的效果。

方法选择2021年12月至2022年12月浙江省人民医院脑卒中患者44例，随机分为对照组和试验组各22例。两组均给予常规康复，对照组采用常规步行训练，试验组采用数字化跑台(Walker View)行步行功能训练，共6周。治疗前后采用Fugl-Meyer评定量表下肢部分、10米步行测试、计时起立-行走测试、患侧步长、步速、功能性步行分级和一般自我效能感量表进行评估。

结果试验组3例脱落。治疗后，两组各项指标均明显改善(|t| > 5.808, |Z| > 2.961, P < 0.01)，试验组各项指标优于对照组(|t| > 2.049, Z = -2.572, P < 0.05)。

结论基于自我效能理论的数字化步行功能训练能够改善脑卒中患者下肢运动功能和步行能力。

关键词: 脑卒中, 下肢, 运动功能, 步行, 自我效能

Abstract:

Objective To investigate the effect of self-efficacy-based intelligent walking training on function of lower extremities of stroke patients.

Methods From December, 2021 to December, 2022, 44 stroke inpatients from Zhejiang Provincial People's Hospital were randomly divided into control group (n = 22) and experimental group (n = 22). Both groups accepted routine rehabilitation, while the control group accepted routine gait training, and the experimental group accepted self-efficacy-based intelligent walking training on the gait training system (Walker View), for six weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities, 10-Meter Walk Test, Timed 'Up and Go' Test, stride length and average walking velocity, Functional Ambulation Category and General Self-Efficacy Scale before and after treatment.

Results Three cases dropped down in the experimental group. All the indexes improved in two groups after treatment (|t| > 5.808, |Z| > 2.961, P < 0.01), and improved more in the experimental group than in the control group (|t| > 2.049, Z = -2.572, P < 0.05).

Conclusion The self-efficacy-based intelligent walking training can promote the recovery of motor function of lower extremities and walking ability in stroke patients.

Key words: stroke, lower extremity, motor function, walking, self-efficacy

中图分类号:

R743.3

金振华, 陈玲, 刘勇. 基于自我效能理论的数字化步行功能训练对脑卒中患者下肢功能的效果[J]. 《中国康复理论与实践》, 2023, 29(5): 504-509.

JIN Zhenhua, CHEN Ling, LIU Yong. Effect of self-efficacy-based intelligent walking training on function of lower extremities of stroke patients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 504-509.

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组别	n	性别 (男/女)/n	年龄/岁	病程/d	卒中类型 (出血/梗死)/n	病灶侧 (左/右)/n	Brunnstrom分期 (Ⅲ/Ⅳ)/n
对照组	22	13/9	53.05±5.40	44.50±7.58	9/13	8/14	13/9
试验组	22	10/12	54.27±6.27	47.05±7.12	11/11	12/10	15/7
χ²/F/Z值		0.820	0.411	0.350	0.367	1.467	-0.620
P值		0.365	0.649	0.257	0.545	0.226	0.536

组别	n	治疗前	治疗后	t值	P值
对照组	22	43.082±5.348	39.009±3.941	6.472	< 0.001
试验组	19	43.026±7.451	34.611±5.671	10.838	< 0.001
t值		0.028	2.915
P值		0.978	0.006

组别	n	治疗前	治疗后	t值	P值
对照组	22	48.959±6.340	42.114±3.766	7.007	< 0.001
试验组	19	49.526±6.955	39.284±5.056	11.456	< 0.001
t值		-0.273	2.049
P值		0.786	0.047

组别	n	治疗前	治疗后	t值	P值
对照组	22	13.805±1.332	18.250±1.040	-27.185	< 0.001
试验组	19	13.337±1.185	19.937±1.491	-22.855	< 0.001
t值		1.180	-4.247
P值		0.245	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	22	0.700±0.237	1.064±0.250	-5.808	< 0.001
试验组	19	0.695±0.235	1.232±0.214	-11.666	< 0.001
t值		0.071	-2.294
P值		0.944	0.027