悬吊固定Flexi-bar训练对恢复期脑卒中患者的效果

doi:10.3969/j.issn.1006-9771.2020.09.003

摘要/Abstract

摘要：

目的观察悬吊固定Flexi-bar振动训练对脑卒中恢复期偏瘫患者运动功能恢复的影响。
方法 2018年10月至2019年6月脑卒中恢复期患者45例,随机分为对照组(n = 23)和训练组(n = 22),两组均进行为期4周的常规康复训练,训练组加用悬吊法固定Flexi-bar棒进行训练。治疗前后采用脑卒中姿势控制量表(PASS)、Fugl-Meyer评定量表(FMA)运动和平衡部分、改良Barthel指数(MBI)进行评定,采集坐位偏瘫侧腹直肌、腹外斜肌、腹内斜肌、竖脊肌表面肌电图振幅均方根值(RMS)。
结果训练组2例脱落。治疗后,两组各项评分均提高(|t| > 2.750, P < 0.05),训练组除FMA运动评分外,其他评分均较对照组提高更多(| t| > 3.449, P < 0.05)。治疗后,两组各肌表面肌电RMS均提高(| t| > 2.156, P < 0.05),训练组较对照组提高更多(| t| > 2.368, P < 0.05)。
结论悬吊固定Flexi-bar训练可提高脑卒中恢复期患者的躯干肌运动功能,提高姿势控制和平衡功能。

关键词: 脑卒中, Flexi-bar, 运动, 姿势控制, 平衡, 振动

Abstract:

Objective To investigate the effects of fixing Flexi-bar training on motor function in chronic stroke patients.
Methods From October, 2018 to June, 2019, 45 chronic stroke patients with hemiplegia were randomly divided into control group (n = 23) and Flexi-bar group (n = 22). All the patients received routine rehabilitation treatment for four weeks, while the Flexi-bar group received fixing Flexi-bar training with hanging in addition. They were assessed with Postural Assessment Scale for Stroke Patients (PASS), Fugl-Meyer Assessment (FMA) for motor and balance and modified Barthel index (MBI) before and after treatment, while the root mean square (RMS) of surface electromyography of rectus abdominis, external oblique muscle, internal oblique muscle and erector spinae of affected side were measured.
Results There were two cases lost in the Flexi-bar group. The scores of PASS, FMA for balance and MBI increased in both groups after treatment (|t| > 2.750, P < 0.05), and increased more in the Flexi-bar group than in the control group (| t| > 3.449, P < 0.05), except the score of FMA for motor. The RMS of all the muscles increased in both groups after treatment (| t| > 2.156, P < 0.05), and increased more in the Flexi-bar group than in the control group (| t| > 2.368, P < 0.05).
Conclusion Fixing Flexi-bar training could promote the recorvery of activities of trunk muscles in chronic stroke patients, to improve postural control and balance.

Key words: stroke, Flexi-bar, motor, postural control, balance, vibration

张倩,张通. 悬吊固定Flexi-bar训练对恢复期脑卒中患者的效果[J]. 《中国康复理论与实践》, 2020, 26(9): 1010-1014.

ZHANG Qian,ZHANG Tong. Effects of Fixing Flexi-bar Training on Motor Function for Patients with Stroke at Recovery Stage[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(9): 1010-1014.

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项目	对照组(n = 23)	训练组(n = 22)	χ²/F值	P值
性别(男/女, n)	18/5	17/5	0.172	0.653
年龄(岁)	55.33±9.85	52.36±8.98	0.010	0.811
身高(cm)	169. 56±6.34	175.35±6.12	0.013	0.772
体质量(kg)	73.40±7.73	55.43±7.15	0.462	0.512
腹围(cm)	89.69±7.36	89.58±5.66	0.372	0.541
病程(d)	55.70±29.73	45.8±31.45	0.459	0.488
病因(脑出血/脑梗死, n)	17/6	15/7	0.216	0.615
偏瘫侧(左/右, n)	18/5	16/6	0.298	0.568

组别	n	治疗前	治疗后	t值	P值
对照组	23	17.66±6.39	21.77±4.73	-2.750	0.025
训练组	20	17.80±7.01	28.20±5.06	-8.843	< 0.001
t值		-0.065	-3.821
P值		0.949	0.001

组别	n	治疗前	治疗后	t值	P值
对照组	23	40.89±14.85	49.55±15.39	-6.949	< 0.001
训练组	20	39.40±14.71	51.10±17.89	-9.379	< 0.001
t值		0.218	-0.210
P值		0.830	0.843

组别	n	治疗前	治疗后	t值	P值
对照组	23	6.78±1.86	7.89±1.45	-4.000	0.001
训练组	20	7.40±2.07	10.70±1.83	-5.124	< 0.001
t值		-0.688	-3.680
P值		0.501	0.002

组别	n	治疗前	治疗后	t值	P值
对照组	23	53.89±11.47	63.33±10.90	-12.348	< 0.001
训练组	20	51.50±15.72	75.50±14.77	-10.000	< 0.001
t值		0.650	-3.449
P值		0.524	0.003