外部注意焦点的康复策略对脑卒中后步行功能的影响

doi:10.3969/j.issn.1006-9771.2025.10.012

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (10): 1206-1213.doi: 10.3969/j.issn.1006-9771.2025.10.012

外部注意焦点的康复策略对脑卒中后步行功能的影响

王月¹^,², 张通¹^,²(), 刘惠林¹^,², 刘建华¹^,², 朱晓敏¹^,², 赵军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:2025-09-08 修回日期:2025-09-30 出版日期:2025-10-25 发布日期:2025-11-10
通讯作者: 张通(1961-)，男，汉族，北京市人，博士，主任医师，博士研究生导师，主要研究方向：神经康复，E-mail： Tom611@126.com；赵军(1968-)，男，汉族，山东滕州市人，博士，主任医师，博士研究生导师，主要研究方向：神经康复，E-mail： zaojun@aliyun.com
作者简介:王月(1995-)，女，汉族，北京市人，硕士，主管技师，主要研究方向：神经康复。
基金资助:
国家重点研发计划项目(2023YFC3605200);国家重点研发计划项目(2023YFC3605203)

Effect of external attentional focus strategy on walking function after stroke

WANG Yue¹^,², ZHANG Tong¹^,²(), LIU Huilin¹^,², LIU Jianhua¹^,², ZHU Xiaomin¹^,², ZHAO Jun¹^,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:2025-09-08 Revised:2025-09-30 Published:2025-10-25 Online:2025-11-10
Contact: ZHANG Tong, E-mail: Tom611@126.com; ZHAO Jun, E-mail: zaojun@aliyun.com
Supported by:
National Key Research and Development Program(2023YFC3605200);National Key Research and Development Program(2023YFC3605203)

摘要/Abstract

摘要：

目的观察外部注意焦点策略对脑卒中后步行功能的影响。
方法 2024年7月至12月，选择北京博爱医院脑卒中患者40例。随机分为对照组(n = 20)和试验组(n = 20)。两组分别进行常规康复，在此基础上，对照组给予常规步行训练，试验组给予基于外部注意焦点策略下的步行训练，共3周。训练前后分别采用Gait Watch三维步态分析、计时起立-行走测试(TUGT)、Berg平衡量表(BBS)、Fugl-Meyer评定量表下肢部分(FMA-LE)进行评定。
结果训练后，两组步速、步频、步行周期、TUGT时间、BBS和FMA-LE评分均明显改善(|t| > 3.098, P < 0.01)；且试验组的步速、步频、步行周期和FMA-LE评分均优于对照组(|t| > 2.572, P < 0.05)。
结论外部注意焦点策略可以改善脑卒中患者步行功能。

关键词: 脑卒中, 外部注意焦点策略, 步行功能, 康复

Abstract:

Objective To explore the effect of external attentional focus strategy on walking function after stroke.
Methods From July to December 2024, 40 stroke patients admitted in Beijing Bo'ai Hospital were randomly divided into control group (n = 20) and experimental group (n = 20). Both groups underwent conventional rehabilitation. On this basis, the control group received conventional walking training, while the experimental group received walking training based on external attentional focus strategy, for three weeks. Before and after training, they were assessed with Gait Watch 3D gait analysis, Timed Up and Go Test (TUGT), Berg Balance Scale (BBS) and Fugl-Meyer Assessment-Lower Extremities (FMA-LE).
Results After training, the step speed, step frequency, walking cycle, time of TUGT, and the scores of BBS and FMA-LE improved in both groups (|t| > 3.098, P < 0.01), and the step speed, step frequency, walking cycle and the score of FMA-LE improved more in the experimental group than in the control group (|t| > 2.572, P < 0.05).
Conclusion External attentional focus strategy can improve the walking function of patients with stroke.

Key words: stroke, external attentional focus strategy, walking function, rehabilitation

中图分类号:

R743.3

王月, 张通, 刘惠林, 刘建华, 朱晓敏, 赵军. 外部注意焦点的康复策略对脑卒中后步行功能的影响[J]. 《中国康复理论与实践》, 2025, 31(10): 1206-1213.

WANG Yue, ZHANG Tong, LIU Huilin, LIU Jianhua, ZHU Xiaomin, ZHAO Jun. Effect of external attentional focus strategy on walking function after stroke[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(10): 1206-1213.

图/表 5

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项目	对照组(n = 20)	试验组(n = 20)	χ²/t值	P值
性别/n			2.667	0.102
男	15	10
女	5	10
年龄/岁	51.55±13.94	55.55±12.47	0.956	0.345
卒中类型/n
脑出血	10	12
脑梗死	10	8	0.404	0.525
偏瘫侧/n			2.667	0.102
左	10	5
右	10	15
平均病程/月	4.10±4.59	4.10±4.72	0.000	1.000

变量	组别	n	测试	$\bar{x}±s$	t值	P值
步速/cm·s^-1	对照组	20	前测	77.95±26.37	-7.594	< 0.001
			后测	107.00±28.29
	试验组	20	前测	87.70±21.48	-14.633	< 0.001
			后测	169.00±36.08
	训练前两组均值差			9.75±7.61	1.282	0.208
	训练后两组均值差			62.00±10.25	6.048	< 0.001
步频/min^-1	对照组	20	前测	66.85±12.05	-9.253	< 0.001
			后测	87.05±11.47
	试验组	20	前测	67.70±8.06	-11.619	< 0.001
			后测	97.90±12.85
	训练前两组均值差			0.85±3.24	0.262	0.795
	训练后两组均值差			10.85±3.85	2.817	0.008
步行周期/s	对照组	20	前测	1.85±0.34	8.283	< 0.001
			后测	1.40±0.19
	试验组	20	前测	1.80±0.23	10.574	< 0.001
			后测	1.25±0.19
	训练前两组均值差			-0.05±0.09	-0.537	0.594
	训练后两组均值差			-0.16±0.06	-2.572	0.014

组别	n	测试	$\bar{x}±s$	t值	P值
对照组	20	前测	31.15±20.37	3.712	0.001
		后测	22.87±10.78
试验组	20	前测	25.21±13.83	3.098	0.006
		后测	19.08±5.42
训练前两组均值差			5.94±5.51	-1.079	0.287
训练后两组均值差			-3.80±2.70	-1.408	0.167

组别	n	测试	$\bar{x}±s$	t值	P值
对照组	20	前测	42.20±4.86	-7.464	< 0.001
		后测	48.30±3.18
试验组	20	前测	44.65±5.48	-8.788	< 0.001
		后测	49.95±4.06
训练前两组均值差			2.45±1.64	1.496	0.143
训练后两组均值差			1.65±1.15	1.431	0.161

组别	n	测试	$\bar{x}±s$	t值	P值
对照组	20	前测	18.25±1.07	-46.917	< 0.001
		后测	26.50±0.95
试验组	20	前测	17.90±1.21	-42.236	< 0.001
		后测	30.90±1.55
训练前两组均值差			-0.35±0.36	-0.969	0.339
训练后两组均值差			4.40±0.41	10.823	< 0.001

外部注意焦点的康复策略对脑卒中后步行功能的影响

Effect of external attentional focus strategy on walking function after stroke

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