治疗性体位摆放对脑卒中偏瘫患者姿势控制和平衡能力的影响

doi:10.3969/j.issn.1006-9771.2023.11.014

摘要/Abstract

摘要：

目的探讨治疗性体位摆放对脑卒中患者姿势控制和平衡能力的影响。

方法 2020年1月至2022年6月，河北省沧州中西医结合医院脑卒中患者60例随机分为对照组(n = 30)和观察组(n = 30)。两组均给予常规康复治疗，观察组另给予基于Bobath理念的治疗性体位摆放。分别于治疗前和治疗4周后采用Fugl-Meyer评定量表下肢部分(FMA-LE)、Berg平衡量表(BBS)、脑卒中姿势控制量表(PASS)进行评定，采用Pro-kin平衡仪测评患者睁眼、闭眼状态下运动椭圆面积和运动长度。

结果治疗后，两组FMA-LE、PASS、BBS评分均显著提高(|t| > 3.856, P < 0.001)，睁眼、闭眼状态下运动椭圆面积和运动长度均显著下降(|t| > 4.083, P < 0.001)；且观察组均优于对照组(|t| > 2.261, P < 0.05)。

结论基于Bobath理念的治疗性体位摆放可以有效改善脑卒中患者的姿势控制能力和平衡功能。

关键词: 脑卒中, 治疗性体位摆放, 姿势控制, 平衡功能

Abstract:

Objective To explore the effect of therapeutic postural placement on postural control and balance in stroke patients with hemiplegia.

Methods From January, 2020 to June, 2022, 60 stroke patients in Cangzhou Hospital of Integrated TCM-WM•Hebei were randomly divided into control group (n = 30) and observation group (n = 30). Both groups accepted routine rehabilitation, while the observation group accepted therapeutic postural placement based on the concept of Bobath additionally. Fugl-Meyer Assessment-Lower Extremity (FMA-LE), Berg Balance Scale (BBS), Postural Assessment Scale for Stroke Patient (PASS) and Pro-kin balance instrument were used to evaluate the postural control and balance function before and four weeks after treatment, while the area of ellipse and length of motion with eyes open and closed were recorded, respectively.

Results After treatment, the scores of FMA-LE, PASS and BBS significantly increased (|t| > 3.856, P < 0.001), and the area of ellipse and length of motion with eyes open and closed decreased in both groups (|t| > 4.083, P< 0.001); all the indexes were better in the observation group than in the control group (|t| > 2.261, P< 0.05).

Conclusion The therapeutic postural placement could effectively improve the postural control ability and balance function in stroke patients.

Key words: stroke, therapeutic postural placement, posture control, balance function

中图分类号:

R743.3

王晓君, 王利春, 史美超, 刘俊, 应宵策, 白德浩. 治疗性体位摆放对脑卒中偏瘫患者姿势控制和平衡能力的影响[J]. 《中国康复理论与实践》, 2023, 29(11): 1353-1358.

WANG Xiaojun, WANG Lichun, SHI Meichao, LIU Jun, YING Xiaoce, BAI Dehao. Effect of therapeutic postural placement on postural control and balance in stroke patients with hemiplegia[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(11): 1353-1358.

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组别	n	性别/n		年龄/岁	病程/周	卒中类型/n		病变侧/n
组别	n	男	女	年龄/岁	病程/周	脑梗死	脑出血	左侧	右侧
对照组	30	25	5	50.73±11.44	10.20±1.61	14	16	15	15
观察组	30	24	6	52.13±12.58	9.87±2.08	20	10	15	15
χ²/t值		0.111		-0.451	-0.887	2.443		1.071
P值		0.738		0.654	0.375	0.118		0.301

组别	n	治疗前	治疗后	t值	P值
对照组	30	12.83±6.26	22.50±6.30	-4.801	< 0.001
观察组	30	13.33±6.34	25.80±5.70	-26.168	< 0.001
t值		-0.371	-2.127
P值		0.711	0.033

组别	n	治疗前	治疗后	t值	P值
对照组	30	29.37±3.92	31.03±3.60	-3.856	< 0.001
观察组	30	29.23±4.10	33.57±4.07	-4.807	< 0.001
t值		-0.231	-2.976
P值		0.817	0.003

组别	n	治疗前	治疗后	t值	P值
对照组	30	35.13±9.47	42.43±8.67	-7.892	< 0.001
观察组	30	36.50±8.14	46.27±5.56	-4.790	< 0.001
t值		-0.600	-2.039
P值		0.551	0.046

组别	n	治疗前	治疗后	t值	P值
对照组	30	4060.20±461.46	3924.20±472.54	12.870	< 0.001
观察组	30	4046.27±388.33	3669.83±393.06	-4.782	< 0.001
t值		0.127	2.267
P值		0.900	0.027