足底脱敏运动疗法对脑卒中恢复期患者站立平衡和步行能力的影响  

The effects of sole desensitization physical therapy on the standing balance and patients

作　　者：邓永萍 王文威[2] 肖桂扬 梁淑芬 

机构地区：[1]广州市老人院康复医学科,广州510550 [2]广州医学院第二附属医院康复医学科

出　　处：《中华物理医学与康复杂志》2011年第8期602-605,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的探讨足底脱敏运动疗法对脑卒中恢复期患者站立平衡和步行能力的影响。方法将符合入选标准的脑卒中偏瘫患者随机分为观察组（40例）和对照组（40例），对照组采用常规康复方法进行治疗，观察组在对照组治疗方法的基础上采用足底脱敏的运动训练。2组患者均于治疗前和治疗1个月后采用Berg平衡评分量表（BBS）和Holden步行功能分级（FAC）进行平衡功能和步行能力的评定，同时采用Fugl-Meyer运动功能评分表评定患侧踝关节的运动功能，采用足印分析法测量并记录步行时的时间距离参数的变化，分析步态的改善情况。结果治疗1个月后，2组患者各项指标较组内治疗前均有明显改善，差异有统计学意义（P〈0．05）。观察组治疗1个月后各项指标[BBS评分为（37．41±8．14）分，FAC分级为（3．91±0．92）级，FMA评分为（6．42±1．12）分，步长为（42．99±7．21）cm，步宽为（10．26±1．05）em，步速为（0．44±0．05）m／s]与对照组治疗1个月后[BBS评分为（31．31±8．85）分，FAC分级为（2．96±1．16）级，FMA评分为（4．23±1．01）分，步长为（39．76±6．45）cm，步宽为（9．88±1．75）em，步速为（0．41±0．06）m／s）]比较，差异均有统计学意义（P〈0．05）。结论足底脱敏运动疗法可通过动态接触影响脑卒中患者的本体感觉控制能力达到脱敏的目的，使其足部适应周围的环境，重新获得生理性支撑面，促进踝关节运动功能，从而提高患者的站立平衡功能和步行能力。Objective To explore the effects of sole desensitization physical therapy on standing balance and walking function among recovering stroke patients. Methods Stroke patients who met the inclusion criteria were randomly assigned to the observation group （40 cases） or the control group （40 eases）. All patients received traditional rehabilitation. In addition, the observation group received sole densensitization physical therapy. The total course of treatment lasted for 1 month. The Berg balance scale （BBS） and Holden＇s functional ambulation classifica- tion （FAC） were used to evaluate balance and walking ability before and after treatment. The Fugl-Meyer assessment （FMA） was used to assess the motor function of the affected ankle, and footprint analysis was used to measure and record any changes in time and distance walked and to analyze improvements in gait. Results After the sole desensitization training, the BBS （37.41± 8.14） , FAC （3.91 ± 0.92） and FMA motor function （6.42 ± 1.12） results of the observation group were all significantly better than before training. Walking time and distance also improved. Conclusions Sole desensitization can affect foot proprioception. As a result, stroke patients＇ soles adapt to the surroundings, recover their ability to provide physiological support and promote improved motor function of the ankle. Sole desensitization can thus improve the standing balance and walking of stroke patients.

关 键 词：脱敏 站立平衡 步行能力 运动疗法 脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]