有氧运动联合常规康复治疗对卒中偏瘫患者心肺运动功能及康复效果的影响  

Effect of aerobic exercise combined with routine rehabilitation therapy on cardiopulmonary exercise function and rehabilitation efficacy in stroke patients with hemiplegia

作　　者：徐泉[1] 潘钰[1] 杨晓辉[1] 马迪[1] 萧演清[1] 吴琼[1] 阎澍妤 杨緋 李颜杝 孙小花 Xu Quan Pan Yu Yang Xiaohui Ma Di Xiao Yanqing Wu Qiong Yan Shuyu Yang Fei Li Yanyi Sun Xiaohua(Department of Rehabilitation, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China)

机构地区：[1]清华大学附属北京清华长庚医院康复医学科清华大学临床医学院,102218

出　　处：《中国脑血管病杂志》2017年第9期465-469,共5页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的探讨有氧运动联合常规康复治疗对卒中偏瘫患者心肺运动功能及康复效果的影响。方法前瞻性连续纳入30例首次发病的卒中偏瘫患者,按随机数字表法随机分为试验组和对照组,每组15例。4例患者退出,最终26例患者完成研究,每组13例,两组患者均给予常规康复治疗,试验组在常规康复治疗基础上增加有氧运动训练,每天1次,每次30 min,共训练4周。分别于治疗前和治疗4周后对两组患者进行心肺运动试验[峰值摄氧量(VO2peak)、无氧阈(AT)、峰值分钟通气量(VEpeak)]以及运动功能[Fugl-Meyer评定量表(FMA)]、日常生活活动能力[Barthel指数(BI)]的评估,比较两组患者治疗前后的差异。结果 (1)心肺运动试验结果:与治疗前比较,试验组患者治疗后VO2peak、AT、VEpeak均明显提高[分别为(16±4)ml/(kg·min)比(13±3)ml/(kg·min)、(12.9±2.5)ml/(kg·min)比(10.0±2.7)ml/(kg·min)、(41±12)L/min比(34±9)L/min;t值分别为9.668、4.328、3.662,均P<0.01],对照组患者治疗后与治疗前VO2peak、AT、VEpeak比较[分别为(14±4)ml/(kg·min)比(14±4)ml/(kg·min)、(11.8±2.6)ml/(kg·min)比(11.5±2.9)ml/(kg·min)、(29±8)L/min比(28±6)L/min],差异无统计学意义(t值分别为0.863、0.583、0.314,均P>0.05);对照组患者治疗前后VO2peak、AT、VEpeak差值分别为0.4(0.2,0.6)、0.1(-0.5,0.7)ml/(kg·min)和0(-2.5,5.0)L/min,试验组患者治疗前后VO2peak、AT、VEpeak差值分别为3.0(2.2,3.9)ml/(kg·min)、2.7(1.8,5.3)ml/(kg·min)、7.0(1.0,13.0)L/min,两组间治疗前后VO2peak、AT、VEpeak差值差异有统计学意义(Z值分别为4.287、3.721、2.236,均P<0.05)。(2)FMA评分与BI评估结果:与治疗前比较,试验组患者治疗后FMA评分、BI均明显提高[分别为(70±24)分比(52±28)分、(78±20)比(60±28);t值分别为4.076,4.239,均P<0.01],对照组治疗后FMA评分、BI较治疗前有明显改善[分别为(68±25)分比(60±27)分、(69±22)比(59±26);t值分别为3.168,5.436,均P<0.05]。对照组Objective To investigate the effect of aerobic exercise com bined with routine rehabilitation therapy on cardiorespiratory exercise function and rehabilitation efficacy in stroke patients with hemiplegia. Methods Thirty consecutive stroke patients with the first-ever hemiplegia were enrolled prospectively. They were randomly assigned to an experimental group（ n = 13） or a control group（ n = 13） according to the random number table（ n = 15 in each group）. Four patients withdrew,and finally2 6 patients com pleted the study（ n = 1 3 in each group）. The two groups of patients were given routine rehabilitation therapy. On the basis of routine rehabilitation therapy,the experim ental group was also treated with aerobic exercise training,once a day,3 0 min each time for 4 weeks. The evaluations of cardiopulmonary exercise tests were performed on both groups before treatment and after 4weeks of treatment（ peak oxygen uptake [VO2peak]）,anaerobic threshold [AT],peak minute ventilation[VEpeak]）,and motor function（ Fugl-Meyer assessment scale [FMA],activities of daily living（ Barthel index [BI ]） were performed. The differences between the two groups before and after treatment were compared. Results（ 1） Cardiopulmonary exercise test results： Compared with before treatment,VO2 peak,AT,and VEpeak were increased significantly（ 16 ± 4 ml/[kg·min] vs. 13 ± 3 ml/[kg·min],12. 9 ± 2. 5 kg·min vs. 10. 0 ± 2. 7 ml/[kg·min],41 ± 12 L/min vs. 34 ± 9 L/min,t = 9. 668,4. 328,and3. 662,respectively,all P〈0. 01）. There were no significant differences in VO2 peak,AT,and VEpeak（ 14 ±4 ml/[kg·min] vs. 14 ± 4 ml/[kg·min],11. 8 ± 2. 6 ml/[kg·min] vs. 11. 5 ± 2. 9 ml/[kg·min],29 ±8 L/min vs. 28 ± 6 L/min） in patients of the control group between before treatment and after treatment.There were no significant differences（ t = 0. 863,0. 583,and 0. 314,respectively,all P〈0. 05）. The differences in VO2 peak,AT,and VEpeak in the patients of the control group before and after treatmen

关 键 词：偏瘫 康复 有氧运动 

分 类 号：R493[医药卫生—康复医学] R743.3[医药卫生—临床医学]