改良八段锦身体活动对脑卒中患者心肺功能、运动功能和日常生活活动能力的效果

doi:10.3969/j.issn.1006-9771.2024.01.010

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (1): 74-80.doi: 10.3969/j.issn.1006-9771.2024.01.010

改良八段锦身体活动对脑卒中患者心肺功能、运动功能和日常生活活动能力的效果

陈珺雯¹, 陈谦², 陈程², 李淑月¹, 刘玲玲³, 吴存书¹, 龚翔¹, 鲁俊³, 许光旭³()

1.南京医科大学康复医学院，江苏南京市 210029
2.南京市栖霞区医院康复科，江苏南京市 210046
3.南京医科大学第一附属医院康复医学中心，江苏南京市 210029

收稿日期:2023-11-29 修回日期:2023-12-29 出版日期:2024-01-25 发布日期:2024-02-04
通讯作者: 许光旭(1966-)，男，汉族，江苏徐州市人，主任医师、教授，主要研究方向：中枢神经损伤运动控制分析与康复干预。E-mail：xuguangxu1@126.com
作者简介:陈珺雯(1998-)，女，汉族，江苏泰州市人，硕士研究生，主要研究方向：神经康复及心肺康复。
基金资助:
1.江苏省卫生健康发展研究中心开放课题(JSHD2021003);2.江苏省体育局重大体育科研课题(ST213101)

Effect of modified Baduanjin exercise on cardiopulmonary function, motor function and activities of daily living for stroke patients

CHEN Junwen¹, CHEN Qian², CHEN Cheng², LI Shuyue¹, LIU Lingling³, WU Cunshu¹, GONG Xiang¹, LU Jun³, XU Guangxu³()

1. School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, China
2. Department of Rehabilitation, Nanjing Qixia District Hospital, Nanjing, Jiangsu 210046, China
3. Rehabilitation Medicine Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China

Received:2023-11-29 Revised:2023-12-29 Published:2024-01-25 Online:2024-02-04
Contact: XU Guangxu, E-mail: xuguangxu1@126.com
Supported by:
Jiangsu Health Development Research Center Opening(JSHD2021003);Jiangsu Provincial Sports Bureau Major Sports Research Projects(ST213101)

摘要/Abstract

摘要：

目的探究改良八段锦运动训练对脑卒中患者心肺功能、运动功能和日常生活活动能力的影响。

方法选取2023年1月至9月南京市栖霞区医院收治的脑卒中患者42例，随机分为对照组(n = 21)和试验组(n = 21)，对照组予以常规康复训练，试验组增加改良八段锦运动训练，共4周。干预前后分别采用峰值摄氧量(VO_2peak)、无氧阈(AT)、峰值氧脉搏(VO_2peak/HR)、用力肺活量(FVC)、第一秒用力呼气量(FEV₁)、峰值呼气流速(PEF)、Fugl-Meyer运动功能评定量表上肢部分(FMA-UE)、Berg平衡量表(BBS)和改良Barthel指数(MBI)进行评定。

结果干预后，对照组VO_2peak、AT，以及FMA-UE、BBS和MBI评分改善(|t| > 2.256, |Z| > 2.936, P < 0.05)，试验组VO_2peak、AT、VO_2peak/HR、FVC、FEV₁、PEF，以及FMA-UE、BBS和MBI评分显著改善(|t| > 4.390, |Z| > 3.451, P < 0.001)，除BBS和MBI外，其余指标试验组均明显优于对照组(|t| > 4.136，|Z| > 2.751，P < 0.01)。

结论改良八段锦运动训练有助于改善脑卒中患者的心肺功能和上肢运动功能。

关键词: 脑卒中, 运动康复, 八段锦, 心肺功能, 运动功能

Abstract:

Objective To investigate the effect of modified Baduanjin exercise, as an rehabilitation exercise, on cardiopulmonary function, motor function and activities of daily living in patients with stroke.

Methods From January to September, 2023, 42 stroke patients in the Nanjing Qixia District Hospital were randomly divided into control group (n = 21) and experimental group (n = 21). The control group received routine rehabilitation, and the experimental group received modified Baduanjin exercise in addition, for four weeks. They were assessed with peak oxygen uptake (VO_2peak), anaerobic threshold (AT), peak oxygen pulse (VO_2peak/HR), forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), peak expiratory flow (PEF), Fugl-Meyer Assessment-upper extremities (FMA-UE), Berg Balance Scale (BBS) and modified Barthel Index (MBI) before and after intervention.

