无步行能力脑卒中偏瘫患者踏车有氧训练有效性的初步研究  

A pilot study of the effect of aerobic training with bicycle ergometer on hemiplegic stroke patients without ambulation ability

作　　者：王尊[1] 范宏娟[2] 陆晓[2] 王翔[1] 朱晓军[2] 顾一煌[1] 王磊[1] 王彤[2] 

机构地区：[1]南京中医药大学第二临床学院康复治疗教研室,南京210046 [2]江苏省人民医院康复医学科

出　　处：《中华物理医学与康复杂志》2011年第12期924-927,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：江苏省333高层次人才培养工程基金（2009-1-09）

摘　　要：目的研究无辅助步行和独立步行能力的脑卒中偏瘫患者进行低强度踏车有氧训练的有效性。方法将无辅助步行和独立步行能力的脑卒中偏瘫患者30例分为对照组和有氧训练组。2组患者均接受常规康复治疗，有氧训练组患者在常规康复治疗的基础上进行每周3次、每次30min、共6周的低强度踏车有氧训练。2组患者总康复治疗时程和时间均相等。治疗前、后2组患者均采用Fugle-Meyer运动功能评分法（FMA）和Rivermead运动指数评定肢体功能，运用Barthel指数（BI）评定日常生活活动（ADL）能力，并进行运动试验终止心率、耐受时间及实验室检查[空腹血糖、血胰岛素、血脂、血胆固醇、高敏C反应蛋白、口服葡萄糖耐量试验（OGTT）2h血糖和胰岛素等，并计算稳态模型胰岛素抵抗指数（HOMA—IR）]。结果24例患者完成观察程序（每组12例）。2组患者治疗前、后肢体运动功能、运动试验耐受时间、空腹胰岛素、OGTT2h血糖、HOMA-IR等指标明显改善（P〈0．05），治疗后2组间FMA、Rivermead指数、BI、运动试验耐受时间、空腹胰岛素及OGTT2h血糖等差异均有统计学意义（P〈0．05）。结论低强度踏车有氧训练可以有效应用于无步行能力的脑卒中偏瘫患者。Objective To study the effectiveness and feasibility of low intensity of aerobic bicycle ergometer training on bemiplegic stroke patients unable to perform assistive or independent ambulation. Methods Thirty stroke patients unable of assistive or independent ambulation were randomly divided into a control group and a aerobic training group. Patients in the aerobic training group performed low intensity of aerobic bicycle ergometer training for 30 min, 3 times a week for 6 weeks in addition to a routine rehabilitation regime. The training duration and course of routine rehabilitation training were the same in both groups. The related cardiovascular response in aerobic training and changes in motor performance as well as the risk factors for stroke were observed in both groups. Results Twenty-four patients （ 12 patients in each group） completed the experiment. Patients in aerobic training group performed all training regime safely without any adverse response. Their motor function （including FMA score, Rivermead index, BI ADL ability） , exercise endurance duration in exercise test, glucose level at 2 h in oral glucose tolerance test, fasting insulin level and HOMA-IR index all improved greatly as compared to the control group（ P 〈 0.05 ）. Conclusion Low intensity of aerobic bicycle ergometer training can be safely and effectively administered in hemiplegie stroke patients unable of assistive ambulation or independent ambulation.

关 键 词：脑卒中 有氧训练 有效性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]