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不同频率悬吊强化训练对脑卒中患者的疗效研究

Study on the effect of different frequencysling exercise therapyon stroke patients

摘要目的:探讨不同频率悬吊强化训练对脑卒中患者躯干控制平衡和后期步行生活能力研究。方法:将符合纳排标准90例于2018年1月至2018年12月在华中科技大学同济医学院附属协和医院康复医学科住院治疗的脑卒中患者在常规训练基础上接受悬吊训练,行前瞻性研究,并按照随机数字法均分为1次/d低频组,2次/d中频组,3次/d高频组;20 min/次,共训练3个月。1、2、3个月后分别对3组患者采用躯干控制测试(trunk control test,TCT)、 Berg平衡量表(berg balance scale,BBS)、Holden功能性步行分级(functional ambulation classification, FAC)、改良Barthel指数(modified Barthel index,MBI)评定。结果:低、中、高频组患者治疗后较治疗前TCT 、BBS、FAC与MBI差异均有统计学意义( P均<0.05)。治疗1个月与2个月低、中、高频组TCT分别为(36.21±6.31)、(42.51±4.33)、(49.52±4.90)分与(41.23±6.31)、(50.32±8.32)、(58.12±7.23)分,BBS分别为(15.11±4.31)、(19.69±5.86)、(24.56±8.74)分与(21.43±5.37)、(27.61±7.50)、(33.81±6.99)分,较治疗前[(23.46±12.80)、(24.69±9.33)、(22.84±10.11)分与(9.32±3.11)、(9.504.10)、(9.47±3.73)]均明显改善,且高频组较中频组与低频组、中频组较低频组差异均有统计学意义( P均<0.05),但训练3个月3组间差异无统计学意义( P>0.05)。低、中、高频组患者在训练1个月时FAC与MBI差异均无统计学意义,但训练2个月与3个月FAC[(1.84±0.41)、(2.39±0.44)、(3.29±0.33)分与(2.74±0.77)、(3.63±0.56)、(4.50±0.43)分]与MBI[(27.32±9.33)、(34.45±9.21)、(44.77±10.27)分与(41.33±11.21)、(52.73±12.31)、(75.94±13.22)分]差异有统计学意义,且高频组较中频组与低频组、中频组较低频组差异均有统计学意义( P均<0.05)。 结论:1 d多次悬吊训练可以进一步提高脑卒中患者人躯干控制平衡和步行生活能力,缩短病程。

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abstractsObjective:To investigate the effects of different frequency sling exercise therapy (SET) on the balance of trunk control and walking ability in stroke patients.Methods:A total of 90 patients with stroke who were admitted to the Department of Rehabilitation Medicine, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, from January 2018 to December 2018, received sling exercise therapy on a routine basis and were divided into 1 time/Day low frequency group, 2 time/Day medium frequency group, 3 time/Day high frequency group, 20 min/time, for a total of 3 months.After 1, 2 and 3 months, trunk control test (TCT), Berg balance scale(BBS), functional ambulation classification (FAC) and modified Barthel Index (MBI) were used to evaluate the three groups of patients.Results:There were significant differences in TCT, BBS, FAC and MBI between the low, middle and high frequency groups (all P < 0.05). The scores of TCT in the low, middle and high frequency groups were (36.21±6.31), (42.51±4.33), (49.52±4.90) and (41.23±6.31), (50.32±8.32), (58.12±7.23) respectively, and the scores of BBS were (15.11±4.31), (19.69±5.86), (24.56±8.74) and (21.43±5.37), (27.61 ± 7.50), (33.81±6.99) respectively, compared with those before treatment )The scores of (24.69±9.33), (22.84 ± 10.11) and (9.32 ± 3.11), (9.504.10), (9.47 ± 3.73) were significantly improved, and the differences between the high frequency group and the low frequency group and the medium frequency group were statistically significant (all P< 0.05), but there was no statistically significant difference between the three groups after three months of training ( P> 0.05). There was no significant difference between fAC and MBI in the low, medium and high frequency group, but there was no significant difference between the two groups after training for 2 and 3 months There were significant differences between fAC ((1.84±0.41), (2.39±0.44), (3.29 ± 0.33) and MBI ((27.32 ± 9.33), (34.45 ± 9.21), (44.77 ± 10.27) and (41.33±11.21), (52.73±12.31), (75.94±13.22)). There was significant difference between the high frequency group and the low frequency group ( P< 0.05). Conclusion:Multiple sling exercise therapy in one day can further improve the balance of trunk control and walking ability of stroke patients, and shorten the course of disease.

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