Results VO_2peak, AT, and the scores of FMA-UE, BBS and MBI improved in the control group after intervention (|t| > 2.256, |Z| > 2.936, P < 0.05); while VO_2peak, AT, VO_2peak/HR, FVC, FEV₁, PEF, and the scores of FMA-UE, BBS and MBI improved in the experimental group (|t| > 4.390, |Z| > 3.451, P < 0.001); and all the indexes were better in the experimental group than in the control group (|t| > 4.136，|Z| > 2.751，P < 0.01), except the scores of BBS and MBI.

Conclusion Modified Baduanjin exercise can improve the cardiopulmonary function and upper limb motor function for stroke patients.

Key words: stroke, exercise rehabilitation, Baduanjin, cardiopulmonary function, motor function

中图分类号:

R743.3

陈珺雯, 陈谦, 陈程, 李淑月, 刘玲玲, 吴存书, 龚翔, 鲁俊, 许光旭. 改良八段锦身体活动对脑卒中患者心肺功能、运动功能和日常生活活动能力的效果[J]. 《中国康复理论与实践》, 2024, 30(1): 74-80.

CHEN Junwen, CHEN Qian, CHEN Cheng, LI Shuyue, LIU Lingling, WU Cunshu, GONG Xiang, LU Jun, XU Guangxu. Effect of modified Baduanjin exercise on cardiopulmonary function, motor function and activities of daily living for stroke patients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 74-80.

图/表 10

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组别	n	性别(男/女)/n	年龄/岁	病程/d	卒中类型(缺血性和出血性)/n	偏瘫侧(左/右)/n
对照组	21	17/4	54.14±12.30	183.67±234.44	16/5	13/8
试验组	21	17/4	52.86±14.84	210.57±398.09	17/4	13/8
χ²/t值		0.000	0.306	-0.267	0.141	0.000
P值		1.000	0.761	0.791	1.000	1.000

组别	n	干预前	干预后	t值	P值
对照组	21	2.63±1.01	2.70±0.90	-1.058	0.303
试验组	21	3.02±0.62	3.41±0.62	-8.818	< 0.001
t值		1.759	-4.039
P值		0.086	< 0.001

组别	n	干预前	干预后	t值	P值
对照组	21	1.67±0.63	1.77±0.54	-1.791	0.088
试验组	21	2.02±0.50	2.43±0.58	-8.448	< 0.001
t值		1.972	4.437
P值		0.056	< 0.001

组别	n	干预前	干预后	t值	P值
对照组	21	2.58±1.10	2.53±1.00	0.793	0.437
试验组	21	2.95±0.83	3.84±1.04	-3.451	< 0.001
t值		-1.610	6.599
P值		0.107	< 0.001

组别	n	干预前	干预后	t值	P值
对照组	21	14.94±5.84	15.35±5.59	-2.338	0.030
试验组	21	14.51±2.91	16.80±2.94	-8.456	< 0.001
t值		-0.306	5.813
P值		0.761	< 0.001

改良八段锦身体活动对脑卒中患者心肺功能、运动功能和日常生活活动能力的效果

Effect of modified Baduanjin exercise on cardiopulmonary function, motor function and activities of daily living for stroke patients

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组别	n	干预前	干预后	t值	P值
对照组	21	11.18±2.86	11.53±2.83	-2.256	0.035
试验组	21	10.88±2.26	13.62±2.38	-10.350	< 0.001
t值		-0.381	7.760
P值		0.705	< 0.001

组别	n	干预前	干预后	t值	P值
对照组	21	9.13±2.18	9.14±2.07	-0.137	0.892
试验组	21	9.22±1.91	10.17±1.70	-4.390	< 0.001
t值		0.151	4.136
P值		0.881	< 0.001

组别	n	干预前	干预后	Z值	P值
对照组	21	49.52±19.80	50.76±19.19	-3.342	0.001
试验组	21	44.29±19.08	49.05±15.38	-4.883	< 0.001
Z值		-0.884	-2.751
P值		0.376	0.006

组别	n	干预前	干预后	Z值	P值
对照组	21	47.33±5.64	49.43±5.04	-5.067	< 0.001
试验组	21	45.86±6.25	48.95±5.18	-5.290	< 0.001
Z值		-0.804	-1.136
P值		0.426	0.256

组别	n	干预前	干预后	Z值	P值
对照组	21	84.86±18.24	89.90±13.49	-2.936	0.003
试验组	21	86.24±11.50	90.48±9.95	-4.671	< 0.001
Z值		-0.331	-0.939
P值		0.741	0.348

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